New Research Suggests Brain Abnormalities in ‘Schizophrenia’ May Result From Antipsychotics

Study finds that reduced cortical thickness and brain surface area associated with 'schizophrenia' may result from antipsychotic drug use.

Peter Simons
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A new study published in Biological Psychiatry finds that the reduced cortical thickness and brain surface area are correlated with a schizophrenia diagnosis but that these differences may be explained by the widespread use of antipsychotic medications.

The researchers report that “effect sizes were two to three times larger in individuals receiving antipsychotic medication relative to unmedicated individuals.”

In fact, the researchers found that participants with a schizophrenia diagnosis, who were unmedicated, were not significantly different from healthy control subjects regarding cortical thickness.

The researchers were from the large, worldwide consortium called the ENIGMA Schizophrenia Working Group. The study included data from 9,572 participants across 39 worldwide tests (4,474 were diagnosed with schizophrenia; 5,098 were “healthy” control subjects). The researchers examined data on cortical thickness and surface area of the overall brain.

The researchers found that individuals with a schizophrenia diagnosis had thinner cortices than control subjects in specific areas, and thicker cortices than controls in other areas. However, when participants were grouped based on their medication use, the researchers discovered that unmedicated participants with schizophrenia showed no statistically significant differences from healthy control subjects.

The effect size for reduced cortical thickness was twice as large for participants taking second-generation antipsychotics. For those taking first-generation antipsychotics, the effect size was three times larger when compared to unmedicated participants.

The researchers also note that higher medication doses “were significantly correlated with thinner cortex in almost all” regions of the brain.

In these analyses, researchers controlled for possible confounding variables, such as age at schizophrenia diagnosis, duration of symptoms, the severity of symptoms, current age, and gender. However, even after controlling for severity of symptoms, people diagnosed with schizophrenia taking antipsychotics had significantly reduced cortical thickness, while those who went unmedicated were not significantly different from healthy control subjects.

The researchers did find that the brain surface area was lower on average for participants diagnosed with schizophrenia than for control participants and that this finding was not explained by medication use. However, they also note that this finding involved a much smaller effect size than their other results—indicating that there was significant overlap in surface area between the groups.

The researchers write that future studies on brain differences should take care to include medication use as a potential confounding factor. They suggest that this could be a contributing factor to why even after several hundred studies of cortical thickness and surface area in schizophrenia, no consensus has yet emerged.

 

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van Erp, T. G. M., Walton, E., Hibar, D. P., Schmaal, L., Jiang, W., Glahn, D. C. . . . Turner, J. A. (2018) Cortical brain abnormalities in 4474 individuals with schizophrenia and 5098 control subjects via the Enhancing Neuro Imaging Genetics Through Meta-Analysis (ENIGMA) Consortium. Biological Psychiatry. Published online ahead of print. https://doi.org/10.1016/j.biopsych.2018.04.023 (Link)

36 COMMENTS

  1. Very interesting, good find, and it’s a very large sample.

    It ought to be a heart stopping moment for Psychiatry, which has advanced the theory that medication is required to resist a degenerative process. This was already proved wrong with the macacque monkey study, but, hey, they are just monkeys. So now we find there is a small, barely significant shrinkage due to the condition but that this more than doubles on medication. If you believe cortex volume matters at all (and, actually, does it?), and you believe in “do no harm” you should be thinking, heck, we just made the the thing we are trying to prevent twice as bad. It should be a palpitation moment.

    Instead, as happens so often in papers like this, we get the sycophantic platitudes that this doesn’t mean antipsychotics are bad, because we have lots of (discredited) literature that says they work, without any questioning of that work. Wow, so you think that cortex shrinkage is a price worth paying. If that’s the case, then, FDA and MHRA, that warning should be on the label, now, as follows:

    “studies show that antipsychotics significantly reduce brain cortex volume”

  2. The neuroleptics/antipsychotics can create the negative symptoms of “schizophrenia,” via neuroleptic induced deficit syndrome.

    https://en.wikipedia.org/wiki/Neuroleptic-induced_deficit_syndrome

    They can also create the positive symptoms of “schizophrenia,” like “psychosis” and “hallucinations,” via antipsychotic induced anticholinergic toxidrome.

    https://en.wikipedia.org/wiki/Toxidrome

    Neither of these medically known neuroleptic/antipsychotic induced syndrome are listed in the DSM billing code “bible,” so they are always misdiagnosed as one of the billable DSM disorders.

