慢性军事服务相关PTSD抗抑郁药耐药症状的辅助RISPERIDONE治疗:一个随机试验
John H Krystal1, Robert A Rosenheck, Joyce A Cramer
1Clinical Neuroscience Division, Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System, West Haven, USA. john.krystal@yale.edu
JAMA
|August 5, 2011
概括
这项研究发现,抗精神病药物RISPERIDONE在治疗耐药性创伤后应激障碍 (PTSD) 的退伍军人中没有显著改善症状. 与安慰剂相比,risperidone的不良事件更常见.
科学领域:
- 精神病学是一个精神病学.
- 药理学 药理学是指药理学的学科.
- 临床心理学 临床心理学
背景情况:
- 血清素再吸收抑制剂 (SRIs) 是FDA批准的治疗创伤后应激障碍 (PTSD) 的唯一药物.
- 许多患有PTSD的患者表现出对SRI的治疗耐药性,需要使用替代治疗策略.
研究的目的:
- 评估二代抗精神病药物RISPERIDONE作为慢性军事相关PTSD的辅助治疗的疗效.
- 评估RISPERIDONE对PTSD症状,抑郁,焦虑和SRI耐药退伍军人的生活质量的影响.
主要方法:
- 一个为期6个月的随机,双盲,安慰剂控制,多中心试验,涉及247名退伍军人患有与军事有关的PTSD.
- 参与者除了现有的药物和心理治疗外,还接受了RISPERIDONE (每天最多4毫克) 或安慰剂.
- 主要结果是通过临床医生管理的PTSD尺度 (CAPS) 来衡量;次要结果包括抑郁症,焦虑和生活质量评估.
主要成果:
- 与安慰剂相比,Risperidone没有导致PTSD症状的统计显著减少 (CAPS得分的平均差异:3.74,P = .11).
- 随着RISPERIDONE治疗,没有观察到抑郁症,焦虑或生活质量方面的显著改善.
- 不良事件,包括体重增加,疲劳,嗜睡和唾液过多,在RISPERIDONE组中更为频繁.
结论:
- 六个月的RISPERIDONE治疗在SRI耐药的退伍军人中没有有效地减少PTSD症状.
- 里斯比里增加似乎不是一个有益的策略,为这个患者群体.
- 需要进一步的研究来确定有效的治疗SRI抗性PTSD.
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