Pharmacotherapy of Treatment-resistant Combat-related Posttraumatic Stress Disorder with Psychotic Features

Pivac, Nela; Kozarić-Kovačić, Dragica
June 2006
Croatian Medical Journal;2006, Vol. 47 Issue 3, p440
Academic Journal
Aim To assess retrospectively the clinical effects of typical (fluphenazine) or atypical (olanzapine, risperidone, quetiapine) antipsychotics in three open clinical trials in male Croatian war veterans with chronic combat-related posttraumatic stress disorder (PTSD) with psychotic features, resistant to previous antidepressant treatment. Methods Inpatients with combat-related PTSD were treated for 6 weeks with fluphenazine (n = 27), olanzapine (n = 28), risperidone (n = 26), or quetiapine (n = 53) as a monotherapy. Treatment response was assessed by the reduction in total and subscales scores in the clinical scales measuring PTSD (PTSD interview and Clinician-administered PTSD Scale) and psychotic symptoms (Positive and Negative Syndrome Scale). Results After 6 weeks of treatment, monotherapy with fluphenazine, olanzapine, risperidone, or quetiapine in patients with PTSD significantly decreased the scores listed in trauma reexperiencing, avoidance, and hyperarousal subscales in the clinical scales measuring PTSD, and total and subscales scores listed in positive, negative, general psychopathology, and supplementary items of the Positive and Negative Syndrome Scale subscales, respectively (P<0.001). Conclusion PTSD and psychotic symptoms were significantly reduced after monotherapy with typical or atypical antipsychotics. As psychotic symptoms commonly occur in combat-related PTSD, the use of antipsychotic medication seems to offer another approach to treat a psychotic subtype of combat-related PTSD resistant to previous antidepressant treatment.


Related Articles

  • Antidepressant Usage in the Canadian Forces. Gutschi, L. Maria; Vaillancourt, Régis; Boddam, Randy // Military Medicine;Feb2006, Vol. 171 Issue 2, p107 

    This study was performed to evaluate the use of antidepressant medications among Canadian Forces (CF) memhers. A retrospective chart review was undertaken at seven CF bases for members who received antidepressant medications during a 6-month period. Data were collected on doses, duration, and...

  • Travma Sonrası Stres BozukluÄŸu ve Farmakoterapisi. Karamustafalıoğlu, Oğuz; Bozkurt, Sibel // Klinik Psikofarmakoloji Bulteni;Mar2009 Supplement, Vol. 19, pS94 

    Introduction: Post-traumatic stress disorder (PTSD) is one of the major psychiatric disorders and tends to have a chronic course and to cause functional impairment. Treatment consists of various pharmacologic and psychosocial interventions because of symptom diversity and other comborbid...

  • Ziprasidone therapy for post-traumatic stress disorder. Siddiqui, Zakaria; Marcil, William A.; Bhatia, Subhash C.; Ramaswamy, Sriram; Petty, Frederick // Journal of Psychiatry & Neuroscience;Nov2005, Vol. 30 Issue 6, p430 

    We describe the cases of 2 men with chronic combat-induced post-traumatic stress disorder (PTSD) who benefited from therapy with ziprasidone. They did not have active psychotic symptoms. Both the patients had a history of inadequate response to previous trials of different psychotropic agents....

  • Atypical antipsychotics often prescribed for PTSD. Zolezzi, Monica // New Zealand Doctor;6/5/2013, p36 

    The article provides information on the use of atypical antipsychotics for the treatment of post-traumatic stress disorder (PTSD). It mentions that antipsychotics have been revealed to be helpful in lessening the re-experiencing cluster of symptoms, the cluster that indicates resistance to...

  • Neuroleptic Use in the Treatment of Post-Traumatic Stress Disorder. Sernyak, Michael J.; Kosten, Thomas R.; Fontana, Alan; Rosenheck, Robert // Psychiatric Quarterly;Sep2001, Vol. 72 Issue 3, p197 

    Background. There have been few studies of the use of neuroleptics in the treatment of Post-Traumatic Stress Disorder (PTSD). This study uses data from two large outcome studies to: (1) examine demographic and treatment characteristics associated with neuroleptic prescription in the treatment of...

  • Treating Stress in Patients and in Europe. O'Donnell, Peter // Applied Clinical Trials;Jun2009, Vol. 18 Issue 6, p34 

    The article focuses on the guideline from the European Medicines Agency (EMEA) for studies in post-traumatic stress disorder (PTSD). Drug treatment options for PTSD include antidepressants and antipsychotics but only sertraline and paroxetine are allowed. The guideline requires patients to be...

  • Posttraumatic stress disorder in combat veterans. Lawson, Nicole R. // JAAPA: Journal of the American Academy of Physician Assistants (;May2014, Vol. 27 Issue 5, p18 

    Posttraumatic stress disorder (PTSD) affects up to 18% of combat veterans, many of whom will seek care from clinicians outside the military healthcare system. This article reviews the epidemiology, risk factors, symptoms, diagnosis, treatment, and referral options for PTSD so that PAs in primary...

  • Effects of paroxetine on PTSD-like symptoms in mice. Bentefour, Yassine; Bennis, Mohamed; Garcia, René; M'hamed, Saadia // Psychopharmacology;Jul2015, Vol. 232 Issue 13, p2303 

    Rationale: After exposure to a severe traumatic event, avoidance, fear sensitization, and increased anxiety are among features that can persist over time in people developing posttraumatic stress disorder (PTSD). Basic research on treatment interfering with these symptoms can provide insights to...

  • Down and out. Bromley, Lisa A. // Canadian Family Physician;Sep2007, Vol. 53 Issue 9, p1527 

    In this article, the author discussed how her postpartum depression changed her to become a better person. She says that she consulted a psychotherapist, joined a peer-support group and found that her depression was rooted from post-traumatic stress during childhood, and through the therapy, she...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics