ReviewTherapeutic advances in psychopharmacology2018
Are structural brain changes in schizophrenia related to antipsychotic medication? A narrative review of the evidence from a clinical perspective.
Review in Therapeutic advances in psychopharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
15 citing papers in PubMed.
- Antipsychotics cause reversible structural brain changes within one week.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2025Trial
- A Meta-Analysis of the Converging Effects of Different Classes of Antipsychotics on the Frontal Cortex Transcriptome in Laboratory Rodents and Non-Human Primates.bioRxiv : the preprint server for biology · 2026Article
- Schizophrenia and Neurodevelopment: Insights From Connectome Perspective.Schizophrenia bulletin · 2025Review
- Excessive interstitial free-water in cortical gray matter preceding accelerated volume changes in individuals at clinical high risk for psychosis.Molecular psychiatry · 2024Article
- Basal-Forebrain Cholinergic Nuclei Alterations are Associated With Medication and Cognitive Deficits Across the Schizophrenia Spectrum.Schizophrenia bulletin · 2023Article
- Microstructural Cortical Gray Matter Changes Preceding Accelerated Volume Changes in Individuals at Clinical High Risk for Psychosis.Research square · 2023Article
- Mania-related effects on structural brain changes in bipolar disorder - a narrative review of the evidence.Molecular psychiatry · 2023Review
- Degeneracy and disordered brain networks in psychiatric patients using multivariate structural covariance analyzes.Frontiers in psychiatry · 2023Article
- Structural Brain Volumes of Individuals at Clinical High Risk for Psychosis: A Meta-analysis.Biological psychiatry global open science · 2022Article
- Reaction Time and Visual Memory in Connection with Alcohol Use in Schizophrenia and Schizoaffective Disorder.Brain sciences · 2021Article
- Recent Discussions on Dopamine Supersensitivity Psychosis: Eight Points to Consider When Diagnosing Treatment-Resistant Schizophrenia.Current neuropharmacology · 2021Review
- Reconsidering brain tissue changes as a mechanistic focus for early intervention in psychiatry.Journal of psychiatry & neuroscience : JPN · 2020Article
- COMT-Val158Met polymorphism modulates antipsychotic effects on auditory verbal hallucinations and temporal lobe gray matter volumes in healthy individuals-symptom relief accompanied by worrisome volume reductions.Brain imaging and behavior · 2020Article
- Normalizing the Abnormal: Do Antipsychotic Drugs Push the Cortex Into an Unsustainable Metabolic Envelope?Schizophrenia bulletin · 2020Review
- What Would Digital Early Intervention for Bipolar Disorder Look Like? Theoretical and Translational Considerations for Future Therapies.Frontiers in psychiatry · 2019Article
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Some observational studies and literature reviews suggest that antipsychotic drug use is associated with loss of grey or white matter in patients with schizophrenia, whereas others have contradicted this finding. Here, I summarize and critique the available evidence and put it in the context of clinical practice. This narrative review pools evidence from observational and experimental studies in humans and animals on the relationship between antipsychotic medication use and brain structure and function in patients with schizophrenia. To summarize, the observational evidence in patients with schizophrenia and the experimental evidence in animals suggest that antipsychotic drugs can cause reductions in brain volume, but differ as to where those effects are manifest. The experimental evidence in patients is inconclusive. There is stronger and more consistent evidence that other factors, such as alcohol and cannabis use, are likely causes of progressive brain changes in schizophrenia. Overall, I argue the case against antipsychotics is not proven and the jury is out on any significance of putative antipsychotic-induced brain changes. Taken in the context of strong evidence from clinical trials that antipsychotic drugs have beneficial effects on symptoms, function, relapse and cognition, and observational evidence that treatment normalizes other imaging indices and reduces mortality, the balance of probabilities is that antipsychotic drugs do not cause adverse structural brain changes in schizophrenia.
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