engleski

Pharmacotherapy of treatment-resistant combat-related posttraumatic stress disorder with psychotic features,

Aim: To assess retrospectively the clinical effects of typical (fluphenazine) or atypical (olanzapine, risperidone, quetiapine) antipsychotics were analyzed retrospectively in three open clinical trials in male Croatian war veterans with chronic combat-related 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 the 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, fluphenazine, olanzapine, risperidone, or quetiapine, given as a monotherapy, significantly decreased the scores listed in trauma reexperiencing, avoidance, and hyperarousal subscales 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, in PTSD patients. Conclusion: PTSD and psychotic symptoms were significantly reduced after monotherapy with typical or atypical antipsychotics. Psychotic symptoms commonly occur in combat-related PTSD, and therefore the use of antipsychotic medication seems to offer another approach to treat a psychotic subtype of combat-related PTSD resistant to previous antidepressant treatment.

Combat-related Posttraumatic Stress Disorder; War veterans; Psychotic features; 6-weeks treatment; Fluphenazine; Atypical Antipsychotics; Olanzapine; Risperidone; Quetiapine

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