Menus Subscribe Search

Class of Antipsychotics Ineffective in PTSD Treatment

• August 10, 2011 • 4:00 AM

The future may hold a drug therapy for treating post-traumatic stress disorder, but some of the popular choices of the last few years, like Risperdal, won’t be part of it.

A new era of psychopharmacology combined with two wars in Asia has created its own surge in treating combat stress with prescription drugs. For tough cases doctors have even prescribed antipsychotics. But all drugs are not created equal, and a new study claims that one class of antipsychotic is no better than a placebo for treating post-traumatic stress.

The study underlines that there is no drug for PTSD symptoms. The researchers concentrated on one medication, Risperdal, but the results may apply to a whole class of antipsychotics that work on neurotransmission in the brain.

“It definitely calls into question the use of anti-psychotics in general for PTSD,” Charles Hoge, a senior scientist at the Walter Reed Army Institute of Research, told The New York Times.

Antipsychotics like Risperdal target the way brain cells handle neurotransmitters like serotonin and dopamine. In that sense they’re similar to antidepressants. They ease a symptom that might correspond to PTSD, but recent research indicates that combat stress can cause physical damage to the brain. The cells themselves may have changed shape or started to work in a different way.

Basically, antipsychotics may affect the brain on too shallow a level to help. But there might be hope for drugs that try to fix cells on a level closer to a person’s genes.

“We don’t understand the disorder well enough. All we have are puzzle pieces,” says Dr. Ulrike Schmidt, a PTSD expert at the Max Planck Institute for Psychiatry in Munich. “But I can imagine that with more high-throughput experiments we will identify target genes, or the proteins they produce, which we can then try to steer with pharmaceuticals.”

Her opinion is that the right genes or proteins might be found roughly “in the household of stress hormones,” like cortisol.

Schmidt’s research has shown that PTSD causes semi-permanent damage not only to parts of the brain, but also to the epigenome, the complex of molecules that surrounds a person’s DNA and influences which genes are expressed. It’s like a blow to a person’s firmware — damage to a system that tells the body what to do. It’s not irreversible, though a predisposition for it could be passed on to another generation.

Antipsychotics — widely prescribed as they are — may seem off the mark because psychosis itself is not a typical outcome of post-traumatic stress (the way depression is). But symptoms of psychosis and PTSD can overlap. And doctors have been prescribing antipsychotics “based almost entirely on their experience with them and how they expect them to work,” according to the Times. [class name="dont_print_this"]

European Dispatch

EUROPEAN DISPATCH
Michael Scott Moore complements his standing feature in Miller-McCune magazine with frequent posts on the policy challenges and solutions popping up on the other side of the pond.

[/class]

The big caveat is that PTSD isn’t well understood. And some vets may have been prone to certain psychoses to start with. The current study didn’t select for them.

This research into molecules and brain behavior may wind up emphasizing that PTSD is too fine-grained and changeable to be treated entirely with drugs. As a disorder it seems to straddle the mysterious boundary between the mind and the brain. The simplest treatment — for most people — may still be sports, like surfing or biking, combined with talk therapy.

Schmidt helps run a clinic in Munich for people with severe post-traumatic stress, where the treatment involves drugs as well as therapy. “We have psychotherapy that includes depth psychology, gestalt therapy and behavioral-therapy elements. We never say, ‘Only behavioral therapy is good’ — we combine them. And we try to ease certain symptoms with medication. For example, a patient with severe sleeping problems might receive medication for that. … But the big goal is to lighten the therapy, or speed it up, with a PTSD-specific medication.”

One other non-pharmacological treatment, of course, would be to fight fewer wars.

Sign up for the free Miller-McCune.com e-newsletter.

“Like” Miller-McCune on Facebook.

Follow Miller-McCune on Twitter.

Add Miller-McCune.com news to your site.

Subscribe to Miller-McCune

Michael Scott Moore
Michael Scott Moore was a 2006-2007 Fulbright fellow for journalism in Germany, and The Economist named his surf travelogue, "Sweetness and Blood," a book of the year in 2010. His first novel, "Too Much of Nothing," was published by Carroll & Graf in 2003, and he’s written about politics and travel for The Atlantic Monthly, Slate, the Los Angeles Times, and Spiegel Online in Berlin, where he serves as editor-at-large.

More From Michael Scott Moore

A weekly roundup of the best of Pacific Standard and PSmag.com, delivered straight to your inbox.

Recent Posts

July 23 • 4:00 PM

Who Doesn’t Like Atheists?

The Pew Research Center asked Americans of varying religious affiliations how they felt about each other.


