James H. States1, Clarke D. St Dennis. 1. Adolescent and Young Adult Medicine, Bellevue, Wash.; the College of Pharmacy, Washington State University, Spokane; and the Department of Psychiatry, School of Medicine, University of Washington, Seattle.
Abstract
BACKGROUND: Posttraumatic stress disorder (PTSD) is one of the most prevalent psychiatric disorders in young adults. Early diagnosis and treatment of PTSD are essential to avoid possible long-term neuropsychiatric changes in brain physiology and function. A cardinal symptom of PTSD is chronic sleep disruption, often with recurring nightmares. If untreated, PTSD symptoms often contribute to substance abuse and the development of other comorbid psychiatric disorders. Once PTSD is diagnosed, drug treatment should begin with antidepressant therapy. If antidepressants do not correct the sleep disruption, adjunctive treatment with the atypical antipsychotic olanzapine or other agents should be considered. METHOD: This case series reviews 7 cases of patients with PTSD (DSM-IV criteria) seen in primary care clinics who were successfully treated with olanzapine. In most cases, olanzapine therapy was adjunctive and followed failed treatment with antidepressant monotherapy for sleep disturbances. RESULTS: All patients reported improved sleep with decreased or absent nightmares, as well as improvements in other PTSD symptom clusters. CONCLUSION: Further controlled studies are needed to better characterize and validate this therapeutic indication.
BACKGROUND:Posttraumatic stress disorder (PTSD) is one of the most prevalent psychiatric disorders in young adults. Early diagnosis and treatment of PTSD are essential to avoid possible long-term neuropsychiatric changes in brain physiology and function. A cardinal symptom of PTSD is chronic sleep disruption, often with recurring nightmares. If untreated, PTSD symptoms often contribute to substance abuse and the development of other comorbid psychiatric disorders. Once PTSD is diagnosed, drug treatment should begin with antidepressant therapy. If antidepressants do not correct the sleep disruption, adjunctive treatment with the atypical antipsychotic olanzapine or other agents should be considered. METHOD: This case series reviews 7 cases of patients with PTSD (DSM-IV criteria) seen in primary care clinics who were successfully treated with olanzapine. In most cases, olanzapine therapy was adjunctive and followed failed treatment with antidepressant monotherapy for sleep disturbances. RESULTS: All patients reported improved sleep with decreased or absent nightmares, as well as improvements in other PTSD symptom clusters. CONCLUSION: Further controlled studies are needed to better characterize and validate this therapeutic indication.
Authors: Sandro Galea; Jennifer Ahern; Heidi Resnick; Dean Kilpatrick; Michael Bucuvalas; Joel Gold; David Vlahov Journal: N Engl J Med Date: 2002-03-28 Impact factor: 91.245
Authors: M D De Bellis; M S Keshavan; D B Clark; B J Casey; J N Giedd; A M Boring; K Frustaci; N D Ryan Journal: Biol Psychiatry Date: 1999-05-15 Impact factor: 13.382
Authors: William Berger; Mauro V Mendlowicz; Carla Marques-Portella; Gustavo Kinrys; Leonardo F Fontenelle; Charles R Marmar; Ivan Figueira Journal: Prog Neuropsychopharmacol Biol Psychiatry Date: 2008-12-24 Impact factor: 5.067
Authors: Kevin M Swift; Connie L Thomas; Thomas J Balkin; Emily G Lowery-Gionta; Liana M Matson Journal: J Clin Sleep Med Date: 2022-09-01 Impact factor: 4.324