Antipsychotics Linked to Cognitive & Memory Impairments

Rob Wipond
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1317

Finnish reseachers report in Schizophrenia Research that antipsychotic use is associated with cognitive and memory impairments. The University of Oulu team studied forty people diagnosed with schizophrenia and 73 controls at the ages of 34 and 43 years. “Higher antipsychotic dose-years by baseline were significantly associated with poorer baseline performance in several dimensions of verbal learning and memory, and with a larger decrease in short-delay free recall during the follow-up,” they observed.

“The use of high doses of antipsychotics may be associated with a decrease in verbal learning and memory in schizophrenia years after illness onset,” the researchers concluded. “The results do not support the view that antipsychotics in general prevent cognitive decline or promote cognitive recovery in schizophrenia.”

Lifetime use of antipsychotic medication and its relation to change of verbal learning and memory in midlife schizophrenia — An observational 9-year follow-up study (Husa, Anja P. et al. Schizophrenia Research. Published Online: July 15, 2014. DOI: http://dx.doi.org/10.1016/j.schres.2014.06.035)

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32 COMMENTS

  1. OTOH, the same mechanisms that cause long term psychotic illness could be reaponsible for the cognitive impairments, regardless of medical intervention. Without testing those people with Schizophrenia who were (questionably unethically) non-medicated throughout their timeline, which would be the appropriate control (as opposed to those without a psychotic disorder) , and controlling for whether the high dose cohort were also those whose illness was more severe (or perhaps defined by a different type of psychotic expression, say paranoid versus disorganized ), this study doesn’t really do much to condemn the drugs as purely, or even partially, responsible for the deficit. Even if it did, it would still have to be weighed against the cognitive deficit created while living and operating in a psychotic state (which would be the result of not being on any medication at all).

    • EllenL,

      Your blaming the victims for the toxic effects of these brain damaging/disabling drugs is a well known psychiatry/Big Pharma ploy while pretending such life destroying “treatment” cannot be withheld in the guise of ethics is disingenuous to say the least. You also seem to be unaware of the many studies done by major experts that have more than proven it’s the drugs not the bogus invented stigma of schizophrenia that is used to label many very different types of behavior including falsely accusing people of being “mentally ill” for the most pernicious motives.

      I’m reposting the information from another post about neuroleptic drugs causing brain shrinkage that extends to this post while including the brain damage, atrophy and cognitive decline from these chemical lobotomies:

      Donna on July 21, 2014 at 3:32 pm said:

      Bob Whitaker has done some excellent articles at MIA and Psychology Today exposing that Nancy Andreasen who did some of the most important studies on the lethal effects on the brain from neuroleptics found that not only did these drugs shrink the brain, they also caused cognitive decline and much worse functioning and other negative effects over time:

      http://www.psychologytoday.com/blog/mad-in-america/201102/andreasen-drops-bombshell-antipsychotics-shrink-the-brain

      Here is a great quotation from Bob Whitaker’s article:

      In this February report, Andreasen does not tie the drug-related brain shrinkage to an increase in negative symptoms, functional impairment, and cognitive decline. But in earlier articles, she did just that. And it is that larger context that makes this February report such a bombshell: When pieced together, this is a story of drug treatment that, over the long-term, causes long-term harm.

      Typically, because these lethal drugs have made billions for the psychiatry/Big Pharma cartel, they have been trying to cover up this “inconvenient truth” ever since it has been exposed with even Nancy Andreasen trying to hush it up in later studies and interviews as Bob exposes above. Also, she admits to sitting on her discovery of this drug induced brain damage/atrophy for years. so that psychiatry’s victims would continue to be forced to take their toxic drugs. Moreover, Bob exposed in his books that psychiatrists knew that these drugs caused chemical lobotomies and brain damage right from the start when these poison drugs were introduced to lobotomize the “mentally ill” in institutions to make them easier to “manage.”

