Risperidone in psychotic combat-related posttraumatic stress disorder: an open trial.
BACKGROUND
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.


METHODS
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.


CONCLUSIONS
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.
Kozarić-Kovacić
Dragica
D
National Centre for Psychotrauma, Department of Psychiatry, Dubrava University Hospital, Zagreb, Croatia.
Pivac
Nela
N
Mück-Seler
Dorotea
D
Rothbaum
Barbara Olasov
BO
D000328:Adult; D017109:Akathisia, Drug-Induced / Q000209:etiology; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001480:Basal Ganglia Diseases / Q000139:chemically induced; D003130:Combat Disorders / Q000188:drug therapy*; D017523:Croatia; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000188:drug therapy*; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy*; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology; D014857:Warfare
D014150:Antipsychotic Agents; D018967:Risperidone