Treatment of Post-Traumatic Stress Disorder Nightmares at a Veterans Affairs Medical Center
Treatment of Post-Traumatic Stress Disorder Nightmares at a Veterans Affairs Medical Center
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DOI：
10.3390/jcm5120117
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发表时间：
2016-12-01
影响因子：
3.9
通讯作者：
Lutgens, BrianW.
中科院分区：
文献类型：
--
作者：
Detweiler, Mark B.;Pagadala, Bhuvaneshwar;Lutgens, BrianW.
药物治疗PTSD的有效性已经得到了很好的研究，但药物的有效性还有待进一步研究。专门用于创伤后应激障碍（PTSD）噩梦的NS不太为人所知。这篇回顾性的图表回顾研究了在一家退伍军人事务医院实际治疗PTSD噩梦中使用的各种药物的疗效。从2009年到2013年，对弗吉尼亚州塞勒姆退伍军人事务医疗中心（VAMC）的记录进行了检查，以检查比较中使用的实际治疗的疗效。继续三篇主要评论文章中建议的治疗方法。最终样本包括327名患者和478项单独的药物试验，涉及21种单独的药物和13种不同的药物组合。最常用的三种药物是哌唑嗪（107项试验）、利培酮（81项试验）和喹替卡松（72项试验）。五种药物有20次或更多的试验取得了成功的结果>50%的试验（部分至完全停止噩梦）：利培酮（77%，1.0-6.0 mg）、可乐定（63%，0.1-2.0 mg）、奎替鲁（50%，12.5-800.0 mg）、米氮平（50%，7.5-30.0 mg）和特拉唑嗪（64%，50.0-300.0 mg）。值得注意的是，奥氮平（2.5-10.0）在所有5项处方试验中均获得成功（完全缓解）。根据临床结果，利培酮、可乐定、特拉唑嗪和奥氮平的使用需要在临床对照试验中作为专门用于PTSD噩梦的药物进行额外的研究。
The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio. ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis. on with treatments suggested in three main review articles. The final sample consisted of 327 patients and 478 separate medication trials involving 21 individual medications plus 13 different medication combinations. The three most frequently utilized medications were prazosin (107 trials), risperidone (81 trials), and quetiapine (72 trials). Five medications had 20 or more trials with successful results (partial to full nightmare cessation) in >50% of trials: risperidone (77%, 1.0-6.0 mg), clonidine (63%, 0.1-2.0 mg), quetiapine (50%, 12.5-800.0 mg), mirtazapine (50%; 7.5-30.0 mg), and terazosin (64%, 50.0-300.0 mg). Notably, olanzapine (2.5-10.0) was successful (full remission) in all five prescription trials in five separate patients. Based on the clinical results, the use of risperidone, clonidine, terazosin, and olanzapine warrants additional investigation in clinically controlled trials as medications prescribed specifically for PTSD nightmares.