Abstract
Imaging studies among schizophrenic patients reveal brain structural alterations. These alterations are present at the beginning of the disease and they can also undergo further progression. The most characteristic changes are: lateral ventricular enlargement and decreased grey matter volume of specifi c areas, mostly in the superior temporal gyrus and in the middle temporal area (nucleus amygdaloideum, hippocampus, parahippocampal gyrus). Less repeatable are results of studies of decreased volumes of frontal and parietal brain lobes. Psychotropic drugs are believed to modulate these changes. The most common alteration after typical antipsychotic drugs is enlargement of basal nuclei. Atypical antipsychotic drugs may cause lesser decrease of grey matter volume, what is visible along with disease progression. Some studies even show increased volume of grey matter in some brain structures, rather after short-term atypical antipsychotic drugs therapy. On the other hand other data confi rm correlation of antipsychotic treatment (particularly long-term treatment) with decrease of grey matter volume and lateral ventricular enlargement. It is also diffi cult to differentiate between antipsychotic drugs infl uence and consequences of the disease process. Second generation antipsychotics have some properties indicating their neuroprotective effects, and classical antipsychotics may exhibit neurotoxic effects. Time of treatment is also an important factor – long term observation of treatment may lead to completely different effects than short term observation. Prospective studies among patients in the fi rst episode of treatment so far did not provide evidence of specifi c antipsychotic drugs effects.