Antipsychotics and Brain Shrinkage:
An Update

Joanna Moncrieff, MD

June 19, 2013

Evidence that antipsychotics cause brain shrinkage has been accumulating over the last few years, but the psychiatric research establishment is finding its own results difficult to swallow. A new paper by a group of American researchers once again tries to ‘blame the disease,’ a time-honoured tactic for diverting attention from the nasty and dangerous effects of some psychiatric treatments.

In 2011, these researchers, led by the former editor of the American Journal of Psychiatry, Nancy Andreasen, reported follow-up data for their study of 211 patients diagnosed for the first time with an episode of ‘schizophrenia’. They found a strong correlation between the level of antipsychotic treatment someone had taken over the course of the follow-up period, and the amount of shrinkage of brain matter as measured by repeated MRI scans. The group concluded that “antipsychotics have a subtle but measurable influence on brain tissue loss” (1).

This study confirmed other evidence that antipsychotics shrink the brain. When MRI scans became available in the 1990s, they were able to detect subtle levels of brain volume reduction in people diagnosed with schizophrenia or psychosis. This lead to the idea that psychosis is a toxic brain state, and was used to justify the claim that early treatment with antipsychotics was necessary to prevent brain damage. People even started to refer to these drugs as having “neuroprotective” properties, and schizophrenia was increasingly described in neo-Kraeplinian terms as a neurodegenerative condition(2).

The trouble with this interpretation was that all the people in these studies were taking antipsychotic drugs. Peter Breggin suggested that the smaller brains and larger brain cavities observed in people diagnosed with schizophrenia in these and older studies using the less sensitive CT scans, were a consequence of antipsychotic drugs(3), but no one took him seriously. It was assumed that these findings revealed the brain abnormalities that were thought to constitute schizophrenia, and for a long time no one paid much attention to the effects of treatment. Where the effects of antipsychotics were explored, however, there were some indications that the drugs might have a negative impact on brain volume(4).

In 2005, another American group, led by Jeffrey Lieberman who headed up the CATIE study, published the largest scanning study up to that point of people with a first episode of psychosis or schizophrenia(5). The study was funded by Eli Lilly, and consisted of a randomised comparison of Lilly’s drug olanzapine (Zyprexa) and the older drug haloperidol. Patients were scanned at the start of the study, 12 weeks and one year later and patients’ scans were compared with those of a control group of ‘healthy’ volunteers. 

At 12 weeks haloperidol-treated subjects showed a statistically significant reduction of the brain’s grey matter (the nerve cell bodies) compared with controls, and at one year both olanzapine- and haloperidol-treated subjects had lost more grey matter than controls. The comparative degree of shrinkage in the olanzapine group was smaller than that in the haloperidol group, and the authors declared the olanzapine-related change not to be statistically significant because, although the result reached the conventional level of statistical significance (p=0.03) they said they had done so many tests that the result might have occurred by chance. In both haloperidol and olanzapine treated patients,however, there was a consistent effect that was diffuse and visible in most parts of the brain hemispheres.

The idea that schizophrenia or psychosis represent degenerative brain diseases was so influential at this point, that the authors first explanation for these results was that olanzapine, but not haloperidol, can halt the underlying process of brain shrinkage caused by the mental condition. They did concede, however, that an alternative explanation might be that haloperidol causes brain shrinkage. They never admitted that olanzapine might do this.

It seems as if Eli Lilly and its collaborators were so confident about their preferred explanation, that they set up a study to investigate the effects of olanzapine and haloperidol in macaque monkeys. This study proved beyond reasonable doubt that both antipsychotics cause brain shrinkage. After 18 months of treatment monkeys treated with olanzapine or haloperidol, at doses equivalent to those used in humans, had approximately 10% lighter brains than those treated with a placebo  preparation.(6)

Still psychiatrists went on behaving as if antipsychotics were essentially benign and arguing that they were necessary to prevent an underlying toxic brain disease (Jarskoget al 07 Annual review). Andreasen’s 2011 paper was widely publicised however, and it started to be increasingly acknowledged that antipsychotics can cause brain shrinkage. Almost as soon as the cat was out of the bag, however, attention was diverted back to the idea that the real problem is the mental condition.

Later in 2011 Andreasen’s group published a paper that reasserted the idea that schizophrenia is responsible for brain shrinkage, in which there is barely a mention of the effects of antipsychotics that were revealed in the group’s earlier paper(7). In this second paper, what the authors did was to assume that any brain shrinkage that could not be accounted for by the method of analysis used to explore the effects of antipsychotic treatment must be attributable to the underlying disease. 

The way they had analysed drug treatment in the first paper only looked for a linear association between antipsychotic exposure and changes in brain volume, however. A linear analysis only detects an association that is smooth and consistent- in other words an association in which brain volume shrinks by a consistent amount with each increment in antipsychotic exposure. The total effect of drug treatment may not follow this pattern however. It seems from other evidence that there is a threshold effect whereby being on any amount of an antipsychotic has the greatest relative effect, with a levelling out of the impact as duration of exposure reaches a certain level.(8) In any case, without a comparison group which has not been medicated, a virtual  impossibility in this day and age, it is simply not possible to conclude that the whole effect is not drug-induced.