      Dr. Peter Breggin has also exposed that psychiatry made no secret of the fact that their toxic treatments were meant to damage and disable the brain to dumb people down as so called “treatment” for those targeted by those in power using the pretense that psychiatric fascist agents of control were practicing medicine when they falsely committed dissidents and other inconvenient people to prisons falsely called hospitals against their will and brain damaged them into oblivion while ensuring they would be discredited, ostracized and destroyed socially as “mentally ill.” Such “mental health” tactics were well portrayed in movies like One Flew Over the Cuckoo’s Nest.

      Dr. Peter Breggin on Brain Disabling Treatments in Psychiatry:

      http://www.breggin.com/braindisabling.pdf

      Dr. Nancy Andreasen admits that neuroleptic drugs cause brain atrophy:

      http://www.ahrp.org/cms/content/view/772/9/

      List of articles from Dr. Peter Breggin’s Toxic Psychiatry web site on neuroleptic brain damage and negative impact on cognition and functioning:

      http://www.toxicpsychiatry.com/antipsychotics/

      The Scientific Case Against Forced Treatment by Robert Whitaker

      (Emphasizes perils of neuroleptic drugs mostly used in forced treatment)

      http://www.mhlac.org/Docs/Whitaker_2.1.2013.pdf

      Dr. Grace Jackson on Drug Induced Dementia: The Perfect Crime and Rethinking Psychiatric Drugs: A Guide to Informed Consent

      http://isepp.wordpress.com/2013/07/28/drug-induced-dementia-a-perfect-crime-by-isepp-member-dr-grace-jackson/

      http://www.amazon.com/Drug-Induced-Dementia-MD-Grace-Jackson/dp/1438972318

      Those at MIA who have been reading Robert Whitaker and concerned experts for a long time know about the toxic effects of neuroleptics and other psychiatric drugs, ECT and other so called psychiatric brain/body damaging/disabling treatments.

      It is good to see that studies like the one in this post are still focusing on such neuroleptic induced brain damage/shrinkage, but it seems that like Nancy Andreasen and cohorts, they have been minimizing this damage and not acknowledging the deadly long term effects of thee toxic drugs on the brain and body and one’s quality of life or lack thereof resulting in early death by about 25 years on average.

      Dr. Joanna Moncrieff who posts at this web site has accused psychiatrists of burying their heads in the sand about the truth about toxic neuroleptics, but since she is a psychiatrist, I question if even she acknowledges the huge harm done by these toxic drugs as she justifies their use for so called psychosis or schizophrenics when this so called disease has never been proven to be a disease since there is no scientific, medical or other evidence to show it or any other bogus DSM stigma exists. On the other hand, there have been many treatments like Open Dialog, the Hearing Voices Movement and psychotherapy that have been successful with these people without destroying their brains and bodies.

      Donna on July 21, 2014 at 9:41 pm said:

      As I gave this article some more thought, I did see something quite positive in the following quotation from the article:

      “Symptom severity, functioning level, and decline in cognition were not associated with brain volume reduction in schizophrenia,” stated the researchers. “The amount of antipsychotic medication… over the follow-up period predicted brain volume loss.”

      This admission is rather positive and unusual for psychiatry in that it clearly places the blame for the brain shrinkage on the neuroleptic drugs and not the victim’s so called mental illness as is all too typical of psychiatry. In fact, Dr. David Healy has exposed that Mitch Daniels, a Big Pharma CEO, invented the dirty trick of always blaming the victims’ so called mental illness for any toxic effects of Big Pharma’s nasty psychiatric and other drugs.

      Therefore, it appears that the authors of this study probably had good intentions now that all the negative information about these toxic drugs is being exposed more and more.

      Although the authors didn’t address the decline in cognition and functioning after being on neuroleptics that others noted above have found, it is important that they have also identified the brain shrinkage or atrophy caused by these dangerous drugs. Many experts are now questioning long term use of these drugs as did Robert Whitaker and are emphasizing seeking other alternatives, lower doses and trying to taper people off these drugs whenever possible.

