Is there a link between longterm antipsychotic therapy and cognitive impairment?

[Greg Robbins]

Hello,

I have taken antipsychotics for a number of years and noticed that my memory and attention span aren't what they used to be, so I did research which confirmed my belief that antipsychotics do indeed cause cognitive impairment. This occurs by the reduction of brain volume starting in the parietal cortex and spreading to the frontal lobe.

Of course this is only my belief and I would never stop taking my medication without the consent and supervision of the prescribing MD.

 

[David Baxter PhD]

Hello,

I have taken antipsychotics for a number of years and noticed that my memory and attention span aren't what they used to be, so I did research which confirmed my belief that antipsychotics do indeed cause cognitive impairment. This occurs by the reduction of brain volume starting in the parietal cortex and spreading to the frontal lobe.

Of course this is only my belief and I would never stop taking my medication without the consent and supervision of the prescribing MD.

And how exactly do you know that this is caused by the medication? Are you aware of the research that indicates that this sort of thing happens even in untreated psychotic disorders?

 

[Greg Robbins]

I did research which confirmed my belief that antipsychotics do indeed cause cognitive impairment. This occurs by the reduction of brain volume starting in the parietal cortex and spreading to the frontal lobe.

And how exactly do you know that this is caused by the medication?

I have yet to gather enough evidence to prove it but it makes sense to me because of two things: 1) personal experience with antipsychotic medications. I remember feeling very dull the next day after taking my first antipsychotic dose the night before and over time I became used to that dull feeling. 2) It's what my gut tells me based on what little knowledge I have gathered on schizophrenia and the meds used to treat it. For one, experts say that schizophrenia doesn't lower IQ but mine has been lowered and so if it's not because of the illness then it must be because of the medication. Two, the medication makes the brain less active and inactivity results in the pruning of connections between neurons.

Are you aware of the research that indicates that this sort of thing happens even in untreated psychotic disorders?

I've been trying to find that information without much luck. What is it about psychosis that causes brain volume loss?

 

[David Baxter PhD]

I have yet to gather enough evidence to prove it but it makes sense to me because of two things: 1) personal experience with antipsychotic medications. I remember feeling very dull the next day after taking my first antipsychotic dose the night before and over time I became used to that dull feeling. 2) It's what my gut tells me based on what little knowledge I have gathered on schizophrenia and the meds used to treat it. For one, experts say that schizophrenia doesn't lower IQ but mine has been lowered and so if it's not because of the illness then it must be because of the medication. Two, the medication makes the brain less active and inactivity results in the pruning of connections between neurons.

"Dull" is a subjective and relative term. It's what you feel but it's not necessarily objectively accurate. For example, many people with bipolar disorder who experience hypomania or mania miss all that energy and creativity when it's gone or toned down. But the mania itself is both irrational/delusional/unrealistic and destructive. Similarly, with some forms of schizophrenia the individual may feel that s/he is highly creative and seeing things very clearly and luicidly, but with any objective measure it's easy to identigy the thought disorder and/or delusional perceptions underlying those beliefs. The medications, among other things, dampen that false sense of clarity and creativity and energy. That doesn't mean they are making you "duller" or lowering your IQ...

I've been trying to find that information without much luck. What is it about psychosis that causes brain volume loss?

It's not entirely clear to me that it is cause-effect. It may well be that something in the process is either a cause rather than an effect of schizophrenia, or it may be that they are concomitant or parallel symptoms arising from the same disease process.

One has to be very careful in drawing conclusions from correlational data. Correlation does not necessarily imply cause and effect.

 

[Greg Robbins]

I really believe that the medications are causing the brain volume reduction, and I think people who prescribe these things know about it.

There was a study done among identical twins, one with schizophrenia and the other without. The one who had schizophrenia, had a smaller brain. Have you seen this study? If he wasn't taking antipsychotics, then the illness caused the volume reduction, but if he was, then... it was the antipsychotics!

Antipsychotics have helped me a lot which is why I'm still on them. But after being on them for years, I decided to go off and experienced the worst, most debilitating psychosis of my life. I've been trying to get off them and became suicidal. No one told me this would happen... so maybe I would have been better off without them. Or maybe not. In any case, I want to figure it out.