    But when a “treatment,” creates the symptoms of a medically unprovable “disorder,” that means the primary etiology of that “disorder” is likely iatrogenic, caused by the doctor, not genetic.

    • Non Drug “Schizophrenia” Potential Outcome:-

      “..Next is the testimony of a twenty-nine year-old man.

      He is virtually at the end of a process of full recovery from schizophrenia, a process that revolved around the gradual recovery of his sense of selfhood.

      As I said earlier, the loss of selfhood experienced by people who are diagnosed with schizophrenia is catastrophic, therefore their recovery of selfhood takes correspondingly longer.

      When he first attended me several years ago, he was taking fourteen tablets a day, stuck in a deep rut, constantly at home with his parents, with no external activities in his life and no prospect of any on the horizon.

      Our work together revolved around the principles set out in this book. Twelve weeks ago, having been taking just a quarter of one tablet for the preceding three months, having discussed his situation in detail with me, he ceased taking medication.

      Twelve weeks on, he continues to do and be well in his life. We will remain in regular and frequent contact, to ensure that he remains well.

      He has just completed an honours MA university course, having obtained his degree last year…”

      “Selfhood” page 278, by Dr Terry Lynch

  3. ugh. at best, the tranquilizers suppress paranoia and agitation, to a point. more often…they’re used to shut people up, control people (hence their widespread use in “ODD”). sounds to me like yet another case in which the psych drugs end up creating more problems than they (temporarily…) suppress.

    personally, ive found tapering off the neuroleptics -quite- difficult, even more so than ditching the benzodiazepines. even at low doses, they cause such a profound alteration in brain function that dosage reductions are about all I can handle at this point, rather than full on discontinuation. lame.

  4. Doesn’t this meta-analysis provide yet more compelling evidence and rationale for avoiding “antipsychotics” wherever possible in “first episode psychosis”?
    (Especially where psychotropic drug toxicity such as SSRI induced intense akathisia is misdiagnosed as psychosis).

    Similarly: – more evidence for the smallest dose exposure for the shortest possible time.

    These drugs are not only profoundly neurotoxic.
    They have multi-systems toxicities: Neuro-endocrine, endocrine, cardiac, cardio-vascular, hepatic and gastro-intestinal, metabolic syndrome and diabetes.
    Integumentary, (eg antipsychotic induced pseudo-acne).

    Then the neuro-toxicities which result in changes in behaviour, disinhibition, emotional blunting, aggression, akathisia, – all of which may be misdiagnosed as features of, even proof of “Serious Mental Illness”.

    Drug dosages will then be increased and new drug additions — “augmentation”, increase the intensity and duration of iatrogenic injuries. Some become irreversible.

    Also – “multi-modal” sexual dysfunction. – et al -et al et al.

    No prescriber/enforcer discusses withdrawal syndromes and dependency.

    Human beings are locked up and forced to suffer these acute, subacute, chronic and legacy ADRs (Adverse Drug Reactions) which destroy every aspect of life, hope, happiness, relationships, job and marriage prospects and societal integration.
    How can such mistreatment be compatible with a therapeutic doctor-patient relationship?
    From time zero neither trusts the other.
    Most likely, the patient will ever ever trust any doctor again; for life. They have every justification for that global absence of trust..

    Next, these ADRs and their injuries cause destruction of the lives of partners, parents, carers, loved ones and whole families.
    The inevitable “collateral damage “of psychotropic-drug-dogma masquerading as medicine.
    These drugs are prescribed and are initiated without informed consent.
    They are continued by force.
    Reports of adverse drug reactions by patients and their loved ones are disregarded, and often result in arrogant denial.
    The visible, increasing signs of drug induced cranial nerve lesions and central nervous system damage are apparently invisible to the prescribers and enforcers.

