Clinical trials to size up antipsychotics like Seroquel for PTSD

Military use of the drugs surge even though research questions effectiveness
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The Army is trying to get a better handle on the very complicated issue of how drugs fit into the treatment of the many veterans diagnosed with post-traumatic stress disorder, with a study of the effectiveness of the drugs most often prescribed. The research will be launched next year, reports The Navy Times.

Only GlaxoSmithKline's ($GSK) Paxil, Pfizer's ($PFE) Zoloft and their generics are approved for treatment of PTSD, but they often don't get the job done. So, doctors have been prescribing antipsychotics like Johnson & Johnson's ($JNJ) Risperdal and AstraZeneca's ($AZN) Seroquel, betting that adding one of these drugs will boost antidepressant therapy.

Army physicians last week announced the service will start clinical trials next year to evaluate commonly prescribed PTSD medications like the antidepressant Cymbalta, mirtazapine, prazosin and atypical antipsychotics like Seroquel. It will test hundreds of vets and service members at multiple sites over several years, hoping to catch research up with "clinical practice," says Army Major Gary Wynn of the Walter Reed Army Institute of Research.

The announcement follows a memo in February from Assistant Secretary of Defense Jonathan Woodson to all of the branches of the military about what the military was seeing in PTSD treatment, The Philadelphia Inquirer reports. In it, he points out that while antidepressant use had changed little between 2002 and 2009, the prescription rates for atypical antipsychotics increased by 10 times during that period, from 0.1% to 1%. The memo says AstraZeneca's Seroquel was prescribed to 1.4% of the Army and 0.7% of the Marines in fiscal year 2010.

Research last year on Risperdal by some Veterans Affairs-affiliated researchers set out to determine whether the use of antipsychotics with antidepressants was valid, and they found that adding Risperdal to antidepressant treatment didn't help any more than adding a placebo did.

While more research may invalidate the use of some drugs for PTSD, Wynn says that: "For pharmaceuticals that show benefits in treating combat-related PTSD, the Department of Defense may work toward a new indication or change in labeling."

- read The Navy Times story
- get more from The Philadelphia Inquirer

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