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Ho BC, Andreasen NC, Ziebell S, Pierson R, Magnotta V. Long-term antipsychotic treatment and brain volumes: a longitudinal study of first-episode schizophrenia. Arch Gen Psychiatry . 2011 Feb ; 68(2):128-37. PubMed Abstract

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Comment by:  Jeffrey Lieberman, SRF Advisor
Submitted 13 February 2011 Posted 14 February 2011
  I recommend this paper

The report by Ho et al. and commentary by Lewis illustrate the complexity of disentangling disease from treatment effects in evaluating the pathology of schizophrenia. This potentially confounded relationship has previously emerged in various lines of investigation such as evaluating the DA hypothesis of schizophrenia by measuring D2 receptor density in postmortem tissue.

Reductions in gray matter and increases in ventricular and subarachnoid space volume have been reported extensively in imaging and postmortem studies, including from before the introduction of antipsychotic drugs. Consequently, the neuropathology of schizophrenia, at least in part, is likely due to illness-related effects apart from pharmacologic treatment if not directly from disease pathophysiology. The study by Ho et al. suggests that the brain structural pathology is compounded, if not caused, by drug effects.

There are several limitations to the nature of the evidence that supports this conclusion. The first is the inherent, and potentially confounded, relationship between illness severity and...  Read more

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