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Quetiapine monotherapy effective for PTSD

Quetiapine monotherapy, an atypical antipsychotic approved for treatment of schizophrenia, bipolar disorder and bipolar depression, was effective for PTSD, according to recent findings.

“Two selective serotonin reuptake inhibitor antidepressants (SSRIs), sertraline and paroxetine, are the only agents approved by the FDA for treatment of PTSD. However, many chronic PTSD patients, especially male combat veterans, have a limited or no response to antidepressants,” Gerardo Villarreal, MD, of the Raymond G. Murphy VA Medical Center, Albuquerque, New Mexico, and colleagues wrote.

To assess efficacy of quetiapine monotherapy for PTSD, researchers randomly assigned 80 individuals with PTSD to receive quetiapine or placebo for 12 weeks. After a 1-week placebo run-in, participants received 25 mg of quetiapine daily. Dosage increased to a maximum of 800 mg. The average dose was 258 mg.

Individuals who received quetiapine had significantly greater reductions in Clinician-Administered PTSD Scale (CAPS) total scores (P = .03), re-experiencing (P = .0004) and hyperarousal scores (P = .007), compared with placebo.

Individuals who received quetiapine also had greater improvements on the Davidson Trauma Scale (P = .03), Clinical Global Impressions (CGI) severity and improvement ratings (P = .01), Positive and Negative Syndrome Scale (PANSS) positive symptom (P = .002) and global psychopathology subscales (P = .005), Hamilton Anxiety Rating Scale (P = .01) and Hamilton Depression Rating Scale scores (P = .02), compared with placebo.

Adverse events were generally mild and expected based on previous findings of quetiapine, according to researchers.

Safety measures did not differ between treatment groups.

“These initial results are encouraging because chronic military PTSD is often refractory to a variety of treatments, but the findings need replication. We hope that more studies will be conducted to better define the role of quetiapine and other atypical antipsychotics in patients suffering from PTSD,” the researchers wrote. “We would like to point out that we finished the study in 2008, but we feel our findings continue to be relevant since atypicals are often prescribed in PTSD and there are still relatively few studies testing their efficacy in this condition.” – by Amanda Oldt

Disclosure: Villarreal reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.