July 23 • 2:00 PM

We Need to Start Tracking Patient Harm and Medical Mistakes Now

Top patient-safety experts call on Congress to step in and, among other steps, give the Centers for Disease Control and Prevention wider responsibility for measuring medical mistakes.


July 23 • 12:19 PM

How a CEO’s Fiery Battle Speeches Can Shape Ethical Behavior

CEO war speech might inspire ethical decisions internally and unethical ones among competing companies.


July 23 • 12:00 PM

Why Do We Love the ‘Kim Kardashian: Hollywood’ Game?

It’s easy enough to turn yourself into a virtual celebrity, complete with fame and mansions—but it will likely cost you.


July 23 • 11:49 AM

Modern Technology Still Doesn’t Protect Americans From Deadly Landslides

No landslide monitoring or warning systems are being used to protect vulnerable communities.


July 23 • 10:00 AM

Outing the Death-Drug Distributors

Calling all hackers: It’s time to go Assange on capital punishment.


July 23 • 8:00 AM

The Surprising Appeal of Products That Require Effort to Use

New research finds they enable consumers to re-establish a feeling that they’re in control of their lives.



July 23 • 6:00 AM

How the Other Half Lifts: What Your Workout Says About Your Social Class

Why can’t triathletes and weightlifters get along?


July 23 • 5:02 AM

Battle of the Public Intellectuals: Edward Glaeser vs. Richard Florida

On gentrification and housing costs.


July 23 • 4:00 AM

Our Fear of Immigrants

Why did a group of fourth graders rally in support of an undocumented classmate while the citizens of Murrieta, California, tried to stop immigrant children from entering their town?


July 22 • 4:00 PM

Can Meditation Really Slow Aging?

Is there real science in the spiritualism of meditation? Jo Marchant meets a Nobel Prize-winner who thinks so.



July 22 • 2:00 PM

The Alabama Judge Who Refuses to Let Desegregation Orders Go Ignored

A federal judge in Alabama says a local school board has failed to meet legal mandate to integrate.


July 22 • 12:00 PM

On the Destinations of Species

It’s almost always easier to cross international borders if you’re something other than human.


July 22 • 10:51 AM

The Link Between Carbs, Gut Microbes, and Colon Cancer

Reduced carb intake among mice protected them from colon cancer.


July 22 • 10:47 AM

Irrational Choice Theory: The LeBron James Migration From Miami to Cleveland

Return migrants to Cleveland have been coming home in large numbers for quite some time. It makes perfect sense.


July 22 • 9:32 AM

This Time, Scalia Was Right

President Obama’s recess appointments were wrong and, worse, dangerous.


July 22 • 8:00 AM

On Vegas Strip, Blackjack Rule Change Is Sleight of Hand

Casino operators are changing blackjack payouts to give the house an even greater advantage. Is this a sign that Vegas is on its way back from the recession, or that the Strip’s biggest players are trying to squeeze some more cash out of visitors before the well runs dry?


July 22 • 6:00 AM

Label Me Confused

How the words on a bag of food create more questions than answers.


July 22 • 5:07 AM

Doubly Victimized: The Shocking Prevalence of Violence Against Homeless Women

An especially vulnerable population is surveyed by researchers.


July 22 • 4:00 AM

New Evidence That Blacks Are Aging Faster Than Whites

A large study finds American blacks are, biologically, three years older than their white chronological counterparts.



July 21 • 4:00 PM

Do You Have to Learn How to Get High?

All drugs are socially constructed.


July 21 • 2:14 PM

The New Weapon Against Disease-Spreading Insects Is Big Data

Computer models that pinpoint the likely locations of mosquitoes and tsetse flies are helping officials target vector control efforts.


Follow us


Subscribe Now

How a CEO’s Fiery Battle Speeches Can Shape Ethical Behavior

CEO war speech might inspire ethical decisions internally and unethical ones among competing companies.

Modern Technology Still Doesn’t Protect Americans From Deadly Landslides

No landslide monitoring or warning systems are being used to protect vulnerable communities.

The Link Between Carbs, Gut Microbes, and Colon Cancer

Reduced carb intake among mice protected them from colon cancer.

The New Weapon Against Disease-Spreading Insects Is Big Data

Computer models that pinpoint the likely locations of mosquitoes and tsetse flies are helping officials target vector control efforts.

People Are Clueless About Placebos

Doctors know that sometimes the best medicine is no medicine at all. But how do patients feel about getting duped into recovery?

The Big One

Today, the United States produces less than two percent of the clothing purchased by Americans. In 1990, it produced nearly 50 percent. July/August 2014

Copyright © 2014 by Pacific Standard and The Miller-McCune Center for Research, Media, and Public Policy. All Rights Reserved.