      Donna on July 22, 2014 at 1:19 pm said:

      http://www.mindfreedom.org/kb/psychiatric-drugs/antipsychotics/neuroleptic-brain-damage/brain-tissue-loss

      JAMA Psychiatry, February 7, 2011

      Long-term Antipsychotic Treatment and Brain VolumesA Longitudinal Study of First-Episode Schizophrenia FREE

      Beng-Choon Ho, MRCPsych; Nancy C. Andreasen, MD, PhD; Steven Ziebell, BS; Ronald Pierson, MS; Vincent Magnotta, PhD

      http://archpsyc.jamanetwork.com/article.aspx?articleid=211084

      Study referred to by Robert Whitaker above about antipsychotics causing brain shrinkage/damage/atrophy causing authors of study to recommend rethinking the growing long term usage of these toxic drugs especially for off label non-psychotic symptoms such as the misbehavior of children or the elderly in nursing homes for social control and silencing the vulnerable and powerless.

      • “psychiatrists knew that these drugs caused chemical lobotomies”
        True. The dean of my medical university used that very statement (“the drugs we use are basically chemical lobotomisers”) during a lecture I attended over 10yrs ago.

    • It is important to remember that scientifically, it is not the patient’s job to prove to the psychiatrist that the drug they are administering is unsafe, it is the psychiatrist’s job to prove that it IS safe. So any evidence that brain shrinkage and cognitive decline might be caused by neuroleptics ought to be of extreme concern, and the fact that it MIGHT be a result of the disease should not mitigate that concern one iota!

      Moreover, your comment about the possibility of it being “unethical” to not provide drug treatment flies in the face of emerging evidence, to the point that the APA recently published guidelines stating that trials off medication should be attempted if possible, and that if medication is used, it should be used at the lowest dosage and for the shortest period of time. Studies by Martin Harrow and Wunderlink, as well as the WHO study, have clearly shown that many, probably the majority, of those suffering from what is labeled “schizophrenia,” are able to recover in time, and that medication in fact impedes the likelihood of recovery, probably in part due to the brain shrinkage that has been documented to be a direct and dose-dependent consequence of long-term antipsychotic use. This, again, is science, and is not really in significant dispute. There are some claims around that a different kind of brain damage may happen with repeated psychotic episodes, but I am not seeing a lot of evidence to support this claim, either. In any case, there is no longer a question about brain shrinkage caused by neuroleptics – mainstream psychiatry itself has acknowledged this as a problem.

      Finally, it does appear from the comments of the researchers that they did control for cognitive decline, symptom severity, and overall level of functioning, and none of these correlated directly with brain shrinkage. If schizophrenia itself were responsible, it would seem that those with the highest symptoms and the lowest functioning would be the ones showing the most damage, but that is not the case. This is additional evidence that the theory that the brain shrinkage is caused by the “disease” is not viable.

      You might want to read “Anatomy of an Epidemic” and take a look at the science backing up this concern. It is not something psychiatry wants to admit, but there is a long history of evidence that shows that neuroleptics do, in fact, cause brain damage over time.

      —- Steve

      • Moreover, even if the study didn’t correct for symptom severity and such it still proves that the anti-psychotics don’t prevent cognitive decline – and that’s the most conservative conclusion. It also flies in the face of psychiatry’s talking points about anti-psychotics.

    • Do you have access to full text of the article? Severity of symptoms is something that is routinely corrected for during data analysis…
      Btw, this paper is just one in the number of studies which strongly suggest that long-term use of co-called anti-psychotics may exacerbate the psychotic episodes and lead to progression of the mental problems independently of any underlying disorder (check out the article “The fat lady has sung” on MIA).
      “people with Schizophrenia who were (questionably unethically) non-medicated”
      Many people who are diagnosed with schizophrenia don’t want to take drugs and for good reasons so I don’t see anything unethical in that. What is unethical is forcing people to take drugs which they don’t want and which can make them worse.

