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. 2018 Feb 5;48(2):8-17.
doi: 10.64719/pb.4561.

Characterizing the Effects of Quetiapine in Military Post-Traumatic Stress Disorder

Gerardo Villarreal  1 , Mark B Hamner  1 , Clifford Qualls  1 , José M Cañive  1
Affiliations

Characterizing the Effects of Quetiapine in Military Post-Traumatic Stress Disorder

Gerardo Villarreal et al. Psychopharmacol Bull. .

Abstract

Objectives: A previous randomized placebo-controlled trial in military veterans posttraumatic stress disorder (PTSD) found that quetiapine improved global PTSD symptoms severity, depression and anxiety as well as the re-experiencing and hypearousal clusters. However, it is not known if individual symptoms had a preferential response to this medication. The goal of this study was to analyze the individual symptom response in this group of patients.

Methods: Data from a previous trial was re-analyzed. Each of the of the scale items was analyzed individually using Repeated Measures Analysis of Variance.

Results: Compared to placebo, there was a significant decline in the Clinician-Administered PTSD Scale intrusive memories and insomnia questions. In the Davidson Trauma Scale, greater improvements were observed on irritability, difficulty concentrating, hyperstartle and a trend was observed on avoiding thoughts or feelings about the event. Greater improvements compared with placebo were noted on the Hamilton Depression (HAM-D) middle and late insomnia items. On the Hamilton Anxiety scale (HAM-A), the insomnia item was significantly improved.

Conclusions: Quetiapine demonstrated greater effect than placebo on several symptoms. The strongest response was seen on insomnia, which the highest significance level on the CAPS. The insomnia items of both the HAM-D and HAM-A also demonstrated improvement with quetiapine. These finding indicate quetiapine improved sleep measure. Insomnia can be a difficult problem to treat in PTSD patients, therefore quetiapine should be considered in difficult cases.

Keywords: antipsychotic agents; combat disorders; post-traumatic; psychopharmacology; stress disorders; veterans.

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Figures

Figure 1
Figure 1
Clinician-Administered PTSD Scale (CAPS) for DSM-IV B1 Item, “Intrusive Memories.” Repeated Measures Analysis of Variance (RM ANOVA) Adjusting for Baseline CAPS Score, Using Drug as a Fix Factor and Visit as a Repeated Factor [F = 2.54 (4,240), p = 0.0403]. Figure Displays Least Square Means With Error Bars
Figure 2
Figure 2
Clinician-Administered PTSD Scale (CAPS) for DSM-IV Item D1, “Problems Falling or Staying Asleep.” Repeated Measures Analysis of Variance (RM ANOVA) Adjusting for Baseline CAPS Score, Using Drug as a Fix Factor and Visit as a Repeated Factor [F = 5.11 (4,240), p = 0.0006]. Figure Displays Least Square Means
Figure 3
Figure 3
Davidson Trauma Scale, Item 2, “Distressing Dreams of The Event.” Repeated Measures Analysis of Variance (RM ANOVA) Adjusting for Baseline CAPS Score, Using Drug as a Fix Factor and Visit as a Repeated Factor [F = 5.18 ( 4,240), p = 0.0005]. Figure Displays Least Square Means with Error Bars
Figure 4
Figure 4
Davidson Trauma Scale item 3, “Been Irritable or Had Outbursts of Anger.” Repeated Measures Analysis of Variance (RM ANOVA) Adjusting for Baseline CAPS Score [F = 4.20 (4,240), p = 0.0027]. Figure Displays Least Square Means with Error Bars
Figure 5
Figure 5
Davidson Trauma Scale item 14, “Had Difficulty Concentrating.” Repeated Measures Analysis of Variance (RM ANOVA) Adjusting for Baseline CAPS Score [F = 2.63 (4,240), p = 0.0350]. Figure Displays Least Square Means with Error Bars
Figure 6
Figure 6
Davidson Trauma Scale Item 16, “Been Jumpy or Easily Startled.” Repeated Measures Analysis of Variance (RM ANOVA) Adjusting for Baseline CAPS Score [F = 3.27 (4,240), p = 0.0123]. Figure Displays Least Square Means with Error Bars
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