The latest paper by this research group replicates the findings on antipsychotic-induced brain shrinkage, but also claims that brain volume reduction is related to relapse of the psychotic disorder(9). Relapse was defined retrospectively by the research team for the purposes of this particular analysis, however, and not at the time the study data were collected. Moreover, the definition used does not refer to any significant change in functioning, but only to a deterioration in the severity of symptoms. But the group’s previous analysis of severity of symptoms, using data collected at the time, found that severity had only a weak association with brain volume changes, and moreover that symptom severity was correlated with antipsychotic exposure.(1)

The most recent analysis ignores the probable association between antipsychotic treatment intensity and relapse, but it seems likely that people undergoing periods of ‘relapse,’ or more accurately deterioration of symptoms, would be treated with higher doses of antipsychotics. If this is so, and the two variables ‘relapse’ and ‘treatment intensity’ are correlated with each other, then the analysis is questionable since the statistical methods used assume that the variables are independent of each other.

So Andreasen’s group have found strong evidence of an antipsychotic-induced effect, which they have replicated in two analyses now. The predictive value of the severity of symptoms, on the other hand (which is essentially what relapse appears to define) is weak in the initial analysis, and in neither analysis was it clearly differentiated from drug-induced effects.

These researchers seem determined to prove that ‘schizophrenia’ causes brain shrinkage, although their data simply cannot establish this, as none of their subjects seem to have gone without drug treatment for any significant length of time. So even though their recent analysis once again confirms the damaging effects of antipsychotics, they conclude that the results demonstrate the need to make sure patients take, and do not stop, their antipsychotic medication. The only concession made to the antipsychotic-induced changes revealed is the suggestion that low doses of antipsychotics should be used where possible.

Yet other prominent psychiatric researchers have now abandoned the idea that schizophrenia is a progressive, neurodegenerative condition, and do not consider that Andreasen’s study provides evidence of this.(10) Bizarrely, Nancy Andreasen is a co-author of a recently published meta-analysis which combines results of 30 studies of brain volume over time, which clearly confirms the association between antipsychotic treatment and brain shrinkage (specifically the grey matter) and finds no relationship with severity of symptoms or duration of the underlying condition.(11)

What should antipsychotic users and their families and carers make of this research? Obviously it sounds frightening and worrying, but the first thing to stress is that the reductions in brain volume that are detected in these MRI studies are small, and it is not certain that changes of this sort have any functional implications. We do not yet know whether these changes are reversible or not. Of course the value of antipsychotics has been much debated on this site and elsewhere, and their utility almost certainly depends on the particular circumstances of each individual user, so it is impossible to issue any blanket advice. If people are worried, they need to discuss the pros and cons of continuing to take antipsychotic treatment with their prescriber, bearing in mind the difficulties that are associated with coming off these drugs.(12) People should not stop drug treatment suddenly, especially if they have been taking it for a long time.

People need to know about this research because it indicates that antipsychotics are not the innocuous substances that they have frequently been portrayed as. We still have no conclusive evidence that the disorders labeled as schizophrenia or psychosis are associated with any underlying abnormalities of the brain, but we do have strong evidence that the drugs we use to treat these conditions cause brain changes. This does not mean that taking antipsychotics is not sometimes useful and worthwhile, despite these effects, but it does mean we have to be very cautious indeed about using them.

 

 

Reference List

 

(1) Ho BC, Andreasen NC, Ziebell S, Pierson R, Magnotta V. Long-term Antipsychotic Treatment and Brain Volumes: A Longitudinal Study of First-Episode Schizophrenia. Arch Gen Psychiatry 2011 Feb;68(2):128-37.

(2) Lieberman JA. Is schizophrenia a neurodegenerative disorder? A clinical and neurobiological perspective. Biol Psychiatry 1999 Sep 15;46(6):729-39.

(3) Breggin PR. Toxic Psychiatry. London: Fontana; 1993.

(4) Moncrieff J, Leo J. A systematic review of the effects of antipsychotic drugs on brain volume. Psychol Med 2010 Jan 20;1-14.

(5) Lieberman JA, Tollefson GD, Charles C, Zipursky R, Sharma T, Kahn RS, et al. Antipsychotic drug effects on brain morphology in first-episode psychosis. Arch Gen Psychiatry 2005 Apr;62(4):361-70.

(6) Dorph-Petersen KA, Pierri JN, Perel JM, Sun Z, Sampson AR, Lewis DA. The influence of chronic exposure to antipsychotic medications on brain size before and after tissue fixation: a comparison of haloperidol and olanzapine in macaque monkeys. Neuropsychopharmacology 2005 Sep;30(9):1649-61.

(7) Andreasen NC, Nopoulos P, Magnotta V, Pierson R, Ziebell S, Ho BC. Progressive brain change in schizophrenia: a prospective longitudinal study of first-episode schizophrenia. Biol Psychiatry 2011 Oct 1;70(7):672-9.

(8) Molina V, Sanz J, Benito C, Palomo T. Direct association between orbitofrontal atrophy and the response of psychotic symptoms to olanzapine in schizophrenia. Int Clin Psychopharmacol 2004 Jul;19(4):221-8.

(9) Andreasen NC, Liu D, Ziebell S, Vora A, Ho BC. Relapse duration, treatment intensity, and brain tissue loss in schizophrenia: a prospective longitudinal MRI study. Am J Psychiatry 2013 Jun 1;170(6):609-15.

