Risperidone reduces abuse-related PTSD
January 12, 2005
Psychiatry Matters

Risperidone appears to be effective for treating post-traumatic stress disorder (PTSD) in women who have developed the condition as a result of childhood physical, sexual, verbal, or emotional abuse, preliminary study findings suggest.

"The sedating properties of atypical antipsychotics, as well as their ability to reduce cognitive and perceptual distortions in psychosis, suggest that these medications may be effective in alleviating symptoms of PTSD," explain D Bradford Reich and colleagues from McLean Hospital, Belmont, Massachusetts, USA.

They therefore studied the efficacy of risperidone for reducing PTSD symptoms in women aged between 18 and 64 years who had been abused as children.

The participants were randomly assigned to receive either risperidone (n=12), at flexible daily doses of between 0.5 and 8 mg, or placebo (n=9) for 8 weeks.

Patients taking risperidone demonstrated a greater reduction in total scores on the Clinician-Administered PTSD scale, 1-week version, than placebo-treated individuals, with average decreases of 29.6 points and 18.6 points, respectively.

"The difference of more than 50% in change from baseline was strongly, statistically significant," the researchers note in the Journal of Clinical Psychiatry.

Risperidone was particularly associated with reductions in intrusive and hyperarousal symptoms, with scores on these subscales falling by an average of 7.1 points and 12.1 points, respectively, compared with the 3.3 points and 6.3 points seen with placebo.

The average decrease in scores on the avoidant subscale, however, did not differ between the two treatment groups.

There was also no significant difference in the average change in Clinician-Administered PTSD scale, 1-month version total or subscale scores between women taking risperidone and those given placebo.

Risperidone was generally well tolerated, with four participants reporting adverse effects, including sedation, dry mouth, tremor, apathy, and poor concentration, compared with one case of sedation among placebo-treated patients.

"The results of this preliminary study indicate that risperidone is a safe and effective treatment for PTSD related to childhood physical, sexual, emotional, and verbal abuse in women," Reich et al. conclude.

J Clin Psychiatry 2004; 65: 1601-1606