    These drugs are given to very young children.
    How could any doctor believe that such devastating prescription drug ADR risks are going to benefit a child?

    TRM 123. Retired Consultant Physician.

    • Most likely the patient will Never Never trust any doctor ever again – for life. (typo – sorry)!

      Thus the breadth and continuity of lifetime medical care is compromised directly by the physical, psychological and social damage resulting from the trauma of an initial psychiatric “care” experience.
      There is then double jeopardy as all future clinicians, whatever discipline within medicine, regard the once-psychiatric patient as a forever-psychiatric patient.

      This detrimental pre-judgement applies to those who never ever had any psychiatric condition (mis-diagnosed akathisia) as it does to those who did/do experience the suffering of extreme mental and psychological distress.

      • Totally with you TRM123.

        Certain biological psychiatrists lie to get you on them, lie about the target dose, what it will do to you, and the intended duration. It’s a con. They ruin lives, ruin families, they are dangerous idiots who bring medicine into disrepute.

        The drug we were prescribed, quetiapine, is a busted flush, a fraud. It doesn’t do anything therapeutic except side effects.

      • TRM 123,
        Thank you for highlighting Akathisia and psychiatric drug neurotoxicity. Psychiatry has poisoned many and then they pretend they haven’t. I don’t want to think of what kind of brain shrinkage I’ve had from the years of psych drugs.

      • TRM 123
        Agree totally…I am unable to trust any medical practitioner since my “treatment” (read torture) for depression and sleeplessness that resulted in extreme akathisia and my first “psychotic” episode at age 50, which was then compounded by hospitalisation and more forced drugging with the offending substances and the most evil drugs on earth – “antipsychotics”.

        The total corruption of medicine by drug companies and the refusal of doctors to listen to patients re their experiences of these drugs is fundamentally a crime against humanity…mass torture for financial gain…and should be labelled as such.

  5. And the fraud uncovered by David Rothman into the marketing of the number one first line antipsychotic drug: Risperidone

    https://www.youtube.com/watch?v=K12jE7TH7zQ

    And just as this retired consultant physcian knows the harm done by these drugs so do all the others who have spent their career destorying lives. They do it because they are very well paid and the regulatory bodies allow it – they are unaccountable.

    In the UK we have the ‘Dr’ Jane Barton case. The ‘authorities’ did their best to cover it up but

    https://www.youtube.com/watch?v=iFBwuLKBp5A&feature=youtu.be&t=158

    https://www.gosportpanel.independent.gov.uk/panel-report/

    What do you bet that she will only be prosecuted if they can safely hold back the dam of all the other deaths and horrors very much including psych drugs and limit it to this ‘doctor’.

    People – outside of this context – see us as being extreme, we are not, we ask for justice and in the clear view of the terrible harm and history of killing by psychiatry. Psychiatry needs to be abolished and the psychiatrists who have destroyed lives need to go before a court of law.

    • “The researchers write that future studies on brain differences should take care to include medication use as a potential confounding factor.”

      But this has been well established for decades, do these authors really think they are the first point it out? Psychiatry is a hoax, no amount of data and evidence from scientific studies will make a jot of difference.

      “They suggest that this could be a contributing factor to why even after several hundred studies of cortical thickness and surface area in schizophrenia, no consensus has yet emerged.”

      This brings to mind the infamous Big Tobacco memo of 1969 carrying the words “Doubt is our product.” It applies equally well to guild Psychiatry in 2018.

      SPB says: “People – outside of this context – see us as being extreme, we are not, we ask for justice and in the clear view of the terrible harm and history of killing by psychiatry. Psychiatry needs to be abolished and the psychiatrists who have destroyed lives need to go before a court of law.”

      Couldn’t put it better myself.