(10) Zipursky RB, Reilly TJ, Murray RM. The Myth of Schizophrenia as a Progressive Brain Disease. Schizophr Bull 2012 Dec 7.

(11) Fusar-Poli P, Smieskova R, Kempton MJ, Ho BC, Andreasen NC, Borgwardt S. Progressive brain changes in schizophrenia related to antipsychotic treatment? A meta-analysis of longitudinal mri studies. Neurosci Biobehav Rev 2013 Jun 13.

(12) Moncrieff J. Why is it so difficult to stop psychiatric drug treatment? It may be nothing to do with the original problem. Med Hypotheses 2006;67(3):517-23.

 

Joanna Moncrieff, MD

Dr. Moncrieff is a Senior Lecturer at University College London. She is one of the founders and co-chair person of the Critical Psychiatry Network. She has written three books: The Bitterest Pills,  The Myth of the Chemical Cure, and A Straight Talking Introduction to Psychiatric Drugs.

Antipsychotics and Brain Shrinkage: <br />An Update Comments RSS

65 thoughts on “Antipsychotics and Brain Shrinkage:
An Update

  1. I agree with that Duane!

    I think what I appreciate most, both in those interviews and this written piece is Dr. Moncrieff’s communication style. It is clear, even though discussing complex issues. It avoids excessive “jargon” that typically confounds rather than clarifies. It’s reasonable, measured and fact based.

    I appreciate the post and your ongoing efforts Dr. Moncrieff. You’ve said for years that these drugs are not harmless substances. They produce drug effects (because they’re drugs!) and some of those drug effects will be perceived by individuals to be advantageous while others will experience drug effects that are life-threatening and harmful. Informed consent has been discussed quite a bit on this site and that means being honest about what these drugs actually do, not what some wish or want them to do.

    D

  2. Wow! One of my top favourite critics of current psychiatry in MiA, and blogging about one of my favourite topics. I’ll have to read the post again and the references with more time.

    • Ross,

      I think she is talking here about their use as a last resort, during a psychotic event – for a very brief period of time. Although, Dr. Moncrieff would need to clarify.

      If so, this seems to be the consensus from many of the strongest critics of psychiatry. IMO, in many ways, it’s a tough pill to swallow. But at this time, there are few non-drug treatment centers, or options for a few whose psychotic events warrant the need for immediate sleep and some very short-term relief from overwhelming symptoms.

      It took me a long time (years) to come to some peace with this apparent consensus. In fact, I’m still not sure…

      Duane

      • You don’t need a neuroleptic to get some sleep. A simple sleeping pill can do, if nothing else works. But neuroleptics do indeed have a place in a society that does not offer non-drug support, and where the only “alternative” to, “voluntarily”, inflicting brain damage on yourself is being forcibly brain damaged by others, often in combination with a locked-ward sentence of unknown length. Worrying to me is that Joanna Moncrieff leaves this context out of consideration in her post. Thus, all we learn is that neuroleptics have a place. Not why, when, where. And so we’re left with the impression that, well, some people just need them. No matter what the circumstances. I for one will never consent to that consensus. Nobody needs brain damage.

        • Hi Marian,

          I’ve read other articles from Joanna, and her books, and I’m pretty sure that she views neuroleptics as a last resort.

          I’d agree with you that there are better alternatives to neuroleptics if you want to sleep. In Soteria, they would sometimes use Benzos over a few days to get someones sleep/wake circadian rythm back to normal.

          There’s also this video from Joanna that is a good introduction to her “Myth of the Chemical Cure” book, which may shed more light on her views:

          https://www.madinamerica.com/2013/04/joanna-moncrieff-the-myth-of-the-chemical-cure-the-politics-of-psychiatric-drug-treatment/

          I think that Bob Whitaker has a similar view of neuroleptics as a last resort, in this excellent video:
          http://www.madinamerica.com/2013/01/antipsychotics-in-open-dialogue-therapy

          Regards,

          Mike

        • Marian. Great point and well stated! My response is that we cannot rely on the researchers for social change. That is our job.

          This doctor has done her job well, by looking critically at information and conveying information simply enough for average people like me to understand. It is the role of activists to create the context for this information by planning grassroots events where speakers like Dr. Moncrieff can be featured, disseminating this information through their social networks, planning protests, sit-ins, legislative letter lobbies, organizing press conferences that are accessible to people of modest means and education, organize fundraising drives, letters to the editor, etc.

          We can’t expect the honest researchers to do all the heavy lifting. They are taking enough heat as it is from their peers. For clinical practice to change, we survivors, family members of survivors, and consumers have to organize effectively and create a new language within the ‘cross disability’ movement cable of uniting those who identify with psychiatric labeling/conventional treatment and those who don’t. If we don’t bridge this abyss, our numbers will remain low and we will be disorganized. Thank you for your great comment. You really zeroed on a missing piece in our movement, I just dont think this missing piece is going to come from researchers. It’s a miracle that Dr. Moncrieff can stay gainfully employed in her field.

          • “Marian. Great point and well stated! My response is that we cannot rely on the researchers for social change. That is our job…”

            Agreed.

            Marian’s point is key — as is yours, madmom.

