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Psychiatry at best is randomly proved quackery.
They treat the Brain instead of the Mind.
They are not sure which system of Psychology to follow.
Freud,Jung,Adler et all.
Or William James’s behavior theory!
They end up treating Brain biologically and most of the drugs they prescribe are harmful to health.
Evidence that prescription drugs shrink patients’ brains would, one might think, suggest only one course of action: stop prescribing them. But the matter turns out to be much more complicated, according to research published today inArchives of General Psychiatry on the effects of antipsychotic drugs in people with schizophrenia1.
In the past 15 years, research has indicated that people with schizophrenia have smaller cerebral volumes than the general population, and that this reduction is particularly large in ‘grey-matter‘ structures, which contain the cell bodies of neurons. For instance, one meta-analysis points to 5–7% reductions in the size of the amygdala, hippocampus and parahippocampus2, which are all involved in memory storage and retrieval.
But scientists have debated whether the decrease is caused by the disease alone, or whether powerful antipsychotic drugs also have a role. According to the latest findings, the more antipsychotics patients receive, the more likely they are to have a decreased amount of grey matter.
The research was led by Beng Choon Ho, a psychiatrist and neuroscientist at the University of Iowa in Iowa City. His team used magnetic resonance imaging (MRI) to scan the brains of 211 patients, administering on average 3 scans per patient over a 7.2-year period1. They found that treatment length and the type and dose of antipsychotic drugs taken were both relatively good predictors of total brain volume change. Use of antipsychotics explained 6.6% of the change in total brain volume and 1.7% of the change in total grey-matter volume.
The study developed from a previous work in which Ho’s team analysed the contribution of a genetic variation to grey-matter volume reduction3. In the latest work, the researchers looked again at those results and added data from more patients. This time, they examined the contribution from the dose of antipsychotics prescribed. They found that the greatest reduction came in those who had been recently diagnosed — and so would have just started taking the medications. “We did not expect to see this,” says Ho.
Ho says that the effect is “small but significant”. He adds, “We have been looking at the data for five years. We’ve been very careful to get it right because of the potential implications.”
The scale of the study is impressive, says Andreas Meyer-Lindenberg, a neuroscientist at the University of Heidelberg in Mannheim, Germany. “It’s by far the largest sample studied longitudinally. And there was a great follow-up and retention rate,” he says. Stefan Borgwardt, a neuropsychiatrist at the University of Basel, Switzerland, says that the study “will definitely have a great impact, not only on the field of schizophrenia research but also on clinical practice”.
Animal studies support the link. David Lewis, a neuroscientist and psychiatrist at the University of Pittsburgh, Pennsylvania, found that healthy non-human primates, given doses of antipsychotics similar to those given to humans, showed brain volume reductions of around 10%, mostly attributable to loss of the glial cells that support and protect neurons4,5.
But Lewis, who has written an editorial to accompany Ho’s study6, warns that his own, Ho’s and other studies are “convergent but still circumstantial”. It is impossible to distinguish the effect of the disease from that of the drug, he says, because “both are changing over time”.
Ho acknowledges that his study is marred by the lack of a placebo control group — for ethical reasons, patients cannot be deprived of the medications they need — and the lack of ‘within individual’ studies in which the same patient either uses or does not uses the drugs. “It’s not the ideal study design, but as good as we could ever get with something like this,” says Ho.
Meyer-Lindenberg warns against over-interpreting MRI data, which can be affected by confounding factors including lifestyle, smoking and socioeconomic differences. “Although it does address them as far as possible statistically, this study cannot exclude them,” he says. Meyer-Lindberg himself published a study last year showing that antipsychotics cause quickly reversible changes in brain volume that do not reflect permanent loss of neurons (see ‘Antipsychotic deflates the brain’)7.