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Olanzapine May Be New Option for Post-Traumatic Stress Disorder: Presented at ECNP

By Joanna Lyford

VIENNA, AUSTRIA -- October 19, 2007 -- The atypical antipsychotic agent olanzapine can be effective in the treatment of post-traumatic stress disorder (PTSD), according to a study of veterans presented here at the 20th European College of Neuropsychopharmacology (ECNP) Congress.

In this randomised, double-blind, placebo-controlled trial, olanzapine monotherapy was well tolerated and associated with a significant improvement in PTSD symptoms.

"Despite the limitations of small sample size, these data suggest that olanzapine may have a future role in the treatment of PTSD," said Paul Carey, MD, Codirector of the Brain Imaging Program, Anxiety and Stress Disorders Research Unit, University of Stellenbosch, Tygerberg, South Africa.

The trial included 28 noncombat veterans with PTSD and a Clinician-Administered Scale of PTSD (CAPS) score of 50 or greater. They were randomised to treatment with olanzapine 5 to 15 mg OD or placebo for 8 weeks.

Mean CAPS scores fell by 61% in the patients treated with olanzapine and 35% in the placebo group, a highly significant difference (P =.024). Response rates, defined as a >50% reduction in CAPS score, were also significantly higher with olanzapine.

Between-group differences were statistically significant as early as week 4, mirroring the rapid response to atypical antipsychotics observed in studies of other anxiety disorders.

In addition, olanzapine was generally well tolerated and there were no serious adverse events. All olanzapine-treated subjects gained weight, however, with an average increase of 5.6 kg over the study period.

Other adverse effects associated with olanzapine therapy were sedation and increased appetite; one patient withdrew from the trial due to sedation.

In their discussion, Dr. Carey and coauthors commented that this is the first controlled study to demonstrate the efficacy of olanzapine monotherapy in patients with PTSD. An earlier study in PTSD patients found no difference in clinical response rates between olanzapine and placebo.

The researchers noted that this study gives support to a previous report on the benefits of the antipsychotic drug risperidone in patients with PTSD and adds weight to preliminary data that suggest this drug class may be helpful in PTSD. "Our findings warrant further study in a larger sample," they concluded.


[Presentation title: Olanzapine in Posttraumatic Stress Disorder (PTSD): Efficacy in a Double-Blind, Randomized, Placebo-Controlled Study. Abstract P.4.a.011]

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