engleski

Quetiapine treatment in an open trial in combat related posttraumatic stress disorder with psychotic features

Patients with combat related posttraumatic stress disorder (PTSD) with psychotic features frequently fail to respond to antidepressants. We have previously shown that these patients improved significantly after monotherapy with atypical antipsychotics, olanzapine or risperidone. We investigated the clinical outcome of another atypical antipsychotic, quetiapine, in a large group of well characterized male war veterans with combat related PTSD with psychotic features, in a naturalistic study. Male war veterans (N=53) with DSM-IV-diagnosed PTSD with psychotic symptoms, completed 8-weeks of inpatient treatment (from December 2002 to January 2005) with quetiapine (25-400 mg/day). The reductions from baseline to endpoint (8 weeks) in the total and subscale scores on the Clinician-Administered PTSD Scale, and the increase in five-point Clinical Global Impression-Improvement Scale (CGI-I) were the primary, and in Positive and Negative Syndrome Scale (PANSS) the secondary outcome measures. CGI-Severity of Illness scale (CGI-S) was used to assess the clinical improvement. Drug-Induced Extrapyramidal Symptoms scale recorded adverse effects. Two, 6 and 8 weeks of treatment with quetiapine significantly reduced (p<.0000 ; repeated measures analysis of variance and Scheffe&#8217; s test) total and the subscales scores (a fall between 39.2-71.2%) on the CAPS, PANSS, and CGI-S scales, in patients with psychotic PTSD. The preliminary results indicate that 8-weeks of monotherapy with quetiapine reduced the majority of the psychotic and trauma-related symptoms in psychotic PTSD patients. Our present and previous data suggest that treatment-resistant psychotic PTSD patients may improve after taking atypical antipsychotics.

combat related posttraumatic stress disorder; quetiapine; psychotic symptoms; war veterans; 8-weeks open trial; monotherapy

doi:10.1017/S1461145706006596