Operational Stress Injury Clinic, St, Joseph's Health Care London-Parkwood Hospital, London, Ontario, Canada.
BMC Psychiatry. 2011 May 17;11:86. doi: 10.1186/1471-244X-11-86.
In this chart review, we attempted to evaluate the benefits of adding aripiprazole in veterans with military-related PTSD and comorbid depression, who had been minimally or partially responsive to their existing medications.
A retrospective chart review of patients who received an open-label, flexible-dose, 12- week course of adjunctive aripiprazole was conducted in 27 military veterans meeting DSM-IV criteria for PTSD and comorbid major depression. Concomitant psychiatric medications continued unchanged, except for other antipsychotics which were discontinued prior to initiating aripiprazole. The primary outcome variable was a change from baseline in the PTSD checklist-military version (PCL-M) and the Beck Depression Inventory (BDI-II).
PTSD severity (Total PCL scores) decreased from 56.11 at baseline to 46.85 at 12-weeks (p < 0.0001 from Wilcoxon signed rank test) and the depression severity decreased from 30.44 at baseline to 20.67 at 12-weeks (p < 0.0001 from Wilcoxon signed rank test). Thirty seven percent (10/27) were considered responders, as defined by a decrease in total PCL scores of at least 20 percent and 19% (5/27) were considered as responders as defined by a decrease in total BDI score of at least 50%.
The addition of aripiprazole contributed to a reduction in both PTSD and depression symptomatology in a population that has traditionally demonstrated poor pharmacological response. Further investigations, including double-blind, placebo-controlled studies, are essential to confirm and further demonstrate the benefit of aripiprazole augmentation in the treatment of military related PTSD.
在本次病历回顾中，我们尝试评估对于那些对现有药物治疗反应不佳或部分反应的、与军事相关的 PTSD 合并抑郁共病的退伍军人，添加阿立哌唑的益处。
对 27 名符合 DSM-IV 创伤后应激障碍和共病重度抑郁症标准的退伍军人进行了回顾性病历分析，这些患者接受了为期 12 周的阿立哌唑开放性、剂量灵活的辅助治疗。同时使用的精神科药物保持不变，除了在开始使用阿立哌唑之前停用的其他抗精神病药物。主要观察指标为 PTSD 检查表-军事版本（PCL-M）和贝克抑郁量表（BDI-II）的基线变化。
PTSD 严重程度（总 PCL 评分）从基线的 56.11 降至 12 周时的 46.85（Wilcoxon 符号秩检验，p < 0.0001），抑郁严重程度从基线的 30.44 降至 12 周时的 20.67（Wilcoxon 符号秩检验，p < 0.0001）。37%（10/27）被认为是有反应者，定义为总 PCL 评分至少降低 20%，19%（5/27）被认为是有反应者，定义为总 BDI 评分至少降低 50%。
在传统上药物治疗反应不佳的人群中，添加阿立哌唑可减少 PTSD 和抑郁症状。进一步的研究，包括双盲、安慰剂对照研究，对于证实和进一步证明阿立哌唑在治疗与军事相关的 PTSD 中的益处至关重要。
