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 ......
Letters to the Editor |

Is Olanzapine a Brain-Sparing Medication?

Ridha Joober, MD, PhD; Norbert Schmitz, PhD; Ashok Malla, MD; Sarojini Sengupta, PhD; Sherif Karma, MD
Arch Gen Psychiatry. 2006;63(11):1292. doi:10.1001/archpsyc.63.11.1292.
Text Size: A A A
Published online


Lieberman et al1 reported a significant decrease in whole-brain gray matter in patients diagnosed with a first episode of schizophrenia spectrum disorders treated with haloperidol but not in those treated with olanzapine. Although Lieberman et al took into consideration several possible confounding factors, weight gain induced by neuroleptics was not accounted for. In a previous study, using a sample overlapping with the present one, it was shown that patients treated with olanzapine gained significantly more weight compared with those treated with haloperidol.2 In view of some evidence showing that brain ventricles and brain volume could be affected by the overall body weight3 and nutritional status,4 controlling for weight gain may be important. This may be relevant since patients treated with haloperidol had, on average, a longer duration of illness, which may be associated with more protracted poor nutritional habits. In fact, if we consider only measurements from weeks 12, 24, and 52 (Figure 2 of the Lieberman et al article), the slopes of whole-brain gray matter decrease in both groups are parallel, indicating that the dynamic change of gray matter volume is similar over time. The difference of gray matter in week 12 between the 2 groups may reflect a general nutritional difference rather than a specific effect of olanzapine on counteracting any putative intrinsic pathological process related to schizophrenia. In addition, the fact that patients treated with olanzapine gained gray matter at week 12 is not compatible with the hypothesis of slowing a putative atrophic effect of the disease but rather with other mechanisms of action of olanzapine that may be related to its effects on body mass. In fact, a formal test for differences in the course of gray matter loss over time could have been provided in the form of treatment × time of assessment interaction (excluding week 104 because of small sample sizes).


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.

2 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.