Carey Paul, Suliman Sharain, Ganesan Keith, Seedat Soraya, Stein Dan J
MRC Research Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa.
Hum Psychopharmacol. 2012 Jul;27(4):386-91. doi: 10.1002/hup.2238. Epub 2012 Jun 22.
Although there have been important advances in the treatment of posttraumatic stress disorder (PTSD), many patients fail to respond to first-line pharmacotherapy. Limited evidence suggests that second generation antipsychotics may have a role to play as monotherapy in PTSD.
We undertook a randomized, placebo-controlled study using flexible-dose olanzapine monotherapy for 8 weeks in 28 adult male and female participants (mean age: 40.75 ± 11.59 years) with non-combat related chronic PTSD. Data were analysed with repeated measures analysis of variance, using an intention to treat, last observation carried forward approach.
The olanzapine group (n = 14) demonstrated significantly greater improvement on the Clinician Administered PTSD Scale from baseline to endpoint than the placebo group (n = 14) (F = 5.71, p = 0.018). Olanzapine was generally well tolerated, with no serious adverse events recorded. Substantial weight gain (6-10 kg) was, however, reported in 6/14 participants in the olanzapine group.
To our knowledge, this is the first controlled evidence of the efficacy of olanzapine monotherapy in an exclusively non-combat related chronic PTSD group. Despite the small sample size, these data suggest that olanzapine may have a role in the treatment of PTSD. These findings warrant replication in a larger sample.
尽管创伤后应激障碍（PTSD）的治疗已取得重要进展，但许多患者对一线药物治疗无反应。有限的证据表明，第二代抗精神病药物可能在PTSD的单药治疗中发挥作用。
我们进行了一项随机、安慰剂对照研究，对28名患有与战斗无关的慢性PTSD的成年男性和女性参与者（平均年龄：40.75±11.59岁）使用灵活剂量的奥氮平进行为期8周的单药治疗。采用意向性分析、末次观察结转法，通过重复测量方差分析对数据进行分析。
从基线到终点，奥氮平组（n = 14）在临床医生评定的PTSD量表上的改善明显大于安慰剂组（n = 14）（F = 5.71，p = 0.018）。奥氮平总体耐受性良好，未记录到严重不良事件。然而，奥氮平组14名参与者中有6名报告体重显著增加（6 - 10千克）。
据我们所知，这是奥氮平单药治疗仅与战斗无关的慢性PTSD组疗效的首个对照证据。尽管样本量小，但这些数据表明奥氮平可能在PTSD治疗中发挥作用。这些发现值得在更大样本中重复验证。