  6. In 2007, Nancy Andreasen, the Grand Dame of biological psychiatry, wanted to disprove the idea that antipsychotics made people’s brains shrink. She set up her study and ran it to its conclusion and the end results proved that antipsychotics were shrinking people’s brains. Thinking that she must have made a mistake she ran the entire study over again and got the same result. Confounded by her results she sat on them for two years and then, being the scientist that she is, she published her results and stated that the drugs were the cause for the differences in the brains of people labeled with schizophrenia as compared to people who’d never been on the drugs and who supposedly had normal brains. I have to admire her for this, for having the courage to go against established psychiatric thought. But, then she ran back to her brethren and hid among them by stating that even though this is the truth, that people on the drugs should continue to take them. This is a crazy, crazy world.

  7. I was at a five day training last week where I had an interesting discussion with a young man. He made the observation that he finds it interesting that psychiatrists claim that their wonderful drugs target very specific sections or parts of the brain in order to bring about a difference in the behavior of those labeled with diagnoses. But…..it’s a proven fact that all the drugs used are nothing but general tranquilizers. There is no proof that any of the neuroleptics actually target small and specific areas of the brain. And if anyone tries to state that there are studies to prove that the drugs do this then you have to trace things back to the source of the study and you will most likely find that there’s a drug company behind the lies.

    Most of the people at this training were drinkers of the Kool-Aid and claimed that they owed their lives to the drugs. It’s not my job to convince anyone of anything nor to force anyone to believe the way that I do. However, there were a few individuals there, besides myself, who no longer believe the lies. I met the young man mentioned above and I met a gentleman who took himself off the drugs and no longer uses them at all. There were a few other people at the training who I suspect were not Kool-Aid drinkers. However, all of them were silent about this in the general training. Only in the small, private discussions that took place at lunch did you find anyone willing to stand against the drugs. But there were some people who did and I find this hopeful. Not all of us there at the training were Kool-Aid lovers.

  8. “. . . no consensus has yet emerged,” you say at the very end of your insightful article. Because of not enough data using drugged “schizophrenics” presumably. The numbers looked at in this study were certainly huge enough to consense that drugs cause brain damage. The lack of consensus was then due to something else. Do you have any idea of what that might be?

      • Yep, room for healing on all sorts of levels body, mind & spirit. I haven’t necessarily forgiven but I’m not angry all the time, either. Used to be angry quite a bit when I woke up to what happened to me–same as “millions of others,” as you say. And it can make me angry when I think of the crazy corruption in the world which is so negatively impacting the planet and its inhabitants.

        Although I have taken actions and have created things that have combated corruption in real life, so my anger has fueled my activism quite a bit, of course, as has my sincere desire to see radical change in the world. I’m doing my part every day in a few different ways.

        But I certainly don’t focus on that all the time, I have other things in life which get my attention, thinks which make me feel good, relaxed, happy, etc. Were I to think about injustice and corruption all or even most of the time, and how seriously deep it goes and how it causes such needless suffering, I’d go nuts with feelings of despondence, rage, hatred, and powerlessness.

        Healing my brain was about learning to quiet my mind so that I could derive some meaning from my experience. How was this driving me in life? How is my experience serving me to grow in awareness, and also to help others? And other questions like that, pure introspection. That’s how the healing begins.

        Many stages and steps to healing the brain, mind, heart, and spirit from betrayal and neurotoxicity. Point is, everyone has a path to healing. It’s not a religion to have awareness of who we are as spirit/soul beings. That’s simply a matter of further awakening to who we really are as human beings.

  9. “We caution that the likelihood that antipsychotic medications are associated with thinner cortex in individuals with schizophrenia should by no means be interpreted as a contraindication for their use in treating patients with severe mental illnesses, including schizophrenia. In fact, a recent study found that medication treatment was associated with thinner cortex and better behavioral performance on a cognitive control task (26% higher d′-context score) (24). Most importantly, antipsychotic medications tend to successfully treat severely debilitating psychotic symptoms, reduce relapse risk following a first-episode break (69), and reduce suicide risk (70). As such, they play a critical role in the treatment of psychosis.”

    = Ok we cant run away anymore from the fact our treatments shrink peoples brains and damage them but… we will just carry on giving/ forcing people to consume our lucrative oops remember to say in public helpful drugs because it helps people with this debilitating disease.

