We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Antipsychotic Medications and Brain Volume Do We Have Cause for Concern?

David A. Lewis, MD
Arch Gen Psychiatry. 2011;68(2):126-127. doi:10.1001/archgenpsychiatry.2010.187.
Text Size: A A A
Published online


Since the initiation of antipsychotic drug therapy for schizophrenia, clinical observations and empirical studies have demonstrated that these medications bring benefit and harm. Consequently, efforts to develop new antipsychotic medications during the past 50 years have been motivated, at least partly, by the desire to enhance the benefit to harm ratio relative to existing medications. In this issue of the Archives, Ho and colleagues1 examine one arm of this ratio by asking whether antipsychotic medications contribute to progressive brain volume reductions in schizophrenia. Individuals early in the course of schizophrenia (n = 211) were treated with antipsychotic medications according to standard clinical practice and followed up longitudinally with clinical assessments and serial magnetic resonance imaging (MRI) scans (between 2 and 5 scans per individual) for a mean of 7 years. The authors found that the amount of exposure to antipsychotic medication predicted decrements in cerebral gray and white matter volumes and increased the volume of the putamen. Illness duration and severity were also associated with smaller brain volume measures, but the relationship between antipsychotic medication use and brain volume remained significant after accounting for the effects of illness severity and duration and substance abuse history. Interestingly, changes in brain volume with time were similar for all classes of antipsychotic medications (ie, typical antipsychotics, atypical [ie, excluding clozapine] antipsychotics, and clozapine).

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

21 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles

Care at the Close of Life: Evidence and Experience
Pharmacologic Management

Care at the Close of Life: Evidence and Experience
Typical Antipsychotic Medications