            Thank you both (Marian and madmom) for all of your comments, thus far, on this thread.

            Respectfully,

            ~Jonah

  3. Dear Joanna,

    Thank you so much for this article, and for your books and talks. I’ve signed up for the PCCS event in Birmingham this year, and look forward to seeing your talk there.

    I have a follow up question about brain reduction due to anti-psychotics …

    I was on Olanzapine for 18 months, before developing Tardive Dyskinesia and then slowly coming off the meds. I did some research that led me to your work and others. From these trials, my brain may have reduced by 10%.

    The good news is that by stopping as soon as the Dyskinesia occurred, it was not permanent – disappearing within a few weeks of coming off the drugs.

    My question is, do you know of any work that’s looked into Brain matter reduction/increase after coming off meds?

    My hope is that the brain will repair itself, but I realise that the brain damage could be permanent.

    Thanks,

    Mike

    • The brain shrinkage/atrophy in humans haven’t been as drastic as 10% in that monkey study. Anyway. We don’t know for sure about the mechanisms of this shrinkage, but maybe one way to think of it is that heavy blocking of dopamine receptors reduces the use of dopamine pathways in the brain (to frontal lobes and other areas) and because these pathways don’t get used that much, they atrophy, kind of like unused paths in the woods gradually go away if they’re not used. Even adult human brains are malleable and plastic, so it’s possible to take an axe and hack new paths in the woods. OK, I’ll stop with this metaphor before it goes too far. :)

    • It wasn’t my intention in my post last night to instigate such fear against what neuroleptics have done, that a person would lose hope, had they been on them. Or spend the rest of their life so angry against what happened to them that they still overlook the healing that could have taken place that the neuroleptics didn’t help with.

      I just don’t think neuroleptics would be administered, if the whole truth were known. And since they are administered because of fear based ideas, I think to move away from fear gets you out of that quantum experience, and the whole experiential/time matrix involved with it.

      I still always believe that the human body can do amazing things, and beyond that there are all sorts of healings that occur constantly, which science as we know it can’t explain.

      Bruce Lipton talks about how much a difference not investing in fear makes, that this can change our very genetics. And beyond that there are all sorts of things that occur which would be called miracles, but have a science of their own which main-stream “science” suppresses with great prejudice.

      Anyhow, I don’t want to encourage all sorts of fear and anger, which would hamper anyone’s healing, if they have been forced on neuroleptics.

      I find that people who have a simple faith beyond fear, not only find the answers they are looking for, because of this; but seemingly impossible things happen in their lives. The very fact that “scientists” would give a bunch of monkeys neuroleptics, as if the monkey’s were created for man to abuse to assuage his fear about having to “know” something, points out the limitations with such “science” and how they look at form and matter as having limitations that aren’t really there.

      • Hi Nijinsky,

        I think that in the short term, Neuroleptics can sometimes be useful to get people out of psychosis and let their brain calm down and heal itself.

        However, they should be used as a last resort (as per Soteria) and only over the short term.

        Regards,

        Mike

        • I disagree, because there are people who can relate to a person who is in a psychotic episode, no matter how extreme. If it’s true “psychosis” – that someone has started to create their own world to relate to their trauma, their fear based programming – this simply means the people who can relate can relate to someone who knows how to respond without magnifying fear, to not invest in fear. Incidentally, when I use the word psychosis, that’s something different than what’s going on when someone refers to illogical methods as being “psychotic.” People I know wanted to start a facebook page called “psychotic psychiatry.” I find that insulting to people that have ever been psychotic. A person that is truly psychotic has let go of their need to be controlled by fear based programming to such a degree that they wouldn’t be able to follow the programmed matrix of the illogic of “psychiatry” and fit in.

          Further more, one will never find out how to do this naturally, how to relate to this fragile state called psychosis, when you try to suppress it, which is what neuroleptics do. When a person is manufacturing seemingly ungrounded and unrealistic fear based scenarios in order to get in touch with their own trauma, in order to let go of the entangled fear disrupting their life; one will never find what is going on if the very neurology expressing this is suppressed. And would you be looking at ways to calm the mind so that it can heal, then this by NO MEANS points to neuroleptics. There are all sorts of ways of doing this, from herbs, to yoga, to music, to quiet space, to simply having someone that listens without judgment on whether something it “objectively” true, when we are dealing with a subjective reality that’s more real than objectivity.

          I see using neuroleptics (and their production) as an excuse to not look at the people who actually can relate to psychosis; as a way of saying their ideas are too extreme, are too in left field, and that when someone can’t express themselves anymore, when this is suppressed, backed up, waiting to explode there’s some sort of magical healing going on. This simply isn’t true that neuroleptics are “useful to get people out of psychosis and let their brain calm down and heal itself.” It’s not scientifically true, nor statistically. They’re only “useful” to those making the diagnosis rather than relating, and they are useful to those terrified of who they really are, and believe they need to suppress becoming aware of the illusions in their life, their programming, their fears that if they were themselves rather than a programmed entity whose behavior adds up to normal that then they are OK. The very fact that they are supposed to “come out of” a psychosis already points out that there’s a lack of understanding. That’s like saying people aren’t supposed to react to their environment to such a degree that their reactions would start pointing out the dysfunction of societal programming that it’s convenient for society and it’s beliefs to suppress or ignore. And the danger isn’t in whether the person “comes out of” a psychosis; the danger is in society refusing to understand what’s going on, and how this effects it’s whole matrix of population control. To deny trauma, and say that suppressing it’s neurology… yes this is helpful for people to maintain the illusion that trauma is necessary to control people. But in reality that’s what’s causing all the problems to begin with. Not in the “psychotic” people but in society.

