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Antipsychotic ineffective in vets with PTSD

August 8, 2011

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Doctors have increasingly prescribed a class of drugs referred to as second-generation antipsychotics to veterans with post-traumatic stress who don’t respond to antidepressants. But a study by researchers with the Veterans Administration found that at least one such drug did not significantly reduce the severity of PTSD symptoms. It did not reduce depression or anxiety, and it did not improve quality of life. The drug did cause side effects including fatigue, weight gain, drowsiness, and excess saliva.

Researchers randomly assigned 247 patients at VA outpatient medical centers to take either the drug, called risperidone, or a placebo for six months. Participants had ongoing symptoms of military-related post-traumatic stress despite at least two rounds of treatment with antidepressants.

The researchers said their study should prompt a careful review of how this drug is used in veterans with PTSD.

BOTTOM LINE: An antipsychotic drug commonly prescribed to veterans with PTSD was found ineffective for that use.

CAUTIONS: Researchers did not enroll as many patients as they had hoped, and the study group was almost entirely men. It is not clear whether the results can be applied to other drugs of the same class.

WHERE TO FIND IT: Journal of the American Medical Association, Aug. 3

More children hospitalized for psychiatric care The number of children and adolescents in the United States admitted for psychiatric inpatient stays dramatically increased between 1996 and 2007, as did the number of days they remained in the hospital.

Between 1970 and the 1990s, psychiatric care was moving away from hospital stays for all patients toward more outpatient treatment. But starting around 2004, admissions surged. Joseph C. Blader, a researcher at Stony Brook University School of Medicine, used data from the National Hospital Discharge Survey to look at how age groups were affected.

For every 100,000 children ages 5 to 13, about 283 were discharged from a psychiatric stay in 2007, up from 156 in 1996. The overall number of days spent in the hospital per 100,000 children more than doubled. Among adolescents ages 14 to 19, discharges grew from a rate per 100,000 of 684 in 1996 to 969 in 2007, and the rate of inpatient days increased by 40 percent. The numbers for seniors age 65 and older dropped slightly and stays for other adults were more stable. Among all groups, the portion of inpatient days paid for by private insurance declined.

BOTTOM LINE: Psychiatric inpatient stays for children in the Untied States surged from 1996 to 2007.

CAUTIONS: The survey included limited information about diagnosis, facility type, and illness severity.

WHERE TO FIND IT: Archives of General Psychiatry, Aug. 1

CHELSEA CONABOY

Chelsea Conaboy can be reached at cconaboy@boston.com.

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