Risperidone in Psychotic Combat-Related Posttraumatic Stress Disorder: An Open Trial
J Clin Psychiatry 2005;66(7):922-927
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Rationale: Psychotic symptoms that
frequently occur in combat-related posttraumatic stress disorder
(PTSD) complicate its pharmacotherapy. We hypothesized that war
veterans with psychotic PTSD, resistant to prior antidepressant
treatment, would respond well to 6 weeks of treatment with the
atypical antipsychotic risperidone, given as a monotherapy.
Method: Twenty-six male war veterans with
psychotic PTSD (DSM-IV) completed the 6-week inpatient treatment
with risperidone (2-4 mg/day) during the period from November
1999 through December 2002. The primary outcome measure was
change from baseline to endpoint (6 weeks) in Positive and
Negative Syndrome Scale (PANSS) total and subscale scores.
Secondary outcome measures were changes in PTSD Interview
(PTSD-I) and Clinical Global Impressions-Severity of Illness
scale (CGI-S) total and subscale scores. Clinical improvement was
assessed by CGI-S, CGI-Improvement scale, and Patient Global
Impression of Improvement scale, while adverse events were
recorded by Drug-Induced Extrapyramidal Symptoms Scale.
Results: Treatment with risperidone for either 3
or 6 weeks in an open trial significantly reduced total and
subscales scores on the PANSS and on the PTSD-I and CGI-S when
compared to baseline scores in patients with psychotic PTSD.
Conclusion: Our preliminary data from the open
trial indicate that risperidone decreased most of the psychotic
and PTSD symptoms. Psychotic PTSD patients, unresponsive to
antidepressant treatment, improved significantly after treatment
for either 3 or 6 weeks with risperidone.