van Minnen Agnes, Vos Lizelotte, Bet Pierre M, de Jongh Ad, Linsen Felix, van Marle Hein J F, Meijer Onno C, Otte Willem M, Russcher Marije, Vinkers Christiaan H
Psychotrauma Expertise Centre (PSYTREC) Bilthoven, Bilthoven, Netherlands.
Behavioural Science Institute (BSI), Radboud University, Nijmegen, Netherlands.
Case Rep Psychiatry. 2024 Apr 26;2024:4768647. doi: 10.1155/2024/4768647. eCollection 2024.
Despite the availability of various treatment approaches for patients with posttraumatic stress disorder (PTSD), some patients do not respond to these therapies, and novel treatment approaches are needed. This study investigated the efficacy of mifepristone, a glucocorticoid receptor antagonist, in treatment-resistant PTSD patients. Three patients with PTSD who were resistant to standard psychological and pharmacological treatments were prescribed mifepristone (600-1,200 mg/day) for 1 week. A baseline-controlled single-case design was used, involving a 2-week baseline phase (no intervention), a 1-week intervention phase (mifepristone), and a 2-week postintervention phase. The primary outcome measure, self-reported PTSD symptom severity (PCL-5), was assessed daily, with participants providing their own control condition. Two of the three patients experienced a significant reduction in PTSD symptom severity after the intervention phase and no longer met the diagnostic criteria for PTSD. These positive results were maintained during long-term follow-up. These findings support the potential effectiveness of mifepristone in the treatment of patients with treatment-resistant PTSD. However, our findings must be interpreted with caution, and further studies with larger sample sizes and more rigorous designs are necessary to confirm the promising results.
尽管有多种治疗方法可用于创伤后应激障碍（PTSD）患者，但一些患者对这些疗法没有反应，因此需要新的治疗方法。本研究调查了糖皮质激素受体拮抗剂米非司酮对难治性PTSD患者的疗效。三名对标准心理和药物治疗有抵抗性的PTSD患者服用米非司酮（600 - 1200毫克/天），为期1周。采用基线对照单病例设计，包括2周的基线期（无干预）、1周的干预期（米非司酮）和2周的干预后期。主要结局指标为自我报告的PTSD症状严重程度（PCL - 5），每天进行评估，参与者提供自身的对照情况。三名患者中有两名在干预期后PTSD症状严重程度显著降低，不再符合PTSD的诊断标准。这些积极结果在长期随访中得以维持。这些发现支持了米非司酮治疗难治性PTSD患者的潜在有效性。然而，我们的发现必须谨慎解读，需要进行更大样本量和更严格设计的进一步研究来证实这些有前景的结果。
