There are limited treatment options for tens of thousands of veterans suffering from PTSD who do not respond to anti-depressants, the first line of defense against the debilitating condition, according to authors of the study published Aug. 3 in the Journal of the American Medical Association.
“There is not a lot of evidence to guide psychiatrists caring for patients with treatment-resistant PTSD,” said John Krystal, Robert L. McNeil Jr. Professor of Psychiatry at Yale School of Medicine and director of the Clinical Neuroscience Division of the VA National Center for PTSD, based in West Haven (is this correct?)
Veterans suffering from PTSD are usually prescribed anti-depressants such as Zoloft and Paxil, which boost levels of the neurotransmitter serotonin. However a substantial number of those suffering from chronic PTSD – particularly men and those suffering from long-term illness – do not get relief from symptoms. These patients are often prescribed second-generation anti-psychotics such as risperidone used to treat schizophrenia and bipolar disorder.
The study followed 267 volunteers, mostly male Vietnam War combat veterans enrolled at 23 VA medical centers, who either received risperidone or a placebo in addition to treatment with anti-depressants. About 20 percent in both groups reported relief from symptoms, suggesting these improvements were not due to the drug.
Krystal stressed that there were not enough veterans in the study with high levels of paranoia and psychosis to assess whether risperidone helped with those symptoms.
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