  2. Ellen,

    Where would you get a sufficient sample of people diagnosed with schizophrenia who were not medicated? To acquire the diagnosis the person must have had contact with psychiatry, and in my experience the consequence of contact with psychiatry that results in a diagnosis of schizophrenia is inevitably medication, by consent or otherwise. If such a person is not medicated it must mean they have managed to sever all contact with psychiatry and therefore would not be available or willing to take part in studies.

    Donna has kindly provided lots of references; here are three extracts that report grey and white brain matter shrinkage (cognitive impairment?) is both drug-related and dose-dependent.

    Konopaske / Dorph-Petersen et al exposed three groups of macaque monkeys to oral haloperidol, olanzapine or sham for a 17-27 month period and published this:

    ‘The resulting plasma drug levels were comparable to those seen in subjects with schizophrenia treated with these medications. After the exposure, we observed an 8-11% reduction in mean fresh brain weights as well as left cerebrum fresh weights and volumes in both drug-treated groups compared to sham animals. The differences were observed across all major brain regions (frontal, parietal, temporal, occipital, and cerebellum), but appeared most robust in the frontal and parietal regions. Stereological analysis of the parietal region using Cavalieri’s principle revealed similar volume reductions in both gray and white matter. In conclusion, chronic exposure of non-human primates to antipsychotics was associated with reduced brain volume.’

    Radua et al concluded this in 2012 after their multi-modal meta-analysis:

    ‘The analysis identified conjoint structural and functional differences in the insula/superior temporal gyrus and the medial frontal/anterior cingulate cortex bilaterally. In these regions, large and robust decreases in grey matter volume were found with either reduced or enhanced activation. Meta-regression analyses indicated that grey matter volume in the anterior cingulate and left insular clusters was influenced by exposure to antipsychotics: patients receiving medication were more likely to show structural abnormalities in these regions.’

    And what Nancy Andreasen (Ho et al) reported in 2011 is that long-term use of neuroleptics:

    “correlated with smaller brain tissue volumes and larger cerebrospinal fluid volumes. Greater intensity of antipsychotic treatment was associated with indicators of generalized and specific brain tissue reduction after controlling for effects of the other 3 predictors. More antipsychotic treatment was associated with smaller gray matter volumes. Progressive decrement in white matter volume was most evident among patients who received more antipsychotic treatment. Illness severity had relatively modest correlations with tissue volume reduction, and alcohol/illicit drug misuse had no significant associations when effects of the other variables were adjusted.”

    Food for thought.

  3. I did not blame anyone for anything, nor did I support either the idea of big Pharma or medicating all people with similar, or any, drugs. I said that there was no way to sufficiently control enough intervening variables to decidedly attribute the deficits to medications alone.

    Do i think mental disorders are over- and mis-diagnosed far more often than appropriate? Yup, Do I think meds are both over- and mis-prescribed? Of course.

    I also said withholding drugs was questionably unethical; the suggestion that (some) people with severe mental illness should remain unmedicated comes from a place of privilege that is inexcusable among caregivers. Would I personally risk alternate health deficits, including a shorter life span, cancer, or memory loss in exchange for not experiencing some of the symptoms of my mental illness? You bet your ass I would.

    • “Would I personally risk alternate health deficits, including a shorter life span, cancer, or memory loss in exchange for not experiencing some of the symptoms of my mental illness?”
      Your choice but not so much for hundreds of people who actually would like to make a different choice and in many cases are prevented from doing so (-> forced “treatment”). You’re also ignoring the evidence that most people recover from psychosis spontaneously or with psychological and social interventions and anti-psychotics can cause hypersensitivity psychosis.

      • B,

        Ellen provides only a very limited list of the many, many horrible iatrogenic effects of the lethal neuroleptics, lithium and many other psych poisons.

        For example, I wonder how she would like tardive dyskinesia with her tongue/mouth or torso or other body parts jerking around while having no control to stop it while finding it incurable. Or having liver damage to the point of death. Incontinence. Obesity, Diabetes. Chemical lobotomy effects. Destroyed sex life. Inability to perform in one’s career, parenting and other duties. Loss of job, marriage, family, relationships, friends, financial security due to deadly effects of life destroying stigmas like the latest character assassination of bogus bipolar so the mental death profession can make a literal killing at their victims’ expense and on and on.

