these findings are surely concerning. However, their clinical significance is not yet clear.
Thus, schizophrenia itself is linked with numerous brain abnormalities, such as progressive loss of brain cells, even in persons never exposed to antipsychotic medication. For example, in one study, antipsychotic-naive patients with schizophrenia showed significant gray matter volume deficits in frontal, cingulate, temporal, and other brain regions. (Venkatasubramanian G. Neuroanatomical correlates of psychopathology in antipsychotic-naïve schizophrenia. Indian J Psychiatry. 2010;52:28-36.)Furthermore, Lesh and colleagues (Lesh TA, Tanase C, Geib BR, et al. A multimodal analysis of antipsychotic effects on brain structure and function in first-episode schizophrenia. JAMA Psychiatry. 2015;72:226-234.) found that while short-term treatment with antipsychotics was associated with prefrontal cortical thinning, treatment was also associated with better scores on a continuous performance task (AX-CPT). The authors concluded that the results warranted caution “. . . in interpreting neuroanatomical changes as being related to a potentially adverse effect on brain function.”
In my view, we need more research to sort out this complex issue, while always weighing carefully the neurological risks of antipsychotic treatment (including movement disorders) against their very real benefits.
Ronald W. Pies, MD
http://www.psychiatrictimes.com/blogs/long-term-antipsychotic-treatment-effective-and-often-necessary-caveats/page/0/3