Question:
I’m wondering if anyone has experienced what happened to me. I suffered brain damage from taking neuroleptic medication for 4 months 16 years ago (I’m 38 now) in order to combat obsessive compulsive disorder and depression simultaneously. To summarize a story I could make quite long and boring, it wiped out most of my emotions of a passionate kind. I don’t feel alive in the sense that life is worth living. In fact, I experience a phenomenon that I think must be very unique. I can actually ‘feel’ the damage in the sense that a path going from approximately the back of my head down to my chest feels ‘hollow’. I tried to think of what would cause this feeling. It seems very likely that if in fact the part of my brain which produces the visceral types of feelings were destroyed or severely damaged, the visceral nerve tracts leading from this area down to the organs such as the heart and stomach would eventually atrophy from lack of use. In fact the feeling came on rather gradually after I discontinued the drug and after my initial emotional loss. I’ve told several psychiatrists about this and none have said they’ve encountered this. I know that this phenomenon must be very rare. So I was trying to figure out what could be so special about me. The thing that sticks in my mind is the unbelievably extreme nature and duration of the obsessions I suffered. Normally it seems almost anyone would succumb to using some kind of medication to alleviate this. But the nature of my obsessions were that I obsessed about any type of unnatural agent somehow ‘damaging’ or ‘making impure; the pristine state of my natural mind. I know that extreme distress damages the brain. I’m thinking that my brain was damaged or primed in some way which made it very susceptible to having an area of the brain destroyed by a neuroleptic drug.

Anyway my current emotional state is such that I feel dead emotionally and tend to react emotionally blankly or like a robot in social encounters, though I counteract this by acting very well. I honestly can’t think of a satisfying reason why I should live. I know that I wouldn’t ever actually end my life voluntarily , but still I have such a meaningless existence now. I would feel pretty desperate if not for the fact that the nature of the damage is that it wiped out my ability to feel that kind of emotion, it seems. I’d really like to hear from someone who’s experienced this.

Answer: A study was conducted using MRI measurements of the brains of patients who initially had under 12 weeks of lifetime exposure to neuroleptics, and compared these with measurements taken after 18 months of treatment. The researchers found noticeable abnormal enlargement of a specific region of the brain. The authors concluded that "enlargement occurs early in the course of treatment in young first-episode schizophrenic patients." It was known prior to this study that chronically treated patients had increased volumes in this portion of their brains, but it had been thought this was due to the "disease" and not the treatment.

Using MRI imaging, a study was published in 1998 that monitored changes in the size of the basal ganglia and thalamic regions of the brain as patients were treated with neuroleptic drugs. Treatment by neuroleptics abnormally increased the area of both regions. These researchers reported that increased size of these portions of the brain is associated with greater severity of symptoms.