Dense painting of three Vietnam-era soldiers, awash in a blurred explosion of colors and fallen leaves. Once soldier wears a tag that reads “PTSD.”
A new study suggests that antipsychotics fail to clear away the blurry haze of memories and pain common to veterans' PTSD. (Photo Credit: CC BY/Soaptree/Flickr)

As the nation’s budget battle has proven, the U.S. government has struggled to maintain adequate resources for veterans’ affairs such as the treatment of post-traumatic stress disorder (PTSD). Now a study published in the Journal of the American Medical Association casts an even longer shadow over veterans’ medical treatment. According to the study, the most widely prescribed PTSD drugs are no more effective than placebos at treating the condition, and they carry side effects such as weight gain and fatigue.

Antipsychotics fail to alleviate veterans’ stress

The study, entitled “Adjunctive Risperidone Treatment for Antidepressant-Resistant Symptoms of Chronic Military Service-Related PTSD,” is the largest of its kind conducted on U.S. veterans. Of the 10 to 20 percent of veterans who develop lasting PTSD, the study notes that one-fifth of those are prescribed antipsychotic medication, most often Risperdal. The study questiona the effectiveness of Risperdal and related drugs like Seroquel, Geodon and Abilify.

Dr. Charles Hoge of the Walter Reed Army Institute of Research noted that the study could become a catalyst for real change in veterans’ medical treatment.

“I think it’s a very important study, given how frequently the drugs have been prescribed,” he said. “It definitely calls into question the use of antipsychotics in general for PTSD.”

Antipsychotic results nearly the same as placebo

Over the past decade, thousands of U.S. soldiers returning home from the Middle Eastern theater have faced PTSD and related disorders. Military doctors first used antidepressant medications, but the results were less than encouraging, according to military data. Antipsychotic medications came next, and doctors expected the more radical treatment to have a greater impact upon patient mood.

The recent study, a randomized trial conducted by a team of physicians from the Veterans Affairs medical system, put antipsychotics to the test. PTSD patients from the conflicts in Vietnam, Iraq and Afghanistan – all of whom found little or no relief after antidepressant treatment – went through six months of antipsychotics treatment. Results were nearly identical with those in the placebo group. Only 5 percent recovered fully, and less than 20 percent showed any improvement.

“We didn’t find any suggestion that the drug treatment was having an overall benefit on their lives,” said Dr. John Krystal, lead author of the study and director of clinical neurosciences at the Department of Veterans Affairs’ National Center for PTSD.

Talking it out with antidepressants

Various surveys indicate that only half of U.S. veterans who need treatment actually seek treatment. Of those who do pursue aid, the best known treatment for less severe cases of PTSD is a combination of talk therapy, relaxation techniques and an antidepressant regimen.

Study: Treating U.S. veterans’ stress with Ecstasy

Sources

Journal of the American Medical Association: http://jama.ama-assn.org/content/306/5/493.full

National Institute of Mental Health: http://1.usa.gov/Y7EwZ

New York Times: http://www.nytimes.com/2011/08/03/health/research/03psych.html?_r=1

U.S. Department of Veterans Affairs: http://1.usa.gov/oD4ucU

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