Risperidone for post-traumatic combat nightmares: a report of four cases

Area of Science:

• Psychiatry
• Pharmacology
• Combat Psychiatry

Background:

• Post-traumatic stress disorder (PTSD) is a significant concern for combat veterans and active duty soldiers.
• Combat-related nightmares are a distressing symptom of PTSD, impacting quality of life.
• Effective pharmacological interventions for PTSD combat nightmares are needed.

Observation:

• A case series evaluated the efficacy of low-dose risperidone in four individuals with combat-related PTSD and nightmares.
• Participants included active duty soldiers and veterans with severe medical and mental health conditions.
• Nightmare response was categorized as no response, partial response, or full response (cessation of recall).

Findings:

• Two participants experienced reduced nightmare frequency and severity with 1 mg of risperidone nightly.
• One veteran with high blood alcohol levels showed a partial response to 3 mg of risperidone.
• All four participants achieved complete cessation of nightmares at 2 mg nightly, without active substance abuse, which persisted despite changes in other medications.

Implications:

• Low-dose risperidone (1-3 mg) may be an effective treatment for reducing or eliminating combat nightmares in PTSD.
• Risperidone's efficacy was observed even when used alongside other psychotropic medications.
• Further research is warranted to explore risperidone's role in managing PTSD combat nightmares.