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Am J Psychiatry. 2002 Oct;159(10):1777-9.

Adjunctive olanzapine for SSRI-resistant combat-related PTSD: a double-blind, placebo-controlled study.

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  • 1Anxiety and Traumatic Stress Disorders Program, Psychiatry Service, VA San Diego Healthcare System, San Diego, CA, USA. mstein@ucsd.edu



Posttraumatic stress disorder (PTSD), particularly in combat veterans with chronic illness, is often refractory to standard pharmacological interventions. There is a need to test adjunctive treatments to boost response.


Subjects were 19 patients with PTSD who were minimally responsive to 12 weeks of treatment with a selective serotonin reuptake inhibitor (SSRI) at maximum tolerated dose. Outcomes were compared among subjects whose treatment was augmented with 8 weeks of double-blind olanzapine or placebo administration.


Olanzapine augmentation was associated with statistically significantly greater reduction than placebo in specific measures of posttraumatic stress, depressive, and sleep disorder symptoms. Clinician-rated global response rates did not, however, significantly differ between groups.


This is most likely the first double-blind, placebo-controlled study of an adjunct to SSRIs for PTSD. Despite the small group size, the findings suggest a role for olanzapine or other atypical antipsychotics in treating SSRI-resistant PTSD. Sleep symptoms may especially benefit.

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  • Randomized controlled trials. [Am J Psychiatry. 2003]
[PubMed - indexed for MEDLINE]
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