Olanzapine in the treatment of post-traumatic stress disorder: a pilot study

Because the atypical antipsychotic olanzapine may be efficacious in treatin g post-traumatic stress disorder (PTSD) symptoms, we conducted a 10-week, d ouble-blind, placebo-controlled evaluation in which 15 patients were random ized 2 : 1 to either olanzapine or placebo. The initial dosage was 5 mg / d ay and was titrated to a maximum of 20 mg / day. Eleven patients completed the study, Patients in both groups showed improvement in PTSD symptoms, but no between-group differences in treatment response were observed and a hig h placebo response rate was found. Both treatments were tolerated well, alt hough the olanzapine treatment group had more weight gain. Olanzapine fared no better than placebo in this preliminary study In the treatment of PTSD, The lack of difference between olanzapine and placebo may in part be due t o olanzapine's not being effective in PTSD or, alternatively, a small sampl e size, a high placebo response in certain forms of PTSD and the chronicity of PTSD symptoms in some patients. (C) 2001 Lippincott Williams & Wilkins.