    I continue to be astounded that no matter how much evidence is produced year after year that shows just how damaging psychiatric drug treatment is it is just shrugged off and people continue to be duped, forced coerced convinced etc that they are helpful. Any treatment that functions by damaging the brain cannot and never will be helpful. Basta.

    • So What’s the Alternative?

      From the Book “Selfhood” by Dr Terry Lynch: Page 267: “Case Histories”.

      “… I could see how Stephen was diagnosed as having paranoid schizophrenia…”

      “…Stephen looked terrified, and I asked him why. He replied ‘I’m not sure I can get out of this place alive’. There were only the two of us in my office, and nobody in the waiting room….”

      “…I focused on enabling Stephen to progressively raise his level of selfhood. In particular, I worked with him on self-protection and self-generated security, because his lack of these dominated his life,..”

      “..This practise had the desired effect. His level of self-protection and self-generated security began to increase, slowly at first, then gathering pace. Stephen made considerable progress in raising his level of selfhood, of which, for him, self-protection and self-generated security were key factors…”

      “.. Because he was doing well, his psychiatrist agreed to reduce his medication slightly, and I subsequently continued the process of gradually reducing Stephen’s medication…”

      “..Stephen has been off all schizophrenia medication for over three years. He lives a full life, goes where he likes, thrives in social situations, and has a level of selfhood higher that at any previous time in his life…”

      And how much would it save?

  10. Long before my antipsych awakening, I was interviewing with a doctor who said to me, “I see you are schizoaffective, but I note you do not have ‘flat affect.'”

    I then told the shrink that according to my own personal observation, the drugs we are given caused the “flat affect.”

    He paused, then said, “Likely you are right about that.” He then noted I “tolerated” the drugs well, and said that was why I didn’t have “flat affect.”

    I look back and laugh, but also I realize that this “toleration” led to insane doses of drugs and much harm to me.

    I agree that the brain heals. Or can heal, but doesn’t heal for everyone. For many, it doesn’t heal fast enough. I have studied this and as of yet, they don’t know why some brains heal faster. It is not an “attitude problem,” either. They just don’t know and cannot predict. These drugs also cause damage to the other organs, including the heart and endocrine system. Eventually, the damage is systemic.

    I resent the lofty attitude that some people have who claim such healing is easy, or simple, or that there’s one universal answer that will save the world. I resent the superiority attitude of some of those who have healed. It doesn’t help those who are still struggling to hear others boast about it.

    I figure all I can do is share my own experience, but I also consider myself extremely lucky. If I ever gave off the impression that healing in all areas was easy, or a breeze, then someone heard me wrong.

  11. Thank you dear author,
    a very nice work but, if i overflew the article correctly not much to go by within the close confines
    of valid scientific debate.
    The name of the magazine and group should be enough to find the article,
    but it wouldnt be enough to validly edit on wikipedia or write a biological article.
    The english citing rules for natural science article are quite easy, if you do not know them already.
    (As i might already have sufficiently implied i tend to not read much of articles which are not real news.)
    The proof has been published quite few years ago within real biological animal experiments
    in pubmed. Since then pubmed has been devoured by the National whatever for Biotechnologie and if you do not understand when reading biotechnology, you can always try to google a meaningful truth in the subsection pubmed regarding psycholgical health and probably quite a few other pseudosuperiorites regarding modern genetics and the inevitable and final but most of all, only possible solution to the grave suffering of… yawn…

    btw. the great Monsanto belong BASF now, as if anyone would need or like that one more… 🙂

    Sorry, if i leave again right now and not come back to this page for good, if i can…
    Not only will you never be able to integrate all the strange thinks happening and oppinons posted,
    i went invulnerable Firetroll trying to baptise narcistic nerds in kerosene kiddy pools, within minute the last time i caught one of those self acclaimed know it alls buggering other victims with his textbook bullshit.
    This site is providing valueable data and support for me and i do not want to get banned…. 🙂

    Good luck and success to the author and us all.