          Anti-psychotics don’t heal the brain, and they don’t calm you down. They suppress thought. And there are ways of healing the mind and calming it down that don’t involve medications that are as dangerous as listed above. Just because they are produced by a “drug company” and they are main stream economic fare, and they are available; and it looks good to excuse them, this doesn’t mean that they are an intelligent choice. Not even if it’s just for a “short” time.

          • Hi Nijinsky,

            Thanks very much for this.

            You make some very interesting points, but I need to re-read your post as I’ve not understood your distinction between “psychosis” and “psychotic”.

            I have been in psychosis myself on 3 occasions since 2007, during manic episodes, and have been diagnosed as Bipolar type 1. I have been able to come off all meds by keeping a tight control of my sleep.

            I think I pretty much agree with your points, but I think my previous post may be misleading as it was too short.

            I don’t think that neuroleptics heal the brain in any way, quite the reverse in fact. They are major tranquilisers that can sedate someone so that their brain can heal itself.

            Using less powerful sedatives is always preferential, but from my understanding of Joanna Moncrieff’s work and experience there can be times when someone’s gone too far and neuroleptics is a last resort. I’m not saying I endorse that view, as I’ve only had limited experience of other people in psychosis.

            I believe that you are right that some empathetic people are able to work with people and help them come back to reality without any meds, such as Voyce Hendix at Soteria.

            However, at the moment those people are few and far between. If only we could get funding to roll out Soteria, we could train more people to do this.

            I think you’re absolutely right to promote this ideal method of care.

            Thanks,

            Mike

          • I was referring to psychotic as a negative term. People use this when they think someone’s logic is ridiculous. When a person is truly psychotic, this is actually an opening up of their innocence. They even act out the things that they have been programmed to believe, but in a way that it exposes (if allowed to) that they are being controlled by fear rather than their heart. And yet all of that supposedly disruptive behavior is necessary for them to grow. To see what they can let go of.

            I don’t really think that the people that understand psychosis are so far and in between. They’re in the cracks. I don’t know, maybe I’ve been lucky. Maybe luck doesn’t really exist, and I’m more “normal” than I think. But I find that people actually adore psychosis, because it’s such a child like state. And I find that I’m often more concerned and worried, and feel ashamed about it than they do.

            Of course, I’m not running for president. But neither are the people that manage to get in between the cracks of the system, which actually seem to be more like extremely wide valleys, come to think of it.

            You don’t think that everyone believes all of this static that goes on as if it keeps the sun from extinguishing itself do you?

          • Hi Nijinksy,

            Thanks for clarifying the distinction. I think I might also use mania rather than manic from now on.

            I agree that psychotic is a negative term, and there are many other negative terms used by Psychiatry e.g. take Bipolar Affective Disorder…

            Disorder is very negative. Acronym is BAD, not a wise choice for people that experience mania when their hyperactive brain can connect anything and you can be paranoid.

            I think that terminology is very important to help change people’s thinking, e.g. Richard Dawkins makes a point about referring to children as “christian children” etc when we’d never think of calling someone a “liberal democrat child”.

            Regards,

            Mike

          • Actually I like “psychosis,” I just don’t like it when they use that word in reference to things that don’t warrant the comparison, but try to make it out to be nothing but a lack of comprehension. Someone who is psychotic is very different from someone who is brainwashed and has no idea what they are doing. A psychotic person is letting go of fear, rather than being controlled by it. And when you don’t respond to him or her with fear, than amazing things happen, and healing.

          • I haven’t observed any healing going on neither in the brains nor the minds of people who are on neuroleptics. I’ve only seen the outer manifestations of increasing brain damage, and a mind that, due to the damage done to its tool the brain, got trapped in one-way thinking. In order to work through and heal from their trauma, people need to have their mental capacities left intact, which on its part requires that these capacities’ tool, the brain, is left intact and functioning. Put the mind’s tool, the brain, out of action, and what you get is somebody who can no longer react to life. That certainly is convenient for a society that can’t/won’t deal with people’s reactions to it where these represent a challenge to its at any time agreed upon norms and values. But it’s got nothing to do with “improvement”, or even healing. Actually, suppressing brain activity, and by doing so the person’s ability to react to life, only adds to the initial, trauma-caused stress on this person’s brain and mind. Just because you’ve succeeded in making it difficult, or even impossible for the person to react to the stress they experience, and just because you maybe even have succeeded in getting the person detached from their stress, that doesn’t mean you’ve succeeded in reducing the stress itself.

          • Hi Njinsky,

            I’ve read this post and comments again, and I’ve really been inspired by one of your comments:

            “When a person is truly psychotic, this is actually an opening up of their innocence.”

            This is a great quote, and really captures what psychosis is. When psychotic, you do ask questions that only a child would ask.

            As we grow up, we are conditioned not to ask questions that are deemed to be unacceptable in our western society.

            I also think that psychosis is a dream-like state, and in our dreams we can think laterally and solve problems that are worrying us in real life.

