Rationale for iloperidone in the treatment of posttraumatic stress disorder

Multiple controlled efficacy studies are available to support the use of psychotropic medications in the treatment of posttraumatic stress disorder symptoms. Iloperidone, a recently approved atypical antipsychotic, has yet to be evaluated in such a manner. This unique agent has the highest affinity of all antipsychotics toward alpha-1 receptors. Antagonism of central nervous system alpha-1 receptors has been implicated in certain aspects of posttraumatic stress disorder, as evidenced by the beneficial role of prazosin in treating nightmares. Additional reduction in hypervigilance may occur through blockade of dopamine receptor D2 and serotonin receptors in the 5-HT2 family. Further investigation of iloperidone is warranted in the treatment of patients with posttraumatic stress disorder due to its unique receptor binding profile.