Adjunctive risperidone treatment and sleep symptoms in combat veterans with chronic PTSD
Adjunctive risperidone treatment and sleep symptoms in combat veterans with chronic PTSD
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DOI：
10.1002/da.20187
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发表时间：
2006-01-01
影响因子：
7.4
通讯作者：
Mellman, Thomas A.
中科院分区：
文献类型：
--
作者：
David, Daniella;De Faria, Ludmila;Mellman, Thomas A.
睡眠障碍是创伤后应激障碍（PTSD）的核心症状，通常对治疗有抵抗力。最近在PTSD中使用非典型抗精神病药物的一个原因似乎是它们对睡眠的影响。研究目的是（1）初步评价连续性利培酮对睡眠的影响，（2）评价睡眠日记与更标准的回顾性睡眠评估的使用。这是一项在男性退伍军人中进行的试验性、开放标签、12周、灵活剂量的利培酮试验，主要诊断为慢性、战斗相关的PTSD，对当前药物有部分反应。在基线时进行诊断性访谈，并在基线和6周和12周时获得PTSD评分。在基线和6周时获得自我报告的睡眠测量结果，包括早晨日志。17例患者完成了至少6周的试验。睡眠障碍的总体评分有所改善。觉醒频率的变化和与创伤有关的梦的减少仅通过早晨日志评估明显。夜间觉醒频率来自睡眠日志，而不是从匹兹堡睡眠质量指数（PSQI）显着下降。PSQI噩梦项目没有变化;然而，睡眠日志数据表明，6周时创伤性梦境的比例降低。初步结果表明，利培酮可能有益于与慢性PTSD相关的睡眠障碍。前瞻性日志可能比回顾性尺度对变化更敏感。
Sleep disturbances are core symptoms of posttraumatic stress disorder (PTSD) and are often resistant to treatment. One reason for the recent use of atypical antipsychotics in PTSD appears to be their effects on sleep. Study objectives were (1) to evaluate preliminarily the sleep effects of adjunctive risperidone, and (2) to evaluate the use of sleep diaries versus the more standard retrospective sleep assessments. This was a pilot, open-label, 12-week, flexible-dose trial of adjunctive rispetidone in male veterans with a primary diagnosis of chronic, combat-related PTSD, partially responsive to current medications. Diagnostic interviews were administered at baseline, and PTSD ratings were obtained at baseline and at 6 and 12 weeks. Self-report sleep measures, including morning logs, were obtained at baseline and 6 weeks. Seventeen patients completed at least 6 weeks of the trial. Global ratings of sleep disturbance improved. Changes in frequency of awakenings and reductions in trauma-related dreams were only evident via morning log assessments. Nighttime awakening frequency derived from the sleep logs but not from the Pittsburgh Sleep Quality Index (PSQI) decreased significantly. There were no changes in the PSQI nightmare item; however, sleep log data indicated a reduced proportion of traumatic dreams at 6 weeks. Preliminary results suggest that adjunctive risperidone may benefit sleep disturbances associated with chronic PTSD. Prospective logs may be more sensitive to change than are retrospective scales.