            Regards,

            Mike

  4. I looked closely at Andreasen’s paper.
    The authors found a “relationship” between
    loss of brain volume and duration of relapses.

    What I found quite startling was the continual
    insistence that this should almost certainly
    be interpreted as meaning that relapses cause
    brain shrinkage.

    Even the most amateur of scientists knows that
    correlation does not imply causation.

    Why didn’t the authors further explore the
    equally valid hypothesis that brain shrinkage
    worsens the severity of symptoms and duration
    of relapses ?

  5. The shrinkage is only small (from neuroleptics).. what EXACTLY is large? And what is going on exactly in the brain (and the rest of the body) to cause such a shrinkage? And there’s the the loss of life (20-25 years) that is “normal.” There’s no mention in the article of the of loss of self initiative, creativity, how this effects a person’s life, and society. The difference between a person on neuroleptics having to actually make intelligent decisions regarding anything that requires true initiative, and one that’s not on them. And when one has to go beyond following what someone else has spelled out is what reality is, or how things work; and actually finding an answer for a critical problem, is there a difference? What degree of difference is there in true problem solving with people who believe they need neuroloptics or those that prescribe them (that evidence is already there for those that prescribe them, would you look at whether there’s recovery)…..

  6. My daughter has been so damaged by psychiatry, it’s a struggle to maintain hope. This evidence supports what many of us have been saying for years, that anti-psychotic medication is harming our children. This evidence will help a future generation but for my daughter who is in the system now? Three years of institutionalization and forced medication, has caused her to deeply retreat into her mind. Without support, many individuals will not be able to taper off toxic medication safely. My dear friend, who has loudly advocated for her son’s right to not take anti-psychotic medication had a five year protection order issued against her by the state of Washington, leaving the state with no impediments to placing her beautiful, 35 year old son in a senior foster home, chemically restrained for the remainder of his life. My friend will be arrested and incarcerated for trying to protect her son and for sticking up for his right to choose. There is no place to turn for struggling families and no justice for victims of psychiatry while the scum who reap profits from pharmaceutical sales flee the sinking ship of psychiatry and reinvest their money in weapons, gambling casinos, tobacco, nuclear energy, McDonald’s and shale oil and the academics scramble to find substitute patrons for their phony research.

  7. I calculated the loss from Andreasen’s paper:
    On average 5.61 cc of brain tissue pr year. That makes for 100 cc in 20 years and medication use for life is going to eat away over one third of your brain. No wonder people die earlier!

      • Well, define brain (define came out defien first try, with a “fruedian” typo: almost de fiend). It’s like the less we use it the more people think there is of it. As long as you don’t use it, you might be more apt to get political awards, and even diplomas, and have a big military budget….

        OK

        Of course what’s actually going on to create this shrinkage of the brain (I still can’t believe that they invented neuroleptics after the word “shrink” came out… as in head shrinkers)…A new form of shrunken heads, the miracle of psychiatry….

        OK

        What’s actually going on to create this shrinkage is I might imagine much worse than the shrinkage, itself. And I’m sure we haven’t heard but a minor fraction of what’s really going on; but then there’s the side effects list.

        http://www.bonkersinstitute.org/zyprexaffex.html

    • So just imagine what we’re doing to our children by allowing them to be put on the so-called antipsychotics at the age of two years old! We’re doing pretty much what Hermes stated about making zombie people.

      This is not going to get any better until we begin bringing people to trial and putting people in prison. It’s not enough to fine drug companies. They just absorb the fine as the cost of doing business and go on doing what they’re famous for. If ceo’s of drug companies were brought to court and faced going to prison then things would begin changing quickly and drastically. If biopsychiatrists continue to drug people into oblivion after being informed of studies such as these, then they need to be brought to court for malpractice. Unfortunately this is the only way that we seem to be able to achieve people being assured their human and civil rights. Until you take your movement into the courts not one blasted thing is going to change one, tiny bit. Witness the Civil Rights Movement, the Women’s Movement, the Gay Rights Movement, and the Disability Rights Movement.

      • Stephen,

        This is a point that Jeffrey has made on MIA numerous times. IMO, it’s a good one.

        Children need protection, especially those in foster care programs. These would need to be investigated at the state level, by contacting state Attorney Generals. -

        http://www.naag.org/current-attorneys-general.php

        At both the state and the level, there is Medicaid fraud. Jim Gottstein, Attorney with PsychRights has gone after some of these prescribers for Medicaid fraud. -

        http://psychrights.org/education/ModelQuiTam/ModelQuiTam.htm

        IMO, there’s enough injury and enough law breaking to warrant the appointment of investigators and federal prosecutors by the U.S. Attorney General. But there would need to be the political will to do so.

        It would take a major campaign to get the needed attention and action.

        Duane

          • Yes, Jeffrey has made many remarks about this and I’ve come to the point of believing that he’s right.

            What we’re lacking is what you point out, the “political will to do so.” I suspect that this is going to be extremely difficult to find because I believe that the drug companies have many lobbyists in Washington. We have a sitting president who calls for “more treatment” for these poor unfortunate people and we have an FDA that supplies people to sit on drug company boards once they retire from the FDA, and two former presidents who sit on drug boards. Politicians have climbed into bed with the unholy alliance of the drug companies and biopsychiatry.