 

[David Baxter PhD]

I really believe that the medications are causing the brain volume reduction, and I think people who prescribe these things know about it.

I'm sorry but really there is zero evidence to support your conclusion.

There was a study done among identical twins, one with schizophrenia and the other without. The one who had schizophrenia, had a smaller brain. Have you seen this study? If he wasn't taking antipsychotics, then the illness caused the volume reduction, but if he was, then... it was the antipsychotics!

See my previous comments. What was the difference between the twin who had schizophrenia and the twin who did not? Schizophrenia.

Antipsychotics have helped me a lot which is why I'm still on them. But after being on them for years, I decided to go off and experienced the worst, most debilitating psychosis of my life. I've been trying to get off them and became suicidal. No one told me this would happen...

You're saying that no one ever told you your condition would get worse if you stopped your medications? I find that hard to believe.

so maybe I would have been better off without them.

No. You would have been much much sicker.

 

[forgetmenot]

You found out by going off them how sick you became I have several family members on these drugs and they are so much better on them I don't understand either hun your doctor would have instructed you how to take medication and not to go off them You need these medications for life. On the medication my daughter is now functioning where like you when she goes off them there is not clear thought pattern for her.
You need your medication just like a diabetic needs insulin you need your meds to keep you stable

 

[Greg Robbins]

You're saying that no one ever told you your condition would get worse if you stopped your medications? I find that hard to believe.

I mean they never told me that antipsychotic medication can make my condition worse. You see, before starting an antipsychotic I was unwell but it paled in comparison to what I experienced after quitting my med for a few weeks.

People have told me that antipsychotics aren't addictive but I found out that too isn't true. I did research and found out that antipsychotics block dopamine receptors. The neuron compensated by growing new ones, and when the antipsychotic is discontinued, there are more receptors which means that symptoms become far worse than they were before medication.

You need your medication just like a diabetic needs insulin you need your meds to keep you stable

I understand that but I think I need to be on the lowest possible dose. At this rate I'm afraid that I'll become a vegetable.

---------- Post Merged at 12:37 PM ---------- Previous Post was at 12:24 PM ----------

I really believe that the medications are causing the brain volume reduction, and I think people who prescribe these things know about it.

I'm sorry but really there is zero evidence to support your conclusion.

Is there any evidence that people with lifelong untreated schizophrenia have smaller brains? If so, I would like to see that evidence.

It's interesting that one identical twin would have schizophrenia while the other wouldn't.

 

[David Baxter PhD]

It's interesting that one identical twin would have schizophrenia while the other wouldn't.

Yes but it's not that uncommon and it's something that's been known for several years.

The incidence of schizophrenia in the general population is roughly 1%.

For those with a near relative who has schizophrenia, the incidence rises to about 8-10%.

For those with an identical twin who has schizophrenia, the incidence is still in the range of only 50%.

 

[Greg Robbins]

I forgot to include this: I developed cognitive impairment after taking antipsychotics for a long time. That's why I think the meds caused it. Addictionally, I had reading trouble on Risperdal.

 

[forgetmenot]

YOu will not become a vegetable hun you won't I have an identical twin ok she ihas been on medication for some time now Her mind is a clear as my mind while ON the medication.

She has been on medication for over 25 yrs and each time she is off them she might as well be a vegetable.


I think your doctor would set the appropriate amt of medication for you so your psychosis will not control you life.
I understand the fear of medication oh i do but i see the positive affects it has on most of my family

One is not so lucky his meds are not working for him.

Talk to your doctor ok about your concerns they should be heard hun and get your doctor to explain to you that all medication not just psychiatric meds have side effect to them

You have to weigh the positives ok they out-due the negatives.

Do you want a stable future one you can chose to live the way you want to or do you want the psychosis to dictate what happens to you.

I am not trying to tell you what to do hun i think you really need to talk to your psychiatrist

It is good you are taking interest in your medication but as far as i can see hun with out medication the proper dosage my siblings my daughter would not be here functioning.

 

[Greg Robbins]

For those with an identical twin who has schizophrenia, the incidence is still in the range of only 50%.

What does the 50% mean exactly?

 

[forgetmenot]

Means i still have a 50 percent chance of developing the illness but to me i think my twin received the genetic gene not me so i won't get it yet so many of family members have it.

