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Improving Care for Veterans with PTSD: Comparing Risks and Benefits of Antipsychotics Versus Other Medications to Augment First-Line Pharmacologic Therapy

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Technical Report,30 Sep 2016,29 Sep 2019

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Northern California Institute for Research and Education Inc. San Francisco United States

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The goal of this project was to use national Veterans Affairs VA healthcare data to determine the benefits and risks of use of antipsychotic medications to augment first-line medication therapy in patients with posttraumatic stress disorder PTSD. We found that patients prescribed antipsychotics or a variety of non-antipsychotic psychiatric medications had small but similar improvements in PTSD symptoms. They had larger improvements in mental health emergency room visits and hospitalizations, suggesting these medications may be of most benefit to those with worsening symptomsinstability. We also found several of these medications, particularly antipsychotics and mirtazapine, were associated with weight gain and other metabolic harms. Though our findings are from observational data and cannot prove causal associations, they suggest patients prescribed these augmenting medications should be carefully observed for treatment response and potential harms. They also highlight the importance of clinical trials dedicated to comparing treatment options in patients who do not have an adequate response to first-line therapy.

Subject Categories:

  • Psychology
  • Medicine and Medical Research

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