PSYCHIATRY UPDATE 2017
SOLVING CLINICAL CHALLENGES, IMPROVING PATIENT CARE
Beyond Efficacy and Effectiveness: Neurotoxicity vs Neuroprotection are the REAL Differences Between Typical and Atypical Antipsychotics
Henry A. Nasrallah, MD, Saint Louis University School of Medicine
Dr. Nasrallah discussed the difference between typical vs atypical antipsychotics—the former is neurotoxic, the latter is neuroprotective. Because patients with schizophrenia experience a loss of brain volume and cerebral grey matter and increased lateral ventricle volume, consider atypical antipsychotics for their neuroprotective properties.
In several studies typical antipsychotics, such as haloperidol, have been found to be neurotoxic, causing apoptosis and decreased cell viability. Atypical antipsychotics may be beneficial for patients with schizophrenia because they:
,- stimulate production of new brain cells and increase neurotropic factors
- reverse PCP-induced changes in gene expression and loss of dendritic spines in the frontal cortex
- are neuroprotective against ischemic stroke damage
- prevent oligodendrocyte damage caused by interferon gamma-stimulated microglia.
