Change in basal ganglia volume over 2 years in patients with schizophrenia: Typical versus atypical neuroleptics

Objective: For many years, it has been assumed that medications affect brai n chemistry and physiology but not structure. Recent reports suggest that n euroleptic medication changes basal ganglia volume. To explore this possibi lity, the authors assessed for basal ganglia volume change in individuals w ho had their basal ganglia structures delineated and measured on magnetic r esonance scans at the beginning and end of a e-year period and who received neuroleptic medication during this time. Method: The basal ganglia volumes of 23 male patients with schizophrenia spectrum disorders were measured fr om manual traces delineating the caudate and lenticular nucleus on magnetic resonance images at admission and 2 years later. Patients' neuroleptic exp osure was calculated over the 2 years by using a dose-year formula. Results : During the 2-year period, mean basal ganglia volume of patients receiving predominantly typical neuroleptics increased, while the opposite was obser ved for patients receiving mostly atypical neuroleptics. Correlation analys is for the entire group showed a positive relationship between the 2-year e xposure to typical neuroleptic medication and change in basal ganglia volum e and the reverse for exposure to atypical neuroleptics. Conclusions: In th is group, basal ganglia volume increased following exposure to typical neur oleptics and decreased following exposure to atypical neuroleptics.