Neuroleptic use in the treatment of Post-Traumatic Stress Disorder

Background. There have been few studies of the use of neuroleptics in the t reatment of Post-Traumatic Stress Disorder (PTSD). This study uses data fro m two large outcome studies to: (1) examine demographic and treatment chara cteristics associated with neuroleptic prescription in the treatment of PTS D, and (2) compare the outcomes of neuroleptic-treated patients with those not receiving neuroleptics. Methods. A secondary analysis of an observation al outcome study of 831 inpatients and 554 outpatients tall males) receivin g treatment at the VA for combat-related PTSD was performed. Patients were classified as having either received neuroleptics during the following year or not. Sociodemographic characteristics, treatment and medication history and detailed information about PTSD symptoms were obtained at baseline and 12 months. First, the two groups were compared with respect to the demogra phic and clinical variables. We then conducted a series of separate paired t-tests to determine whether there was significant improvement from baselin e to follow up in each group and a series of analyses of covariance that co mpared outcomes in the two groups, adjusting for baseline differences. Resu lts. Approximately 9% of inpatients and 10% of outpatients were treated wit h neuroleptics. Patients who received neuroleptics had both more psychiatri c and more social impairment. They also demonstrated more severe PTSD (espe cially intrusive symptoms) despite having similar combat exposure. Outcomes after one year for the group treated with neuroleptics were not significan tly different from the group not: treated with neuroleptics. Conclusions. N euroleptic use in the treatment of PTSD is targeted at more seriously ill p atients and was not associated with substantial improvement.