            I live in a state where the attorney general made sure that Johnson and Johnson was brought to court for Medicare and Medicaid fraud due to prescriptions written for off label use of their wonderful drug Risperdal. The company got popped for a $1.2 billion fine. But no one is willing to take up the legal battle for foster children being drugged.

            Perhaps as a movement it’s time to begin putting more clout and support towards getting more cases into the courtrooms of this country. But I have the feeling that a lot of people in our Movement are extremely reluctant to make this move and take this stand. For some reason these people seem to want us to get in a circle, hold hands with our oppressors, and sing a nice round of Kumbaya my Lord! Our oppressors are not going to turn loose of us out of benign love for us. Look what happened with African American slaves in this country; we had to experience a civil war and it still took us another one hundred years for African American citizens to gain true freedom, and they’re still fighting for it in many ways. Very few slave owners were willing to free their slaves because it was the moral, ethical, Christian, proper and right thing to do. Most of them had to be forced into doing the right thing. Why would people running the oppressive system we’re fighting ever give up the money and ego-stroking that they get at our expense? We are going to have to force them to free us, plain and simple, and holding hands and singing Kumbaya is not going to cut it! Our movement’s reluctance to move to this point reminds me too much of Stockhom Syndrome, isn’t this the name for people taking up for the people holding them hostage?

            It seems that I’m on my soap box. Suffice it to say that I think Jeffrey and you are absolutely correct in stating that we need to take the battle to the courts.

      • “Perhaps as a movement it’s time to begin putting more clout and support towards getting more cases into the courtrooms of this country. But I have the feeling that a lot of people in our Movement are extremely reluctant to make this move and take this stand. For some reason these people seem to want us to get in a circle, hold hands with our oppressors, and sing a nice round of Kumbaya my Lord! ”

        There is an even bigger reason. A lot of the people so harmed by psychiatry and these drugs, the people who would make up the army to stop them, are too messed up to do anything about it. Many more have been brainwashed into accepting the harm that ruins their life as a consequence of feeling accepted and not getting in trouble. I, personally, haven’t done much of anything in years. I’m usually too busy swallowing fist fulls of benadryl and sleeping to keep from eating my own teeth. I’ve had tardive dyskinesia since I was 14 and it’s severity fluctuates from week to week and month to month, but has been getting overall worse year after year. Don’t expect people like me to lead the charge. I can barely even just bitch on the internet.

        • Hi Jeffrey,

          I really appreciate your comments. You have such a down-to-Earth perspective and, you are spot on. “A lot of the people so harmed by psychiatry and these drugs, the people who would make up the army to stop them, are too messed up to do anything about it.” Spot on.

          Thank you for commenting and bringing attention to this page. Please don’t stop commenting, for as long as you’re able.

  8. Do people assume that all psychiatrists who give pills that evidently cause brain damage are not intentional abusers? Does that assumption further justice by best protecting people from predators? How many psychiatrists are so dissociated from awareness of their effects that they think pills that damage brains are healthy? How responsible is it to let this abuse occur? How many people unwittingly aid and abet abusers, thinking they’re being professional? If brains are being damaged on a widespread scale throughout the population, when can it become terrorism? Who can process feelings healthily enough to realize what’s needed to protect people from this harm? If government agencies are unwilling to stop this, are they complicit? Wouldn’t our communities be a lot more secure if people’s brains were better protected? And these psychiatrists and their attendants who are damaging brains are the ones victims are supposed to feel safe and protected reporting to? How is that possible unless a victim is dissociated from how much harm these so-called authorities are actually doing? If they’re mandated reporters, when will they turn themselves in? They longer it takes for them to get help, the more people go unprotected from abuse.

    The level of corruption in conventional psychiatry and all aspects of law enforcement that cooperate with it in ways that harm people, even if unintentional, is a disgust to human’s duty to protect and serve each other. We can’t just protect people by acting like doctors harming people doesn’t deeply terrorize them. More effective treatments and less harmful treatments are available, and who in government is enabling them to be widely used? We need to help these authorities to help themselves by educating them, so they know what they do. Also, it’s minimizing the abuse to claim damaging 5-10% of someone’s brain is “small.” If someone beat someone up and that much damage occurred, any judge who claimed that was “small” would be out of a job. People must be able to process enough feelings of disgust – to fully associate with the reality of what’s happening to people — to realize when they’re facing mass loads of heavily entrenched corruption. Only by fully associating with the problem can one fully associate with the motivation to bring about the solutions, to protect people, including children.

  9. I’ve got a question about other diagnoses and antipsychotics. Since so many people with diagnoses like bipolar disorder, anxiety and depression are also put on these meds, would a study looking at the impact on the brain of those with these diagnoses help to clarify the brain shrinkage debate? Since many people who are on antipsychotics have little/no history with psychosis, hearing voices etc., symptoms that are the markers of schizophrenia, and if those studies still showed brain shrinkage, then wouldn’t that be relevant?

    • That is an awesome point! If someone using antipsychotics as an “adjunct for depression” and their brain volume also decreases, you can’t very well blame it on schizophrenia, can you?

      Brilliant idea. Someone get a grant!

