Evidence for short term application ONLY, of anti-psychotics :overuse prevention
https://www.psychiatrictimes.com/view/antipsychotics-and-shrinking-brain
"Animal studies can begin to address these issues. A study in monkeys conducted by David Lewis’ group prompted concern about antipsychotic neurotoxicity several years ago. Monkeys treated with haloperidol and olanzapine for 17 to 27 months lost roughly 10% of their total brain volume, both gray and white matter, compared with sham-treated controls, with greatest volume loss in frontal and parietal cortex.3 Further examination revealed a reduction in the number of glial cells4; a similar postmortem finding in schizophrenia brains previously had been attributed to the illness. However, this study included only 6 monkeys per treatment group and did not provide information on the time course of neurotoxic changes.
Other studies suggest that antipsychotic effects on brain volume may occur rapidly. For example, Vernon and colleagues5 found a significant loss of frontal cortical volume after only 8 weeks in rats given haloperidol or olanzapine.
Evidence of the rapidity at which antipsychotics can affect brain volume in humans was recently provided by Tost and associates.6 These investigators found a significant, reversible decrease in striatal volume in healthy subjects within 2 hours after they were treated intravenously with haloperidol. Loss of striatal volume powerfully predicted neurological adverse effects.
Taken together, these studies suggest that antipsychotics may contribute to early gray matter loss and, later in the course of treatment, to white matter loss. These effects may be dose-related and probably are not prevented by the use of second-generation agents. This argues for minimizing antipsychotic exposure both acutely and long-term. However, we are left with the additional dilemma that a longer duration of untreated psychosis (DUP) may also be neurotoxic. Longer DUP has been associated with poorer symptomatic and functional outcomes7 as well as brain volume loss.8 Studies of DUP have their own methodological limitations and controversies, but they should serve to warn us that the rapid control of psychosis may also be important.
Psychosis at any phase of the illness can be extremely distressing, disruptive, and potentially dangerous for patient and family. New approaches for early intervention are needed and, with existing drugs, the potential for neurotoxicity must be weighed against short-term and long-term clinical gains. In the meantime, clinicians should avoid using antipsychotics unnecessarily and, when needed, use the lowest effective dose."