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clinmed/2003090010v1 (September 23, 2003)
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Risperidone as a treatment for symptoms associated with Post-Traumatic Stress Disorder and Acute Stress Reaction/Disorder. A systematic review.

Michael Ferriter, Paul Mooney, and Raymond Travers

Background: Exposure to traumatic events accounts for a significant amount of psychological morbidity in the population. The resulting psychological disorder can be acute and time limited (Acute Stress Reaction/Disorder) or chronic (Post-Traumatic Stress Disorder). The traditional approach to these disorders has been through a range of ‘talking’ therapies though there is, at best, a limited evidence base to support their use and in one form of therapy (psychological debriefing) evidence that contraindicates its use. In contrast, the use of pharmacological therapies is a growing area of research. Risperidone is known to impact on both the serotonergic and dopaminergic neurotransmitter systems that research has shown to be altered in Post-Traumatic Stress Disorder. The purpose of this review was to see what evidence there was to support the use of risperidone in the treatment of stress disorders. Method: The relevant databases were searched for suitable studies concerning risperidone treatment of PTSD. Results: The results of the search were disappointing, discovering only one, unpublished, RCT, four case series and two case reports. Conclusion: The evidence was generally in favour of the intervention but of insufficient quantity or quality to make recommendations for clinical practice. However, this is clearly a promising area for research and there is a compelling humanitarian and economic case to carry out better and larger scale trials on risperidone and other pharmacological interventions both as an adjunct and an alternative to traditional psychological approaches.