      — Steve

      • That truly is an inspired idea. A eureka moment! :-)

        Bipolar type 1 can have psychosis with mania, and if you subscribe to the view that it’s on the same spectrum as Schizophrenia (i.e. Schizotypy) then you’ll have to discount those people.

        However, the idea is sound for Bipolar 2, Depression, Anxiety and anyone else Big Pharma can sell it’s brain rotting meds to.

        Mike

        • I wonder how many Macaque Monkeys were thought to have Schizophrenia in the trials that Eli Lily ran? ;-)

          It’s already been shown in primates that brain damage is caused by neuroleptics, regardless of any individual’s illness or lack of.

          We just need to do the same in humans, which is why this proposal is so inspired.

          It’s poetic justice too, because it will get back at Big Pharma mis-selling neuroleptics to people that have never experienced psychosis.

          Isn’t it ironic? :-)

          Regards,

          Mike

  10. Stephen,

    Because psychiatry darn right well knows what the truth is and doesn’t want a study confirming it. It is easier to just throw antipsychotics at a problem come h–l or high water. Sorry for my negativity but I am having one of those “I feel psychiatry is responsible for my current plight” type of moods.

    • I think you are correct. I have the feeling that biopsychiatry is trying to circle the wagons at this point as they’ve watched the uproar over the DSM-5 and have seen Whitaker being invited to speak at more and more venues. We’ve even watched how they attack one another and wash their hands of one another and then turn around and deny that they did anything of the kind and are hugging each other and singing Kumbaya together! I’m kind of stuck on Kumbaya lately for some reason. Anyway, just witness the debacle of Insel denouncing the DSM as unscientific and then he and the new head of the APA come together and give a joint statement about what a great thing the DSM is! Don’t they realize that we’re watching and listening to them or is it a matter of them just not caring whether we catch them in all of this or not?

    • I’m amazed that Eli Lily actually published that study on Macaque Monkeys, given that a standard trick for Big Pharma is to just publish trials that give positive results (and bin negative ones). Hence the http://www.alltrials.net website started by Ben Goldacre.

      I think the trial also involved Haliperidol, so maybe they thought it was a positive result (Olanzapine doesn’t damage your brain as quickly as the worse drug we have).

      Regards,

      Mike

  11. “but the first thing to stress is that the reductions in brain volume that are detected in these MRI studies are small, and it is not certain that changes of this sort have any functional implications”

    Any amount of brain damage is catastrophic. Even just a mild concussion, a mere fraction or less of as much damage as 10% loss of grey matter, is regarded by neurologists as serious and with long-term/life-long implications. And ironically if this damage were in fact caused by “schizophrenia” and not the drugs, it would surely be blamed for everything under the sun; why they aren’t returning to work, why they are developing movement disorders, why they are dying early, etc.

    And surely children whose brains are developing around these damages are never going to have a healthily functioning brain, for how ever long they live.

    • And to add to that. I cant help but to be concerned of the fact that repeated brain damage in all other ways leads to chronic traumatic encephalopathy, a condition in which the brain continues to deteriorate even after the cause of the damage is long gone. There’s no reason to think that a drug induced damage would somehow be immune to this; it’s caused by repeated damage, much like the scarring of skin. It probably doesn’t matter if it’s caused by an internal or external force.

      I don’t doubt that 10-20 years from now that we’ll be talking about this, while millions of adults who were put on these drugs as children are suffering, like myself, even long after they’ve been off the drugs.

    • Exactly, and if a drug is so bad that it is actually making a part of your brain disappear, what do you think is happening to the rest of it? Remember the “this is your brain on drugs” commercial?

  12. Lots of great comments here! The choir is singing on this one!

    Wikipedia says grey matter consists of neuronal cell bodies, dendrites and axons. Myelin composes white matter. Also, “Adolescents who were subjected to abuse and neglect appear to have decreased gray matter in the prefrontal cortex.”

    I’ve seen a video of a signal flowing through a whole path of neural connections. If the neurons are reduced by 5-10%, doesn’t this mean the connections are disrupted? If only .1% of a road at the start is impassable, one simply can’t travel the journey. So, even small damage to neurons can disrupt just about 100% of the whole flow of thoughts and senses.

    Brain technology shows that when all parts of the brain interconnect, symptoms disappear. So, damaging the roads that enable connections ensures symptoms will occur until the roads can somehow be re-grown. The function of the mind is not represented correctly until the focus is on connectivity, rather than just matter.

    Also, diagnosing people as mentally disordered should not be done as an excuse to avoid justice and mandated reporting. That would be misusing victims to avoid stopping predators, claiming their memories can’t be credible in court because police have worked with psychiatrists who have diagnosed them. Why don’t police care more to use tiny drones to spy on predators (or something!) to stop abuse?

    Brain technologies can enable brains to fully connect, and can prove they’re well-connected, rather than disordered. Yet police and “victim advocates” fit in professionally by conforming with conventions that diagnose and treat victims in ways that block the flow of their experience from connecting through their neurons to social support. If the #1 priority is protecting people from abuse, why do police and their related colleagues not adopt the more effective technologies ASAP? It’s an emergency — children and many others are at risk!

    The Whitey Bulger case highlights corruption among law enforcers, who work with psychiatrists. Some predators can be very influential as thought leaders in their professions. They developed exceptionally mental abilities to survive extreme intimate abuse as children.

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