Off-Label Use of Atypical Antipsychotics: An Update
Results: Atypical Antipsychotics for Post-traumatic Stress Disorder
Atypical antipsychotics have been studied as treatment for post-traumatic stress disorder (PTSD). In the effectiveness review, the outcome analyzed was the difference between CAPS scores when compared with placebo. Risperidone was studied as a treatment for PTSD from all causes in 4 studies with a total of 151 patients. In a meta-analysis, the CAPS score was found to be 6.47 points lower with risperidone than with placebo, with the true effect lying in a range from 0.32 to 12.61 points lower. The strength of evidence for the finding is moderate. Three studies with a total of 124 patients with combat-related PTSD showed in a meta-analysis that the CAPS score was 7.95 points lower with risperidone (from 1.06 to 14.84 points lower). The strength of evidence for the finding is moderate. No summary result was produced for studies of abused women, and the strength of evidence for an effect of risperidone is insufficient for that indication. For olanzapine and quetiapine, no summary result was produced because of heterogeneity in studies, and the evidence is insufficient to permit conclusions.
Keywords: antipsychotics | atypical antipsychotics | off-label | second generation | post-traumatic stress | PTSD | risperidone | olanzapine | quetiapine | CAPS
- Maglione M, Ruelaz Maher A, Hu J, et al. Off-Label Use of Atypical Antipsychotics: An Update. Comparative Effectiveness Review No. 43 (Prepared by the Southern California RAND Evidence-based Practice Center under Contract No. HHSA 290-2007-10062-I). Rockville, MD: Agency for Healthcare Research and Quality; September 2011. AHRQ Publication No. 11(12)-EHC087-EF. Available at www.effectivehealthcare.ahrq.gov/offlabelantipsych.cfm.
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