Anti-psychotic medication linked to adverse change in brain structure

February 26, 2020

February 26, 2020 (Toronto) - In a first-of-its-kind study using advanced brain imaging techniques, a commonly used anti-psychotic medication was associated with potentially adverse changes in brain structure. This study was the first in humans to evaluate the effects of this type of medication on the brain using a gold-standard design: a double-blind, randomized, placebo-controlled trial.

The study, conducted across several North American centers, and just published in the journal JAMA Psychiatry, could have an immediate impact on clinical practice according to lead author Dr. Aristotle Voineskos, Chief of the Schizophrenia Division, and Head of the Kimel Family Translational Imaging-Genetics Laboratory at the Centre for Addiction and Mental Health (CAMH) in Toronto, Canada.

Until the 1990s, antipsychotic medications were primarily administered to people with schizophrenia. But since then their use has expanded to major depression and a range of pediatric, adult and geriatric disorders, including anxiety, insomnia and autism, for which one in five patients are prescribed anti-psychotics.

"With the increased off-label prescribing of antipsychotic medications, especially in children and the elderly, our findings support a reexamination of the risks and benefits," said Dr. Voineskos.

Because it is believed that antipsychotics protect against the harmful effects of untreated psychosis in the brain, they remain the foundation of treatment for schizophrenia. But the authors state that the adverse changes in brain structure found in this study are an important consideration for prescribing for psychiatric conditions where alternatives are possible.

The study examined patients with major depression who also experience psychosis who were prescribed antipsychotic medications olanzapine and sertraline for 12 to 20 weeks. For those who went into remission, participants were divided into a randomized double-blind phase -- where one group continued with both medications and one was given a placebo instead of olanzapine. Magnetic Resonance Imaging (MRI) scans were taken before and after the placebo was introduced.

The study found evidence that sustained use of olanzapine verses a placebo was associated with potentially adverse changes in brain structure, namely a thinning of the cortex. These changes were even more prominent in the elderly study participants. But participants who experienced a relapse of psychotic symptoms also had potentially adverse changes in brain structure, emphasizing the essential role antipsychotics play in treating disorders where psychosis is present.

"When psychosis is present, the life-threating effects of untreated illness outweigh any adverse effects on brain structure," said Dr. Voineskos. "But given that half the patients in the trial sustained remission after switching from olanzapine to placebo, future studies could provide a predictive model for which patients need long-term anti-psychotic treatment and which patients can safely discontinue them."
-end-
To read the full study click here.

The Centre for Addiction and Mental Health (CAMH) is Canada's largest mental health and addiction teaching hospital, as well as one of the world's leading research centres in its field. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit http://www.camh.ca.

For further information:

Sean O'Malley
Media Relations
416-595-6015
media@camh.ca

Centre for Addiction and Mental Health

Related Science Articles from Brightsurf:

75 science societies urge the education department to base Title IX sexual harassment regulations on evidence and science
The American Educational Research Association (AERA) and the American Association for the Advancement of Science (AAAS) today led 75 scientific societies in submitting comments on the US Department of Education's proposed changes to Title IX regulations.

Science/Science Careers' survey ranks top biotech, biopharma, and pharma employers
The Science and Science Careers' 2018 annual Top Employers Survey polled employees in the biotechnology, biopharmaceutical, pharmaceutical, and related industries to determine the 20 best employers in these industries as well as their driving characteristics.

Science in the palm of your hand: How citizen science transforms passive learners
Citizen science projects can engage even children who previously were not interested in science.

Applied science may yield more translational research publications than basic science
While translational research can happen at any stage of the research process, a recent investigation of behavioral and social science research awards granted by the NIH between 2008 and 2014 revealed that applied science yielded a higher volume of translational research publications than basic science, according to a study published May 9, 2018 in the open-access journal PLOS ONE by Xueying Han from the Science and Technology Policy Institute, USA, and colleagues.

Prominent academics, including Salk's Thomas Albright, call for more science in forensic science
Six scientists who recently served on the National Commission on Forensic Science are calling on the scientific community at large to advocate for increased research and financial support of forensic science as well as the introduction of empirical testing requirements to ensure the validity of outcomes.

World Science Forum 2017 Jordan issues Science for Peace Declaration
On behalf of the coordinating organizations responsible for delivering the World Science Forum Jordan, the concluding Science for Peace Declaration issued at the Dead Sea represents a global call for action to science and society to build a future that promises greater equality, security and opportunity for all, and in which science plays an increasingly prominent role as an enabler of fair and sustainable development.

PETA science group promotes animal-free science at society of toxicology conference
The PETA International Science Consortium Ltd. is presenting two posters on animal-free methods for testing inhalation toxicity at the 56th annual Society of Toxicology (SOT) meeting March 12 to 16, 2017, in Baltimore, Maryland.

Citizen Science in the Digital Age: Rhetoric, Science and Public Engagement
James Wynn's timely investigation highlights scientific studies grounded in publicly gathered data and probes the rhetoric these studies employ.

Science/Science Careers' survey ranks top biotech, pharma, and biopharma employers
The Science and Science Careers' 2016 annual Top Employers Survey polled employees in the biotechnology, biopharmaceutical, pharmaceutical, and related industries to determine the 20 best employers in these industries as well as their driving characteristics.

Three natural science professors win TJ Park Science Fellowship
Professor Jung-Min Kee (Department of Chemistry, UNIST), Professor Kyudong Choi (Department of Mathematical Sciences, UNIST), and Professor Kwanpyo Kim (Department of Physics, UNIST) are the recipients of the Cheong-Am (TJ Park) Science Fellowship of the year 2016.

Read More: Science News and Science Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.