        I think if most would by psych drugs victims were told the truth about ALL of the risks of deadly, useless psych drugs for bogus, Big Pharma/psychiatry invented/voted in stigmas pretending to be diseases, they would run like hell from any such threats to their lives.

        This is why the biopsychiatry/Big Pharma/NAMI/government cartel must lie to the public and coerce their victims into a nightmare horror story of lies, deceit and terror tactics to inflict this evil on so many citizens or I should say former citizens once such “patients” are robbed of all human, civil, democratic rights in the guise of mental health. Just more evidence psychopaths have hijacked the globe as their deadly greed and predation on normal humans from cradle to grave continues to grow by leaps and bounds in their latest human holocaust.

  4. Ellen,

    Your claim that withholding neuroleptic or other drugs was questionably unethical is only true if one believes psychiatry’s bogus DSM spin that “schizophrenia” is a bona fide medical disease that can be treated with major tranquillizers or neuroleptics known to cause brain shrinkage, atrophy and decline in functioning and cognition to name a few problems and make matters worse in the short and long run.

    Here is a review of the great book, Pseudoscience in Biological Psychiatry, debunking psychiatry’s many spurious claims:

    http://www.antipsychiatry.org/br-pibp.htm

    Here is one of many articles by the brilliant Lawrence Stevens, J.D. about schizophrenia: a nonexistent “disease:”

    http://www.antipsychiatry.org/schizoph.htm

    Another great article by Lawrence Stevens, J.D. on psychiatric drugs: cure of quackery?:

    http://www.antipsychiatry.org/drugs.htm

    This is a great web site with many excellent, classic articles I highly recommend though the web site hasn’t been updated recently.

    • http://news.sciencemag.org/brain-behavior/2014/02/schizophrenia-time-flush-meds
      “In the latest study, published online today in The Lancet, a team led by Anthony Morrison, a clinical psychologist at the University of Manchester in the United Kingdom, conducted a randomized controlled trial of patients diagnosed with schizophrenia and related disorders who had chosen not to take antipsychotic drugs. (…) The team found that at the end of the 18-month trial, the group given CBT had lower overall levels of psychotic symptoms than the TAU-only group, although the differences were modest: The overall “effect size,” a statistical measure of the differences between two groups in a clinical trial, was 0.46 (on a scale where 0.2 is considered low, 0.5 is considered moderate, and anything over 0.8 is considered to be high). Nevertheless, the researchers argued, the effect size they found was equivalent to that typical of most antipsychotic drugs when compared with placebos (dummy pills that contain no medication).” – in other words CTB may be as good as anti-psychotics with no side effects.

  5. I don’t know much about statistics, etc.. I only did one course in university and barely passed it. I’m getting more interested now in learning it. Anyway, this study seems to be of the same cohort as in this news:

    More Evidence Antipsychotics Reduce Brain Volume
    https://www.madinamerica.com/2014/07/evidence-antipsychotics-reduce-brain-volume/

    In that paper, they found out neuroleptic use is associated with brain volume decrease, but brain volume decrease is not associated with cognitive decline. In this other study of the same cohort, they found out that higher neuroleptic use was associated with cognitive decline.

      • Great point. A friend of mine has “diagnosed” himself with schizophrenia based on the so called negative symptoms only. Anyone who’s under stress, overworked, tired stressed etc. has these “symptoms”. So anyone who’s experiencing psychosis is likely to have them too due to the stress associated with the mental state and, probably more importantly, societal reaction to it and psychiatric abuse that comes with it. Add the effect of drugs on top of that and you have “negative schizophrenia symptoms”.

