“Should We Stop Using Antipsychotic Medication?”

Should we stop using antipsychotic medication?

I think we should look at not introducing people to “anitpsychotic” drugs in the first place, and try to assist those already on them to be on the least possible amount (preferably zero). Surely we will look back on these drugs in a similar way to how we now look at lobotomies and that can’t be good.

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Ditto.

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More alarming than the statement about drugs causing loss of brain tissue is the statement in the article that people with schizophrenia have less brain tissue at “first episode”, attributable to the “disease”.

Other studies that have claimed this were found to be flawed. As usual, the data is not in the article nor is it available in the publications cited so that people can figure out what she did this time.

The study does not say how many of the people never got drugs.

It appears that the number of subjects who were not given any drugs AFTER the first measure was zero. No surprise that the more medication that was given, the greater the brain changes. All the brain shrinkage could have been due to drugs, and probably was, but there is no way to tell from the information provided.

Regarding the initial differences in brain size: The study probably had no control to screen out the effects of drugs taken BEFORE the first episode/ first measure. If they were real, the differences may have been due to drugs like stimulants, which cause brain shrinkage and increase the risk of psychosis.

To the extent that the initial differences were not real, they may have related to age or body size, while Andreasen has attributed them to schizophrenia. Sometimes tiny differences are treated as significant when they clearly are not, as indicated by variation among the relevant population. That is the kind of bad science that is often offered in these type of studies.

I think that studies like this should not be posted or quoted unless we know where to go to get the raw data, which often involves uncontrolled variables, and always tells a more complicated story than the narrative.

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I’m starting to think that MIA has a hear-what-you-want to hear mentality when interpreting these articles.

The summary on MIA:
Oh no, the drugs cause brain damage. We’ve more than verified it; should we stop using them?

What the article actually says;
Schizphrenia causes brain damage. The longer the relapse/psychosis the more the damage. It’s a problem that patients and family members interpret the article she published years ago as reasons to quit taking the drugs. The drugs emptied the aslyums and even though they have side effects, “they have fewer side effects than some of the other medications we use.”

Same old, same old.

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Nancy Andreasen is trying to make the unpalatable somehow palatable, she knows that neuroleptics, even the “atypical” ones cause brain shrinkage, animal studies prove this beyond doubt.

I am interested as to how many people in the study were actually drug free (i.e. never at any time taking neuroleptic drugs) at the time of their first MRI scans. I recall reading that people in her study had been on neuroleptics prior to the initial scans, albeit for a short period. The only way that it could be tested that “schizophrenia” causes brain shrinkage (and to what degree this may be so) is by studying people that are truly naive with respect to neuroleptic drugs.

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Yes, Nancy Andreasen is still saying that schizophrenia itself is causing some decline in brain volumes. But here is the key point here, and why we ran a link to this interview: In her last publication, the one referred to here, she so completely obscured the fact that she had previoiusly found declining brain volumes associated with drug usage, that many readers of that article started discounting that association, saying Andreasen had back away from it. I hear this all the time now when I speak–oh, Andreasen no longer believes that to be so. So, from that context, that is the news here, that she acknowledges (again) the drugs do cause this shrinkage. You can see too in this article how she didn’t want to acknowledge this, or even really publish it. That is news here too.

As for the evidence that there is shrinkage associated with the “disease,” meaning that people so diagnosed have smaller brain volumes, JOnathan Leo and Joann Moncrieff did a very good job of investigating this literature, and what you find is that most of the studies that claim to be of drug naive patients (and thus report smaller brain volumes), are not in fact of drug naive patients, but in patients who have been exposed to the drugs for a brief time. IN the three studies where patients trully were drug naive, they did not show significant brain shrinkage comparable to controls.

Now, it may be that trauma and other environmental factors that may lead to psychosis and the other “symptoms” that lead to a schizophrenia diagnosis are associated with brain shrinkage. I don’t know. But the real news here, for the field, is that Andreasen is, within the article, acknowledging that the drugs shrink the brain. Maybe that isn’t “news” to many MIA readers, or those who comment here, but it would be “news” to many in the field who believe that Andreasen had backed away from her earlier findings.

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I am so tired of hearing that “schizophrenics can now live in the community because of our drugs.” It’s such a lie, but Andreasen continues to publish this nonsensical myth. It was a social policy change that had nothing to do with drugs, as Bob so amply demonstrates in his book.

That being said, she is pretty mainstream, and for her to admit that there really is brain shrinkage due to neuroleptic use is very helpful.

It’s also important to remember that any links between “mental illness” and brain volume are based on average measurements. There is no direct correlation where you can say that “this person has schizophrenia and therefore will have a smaller cranial capacity.”

They continue to grasp at straws to hold up their unsupportable brain-damage theories of mental illness. But the data is now becoming clearer and clearer, and sooner or later, they will lose.

— Steve

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Steve, you say “sooner or later, they will lose.” Do you think any of us will see it in our lifetimes?

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I think Bob hit this one on the head. Nancy was THE authority in the so-called ‘Decade of the Brain” her books, The Broken Brain and Brave New Brain were pointed to as “evidence” of the biological underpinnings of so-called mental illness. Her acknowledgement, however grudging, that the drugs cause brain shrinkage (aka Damage) is a big deal because of pedestal she’s been raised to by those espousing the bio-reducio-absurdum view.
D

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Hi Robert,

This statement in the article (see below) appears to say that there’s something wrong with the brain before the first psychotic episode.

“Lack of brain tissue found in schizophrenic patients

‘Scans from the patients’ first episode revealed that they had less brain tissue, compared with healthy individuals without the disorder.

“The researchers say this finding suggests that something is affecting the brains of those with schizophrenia before they demonstrate obvious symptoms of the conditions.”

Dr Andreasen implies that though meds cause damage to the brain, they may be caused by “pregnancy complications or exposure to viruses”. What about trauma in childhood? Perry has proven that trauma in children lasts long after the traumatic incidence(s) and others (eg Heim) have shown the persistence of psychological and neurodevelopmental conditions.(Read, Perry et al comment “As is often the case, women with a history of psychosis were not included in Heim’s study.’)

The neglect of trauma in the causation of psychosis is extraordinary, given its prevalence in the inpatient histories of people with psychosis. Why is it being ignored by researchers? Read et al again: “In the last four decades (60s-90s), for every study on the relationship between child abuse/neglect and schizophrenia, there have been 30 on the biochemistry of schizophrenia and 46 on the genetics.”

I applaud Dr Andreasen’s concerns around the use of antipsychotic medications. However, trauma is “the elephant in the room” which is still invisible in mainstream psychiatry.

Lois Achimovich

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Yes “we” should stop using psychiatric drugs. Psychiatry is suffering from “Münchausen syndrome by proxy” when it prescribes or forces psychiatric drugs into their patients .

Definition of MSbP or MBP “a caregiver deliberately exaggerates, fabricates, and/or induces physical, psychological, behavioral, and/or mental health problems in those who are in their care.”

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