 

[David Baxter PhD]

Association between duration of untreated psyc... [Schizophr Res. 2010] - PubMed - NCBI

Schizophrenia.com - Schizophrenia is a Brain Disease

Additional research done during the past decade has revealed that schizophrenia is caused by a combination of genetic or biological predisposition as well as other factors such as prepregnancy factors, pregnancy stress, other prenatal factors, social stress, family stress or environmental stressors during a person's life. Research has now shown that children's and teen's brains are very sensitive to stress (up to 5 to 10 times more sensitive than adult brains) and can be damaged by frequent or ongoing stress.

To learn more about the causes of schizophrenia, and how to prevent it - read these two documents: Causes of Schizophrenia, Prevention of Schizophrenia.

A brief summary of some of the evidence that proves this point follows.

Significant Loss of Brain Gray Matter: Individuals with schizophrenia, including those who have never been treated, have a reduced volume of gray matter in the brain, especially in the temporal and frontal lobes. Recently neuroscientists have detected gray matter loss of up to 25% (in some areas). The damage started in the parietal, or outer, regions of the brain but spread to the rest of the brain over a five year period. Patients with the worst brain tissue loss also had the worst symptoms, which included hallucinations, delusions, bizarre and psychotic thoughts, hearing voices, and depression.

Please note that while there is significant loss of brain gray matter, this is not a reason to lose all hope. In recent (September, 2004) group of presentations and discussion we had with Dr. Daniel Weinberger and other leading National Institute of Mental Health (NIMH) schizophrenia researchers, we learned that there are reasons to believe that this gray matter loss may be reversible. Moreover, the NIMH is currently researching a drug that seems to have potential for reversing the cognitive decline that is caused by schizophrenia, and there are many drug companies also now researching in this area. It is anticipated that we will see some significant announcements related to these develpments in the next few years.

Elsevier

Abstract

Background

Duration of untreated psychosis (DUP) has been linked with poor prognosis and changes in the brain structure in schizophrenia at least at the beginning of the disease, but it is still unknown whether DUP relates to brain morphometry in the longer term. Our aim was to analyze the relation between DUP and the brain structure in schizophrenia in the general population, after several years of illness.

Methods

Brains of subjects with psychosis from the Northern Finland 1966 Birth Cohort (NFBC 1966) were scanned with MRI during 1999?2001 after an 11-year follow-up. DUP was assessed from medical records and regressed against global and local tissue density measurements. The brain morphometric and the DUP information were available for 46 subjects with DSM-III-R schizophrenia.
Results

The DUP did not correlate with volumes of the total gray or white matter or the cerebrospinal fluid. The length of DUP associated positively with reduced densities of the right limbic area and the right hippocampus.
Conclusions

Long DUP was slightly associated with reductions of gray matter densities in the limbic area and especially the hippocampus after several years follow-up, supporting the hypothesis that, compared to short DUP, long DUP might be a marker of different disease trajectories including subtle morphometric changes.

Progressive Brain Changes in Schizophrenia

Brain changes in schizophrenia. Volumetric MRI study of families multiply affected with schizophrenia--the Maudsley Family Study 5.

Schizophrenia diagnosis associated with progressive brain changes among adolescents

http://www.medscape.com/viewarticle/757151

Mechanisms of schizophrenia - Wikipedia, the free encyclopedia

 

[David Baxter PhD]

The incidence of schizophrenia in the general population is roughly 1%.

For those with a near relative who has schizophrenia, the incidence rises to about 8-10%.

For those with an identical twin who has schizophrenia, the incidence is still in the range of only 50%.

What does the 50% mean exactly?

Means i still have a 50 percent chance of developing the illness but to me i think my twin received the genetic gene not me so i won't get it yet so many of family members have it.

As forgetmenot said, it means even if you have an identical twin with the illness, you still have a pretty good chance of not developing schizophrenia yourself.

However, individuals with a close relative with schizophrenia, even if they themselves do not develop schizophrenia, do have a higher incidence of other mental health issues, including mood disorders, anxiety disorders, and OCD.

Most people who do develop schizophrenia will show clear symptoms in childhood or adolescence and will experience a "first episode" before age 30. So again, that means if you are someone who has not developed schizophrenia by age 30, you have a very good chance of never developing the illness, though you may still be at risk for other mental health issues.