Adjunctive risperidone in the treatment of chronic combat-related posttraumatic stress disorder
Adjunctive risperidone in the treatment of chronic combat-related posttraumatic stress disorder
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DOI：
10.1016/j.biopsych.2004.11.039
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发表时间：
2005-03-01
影响因子：
10.6
通讯作者：
Saunders, CS
中科院分区：
文献类型：
--
作者：
Bartzokis, G;Lu, PH;Saunders, CS
背景：评价利培酮对住院治疗的慢性战斗后应激障碍(PTSD)退伍军人的疗效和安全性。73名受试者自愿参加了这项双盲试验。安慰剂对照研究，包括5周的住院治疗计划和3个月的门诊随访。92%的受试者在稳定的精神药物治疗方案中加入了利培酮。主要的结果衡量标准是临床医生使用的创伤后应激障碍量表(CAPS-TOTAL)及其三个子量表：B(重体验)、C(回避)和D(觉醒)。次要结果为汉密尔顿焦虑量表(HAM-A)和抑郁量表(HAM-D)，阳性和阴性症状量表(PANSS-P)。结果：随机抽取65名受试者，48人完成为期4个月的研究。与安慰剂相比，服用利培酮的受试者在CAPS-TOTAL和CAPS-D子量表以及HAM-A和PANSS-P上的症状改善明显更大。服用利培酮的所有其余指标在数字上都有更大的改善，但差异没有达到统计学意义。利培酮耐受性良好。这些结果表明，辅助性利培酮改善了慢性战斗相关创伤后应激障碍患者的广泛的精神症状。数据支持这样的概念，即典型的抗精神病药物可能具有更广泛的治疗光谱，超出了精神病的治疗。
Background: The efficacy and safety of risperidone was evaluated in veteran patients with chronic combat-related postraumatic stress disorder (PTSD) who were referred to a residential treatment program.Methods. Seventy-three subjects volunteered to participate in this double-blind. placebo-controlled study, which comprised of a 5 week residential program followed by a 3-month outpatient follow-up. Risperidone was added to a stable psychotropic medication regimen in 92% of subjects. Primary outcome measures were the Clinician-Administered PTSD scale (CAPS-total) and its three subscales; B (Re-experiencing), C(Avoidance) and D (Arousal). Secondary outcome measures were the Hamilton Anxiety (HAM-A) and Depression (HAM-D) scales, and the Positive and Negative Syndrome Scale, Positive Subscale (PANSS-P).Results: Sixty-five subjects were randomized and 48 completed the 4-month study. Significantly greater improvement in symptoms was observed in subjects receiving risperidone compared to placebo on the CAPS-total and CAPS-D subscale scores and also on HAM-A and PANSS-P. Numerically greater improvements in all the remaining measures were noted with risperidone, but the differences did not reach statistical significance. Risperidone was well tolerated.Conclusions. These results suggest that adjunctive risperidone improved a broad range of pychiatric symptoms in patients with chronic combat-related PTSD. The data support the concept that a typical antipsychotic medications may have a wider therapeutic spectrum that goes beyond the treatment of psychosis.