      • 300 mg/day is a relatively low amount of Seroquel for psychosis. It maybe has some little effect on dopamine systems, lots of activity for tiring antihistamine, plenty of action on different types of receptors. For psychosis or schizophrenia it’s used at doses like 600-800 mg, and even then it’s not blocking dopamine very efficiently when compared to high doses haloperidol. In any way, of course those other receptor activities can be interpreted as “negative symptoms” by a patient or a psychiatrist.

        So, I pretty much developed negative and maybe cognitive symptoms of schizophrenia in some months when using these drugs. That type of experience is mostly resolved. Of course I sometimes have trouble concentrating on a task a need to do, but the experience and others’ reaction to it is entirely different. I realise this is an anecdote, but on the other hand, our brain systems are quite similar with their neurotransmitters, different brain areas, pathways and so on. Some may say I wasn’t originally schizophrenic, so I got those serious effects from neuroleptics, whereas in schizophrenics, they have some kind of an inborn problem with generating too much dopamine or having dysfunctional dopamine receptors, or whatever, and so in their case the use of a high dose of neuroleptic drugs “balances” their dopamine activity, instead of it going hypo. I just don’t find that kind of thinking very plausible.

        Our body, including brain, is a complex system with interacting hormones, sytokines, neurotransmitters, etc. When a human or an animal is stressed enough, in panic, etc, I guess there may plenty of dopamine, cortisol or other stress hormones utilised. Maybe some dopamine receptors go to a “high” state. Maybe their kind of a natural body regulation system has gone a bit awry. If you insert a drug which blocks enough of those dopamine receptors, of course those people get dulled so much that they start to act like those typical people people consider schizophrenia. At antipsychotic doses, those drugs are given in so large amounts that a big amount of all dopamine receptors are blocked, and it’s not really about balancing their dopamine levels to a normal level, especially when those drugs are given chronically.

        • “In any way, of course those other receptor activities can be interpreted as “negative symptoms” by a patient or a psychiatrist.”
          Not only other. Dopamine pis thought to play a role in a lot of mental processes, including motivation, cognition, learning and memory etc. So blocking dopamine receptors is going to negatively affect all these processes. It’s basic neuroscience. Of course, the fact that these drugs are not even specific for dopamine is not going to make any of it better. You’re basically screwing up the way the whole brain works and surprise surprise you get “side effects” and “negative symptoms”.

          • Yes, but I don’t think that 300 mg of Seroquel blocks those dopamine receptors very much compared to, say, higher doses of haloperidol. Even 600-800 mg of Seroquel does not block dopamine receptors like 10 mg of haloperidol, not even close, because of affinities, discharge times, etc.

    • When I was on Abilify 15 mg plus some Seroquel, I developed a condition which both looked like descriptions of negative (and maybe cognitive) symptoms of schizophrenia, and it felt like it subjectively too. The papers they wrote when I went there say things such as “patient was talking throughout most of the meeting and wouldn’t even stop when..”, whereas some months later they read “patient responds with single words”. Subjectively, it felt pretty dull and colourless, I didn’t get positive feelings from things such as exercise or meditation which I had earlier enjoyed. I remember once drinking two cups of coffee and taking nicotine capsules just before meeting with a psychologics, so that I’d appear at least a bit more fluent or lucid. I guess I at least developed much of what could be called negative or cognitive symptoms of schizophrenia from neuroleptics. However, I still think many people labeled with schizophrenia have something like negative or cognitive symptoms even without drugs. Even prolonged stress, bad nutrition, lack of sleep, etc, can cause all kinds of issues in many people.

      • “Even prolonged stress, bad nutrition, lack of sleep, etc, can cause all kinds of issues in many people.”
        Exactly. Being diagnoses and drugged up and often abused by the system generates stress enough to develop all these problems. They are not specific to “schizophrenia” – pretty much everyone under chronic stress gets them. When I listen to some bs thrown around by the so-called experts who in fact don’t know anything about anything, not even what the drugs do or what basic human psychology should tell them I get angry and frustrated. And these are the same people who later are treated as “experts” in criminal cases, custody disputes, they can lock you away for life… It’s pathetic.