A Preliminary Case Series on the Use of Quetiapine for Posttraumatic Stress Disorder in Juveniles Within a Youth Detention Center

Abstract

Juveniles within the youth justice system have high rates of psychiatric morbidity, including posttraumatic stress disorder (PTSD). This case series describes 6 young people aged 15 to 17 years within a youth detention center who met the criteria for PTSD and reported an improvement in symptoms after 6 weeks of treatment with low-dose quetiapine. The primary outcome measure used was the Traumatic Symptom Checklist in Children. The dose of quetiapine ranged from 50 to 200 mg/d; T scores for PTSD symptoms decreased from 75 (SD, +/-5.2; range, 68-82) to 54 (SD, +/-7.4; range, 43-62) (P < 0.01). Significant improvements in symptoms of dissociation (P < 0.01), anxiety (P < 0.01), depression (P < 0.01), and anger (P < 0.05) were also noted over the 6-week evaluation period. Low-dose quetiapine was tolerated well, with no persisting side effects or adverse events. Nighttime sedation was reported, although this was viewed as beneficial. All young people opted to continue with treatment after the assessment period. This preliminary case series suggests that juveniles in detention who have PTSD may benefit from treatment with quetiapine. Caution is needed in interpreting these findings. Both larger open-label and blinded trials are warranted to define the use of quetiapine in the treatment of PTSD in the adolescent forensic population.

Posttraumatic Stress Disorder in Children and Adolescents: A Review of Psychopharmacological Treatment

“…The use of quetiapine for the treatment of child and adolescent PTSD was assessed in a case series carried out by Stathis et al [44] with the following setup: The subjects in this case series were 6 boys with a mean age of 16.7 years (SD, ±0.7). Of the 2 identified themselves as aboriginal or Torres Strait islanders, and 1 as Maori.…”

Posttraumatic Stress Disorder: Assessment and Treatment

“…The empirical literature is dominated by case studies/series, nonrandomized, and non-placebo-controlled studies on the use of quetiapine (Ahearn, Mussey, Johnson, Krohn, & Krahn, 2006;Filteau, Leblanc, & Bouchard, 2003;Robert et al, 2005;Hamner, Deitsch, Brodrick, Ulmer, & Lorberbaum, 2003;Sokolski, Denson, Lee, & Reist, 2003;Stathis, Martin, & McKenna, 2005), olanzapine (Butterfield, 2003;Izrayelit, 1998;Jakovljevic,Šagud, & Mihaljevic-Peleš, 2003;Labbate & Douglas, 2000;Petty, Brannan, & Casada, 2001;Pivac, Kozaric-Kovacic, & Mück-Šeler, 2004;Prior, 2001), risperidone (David, De Faria, Lapeyra, & Mellman, 2004;David, De Faria, & Mellman, 2006;Kozaric-Kovacic, Pivac, Mück-Šeler, & Rothbaum, 2005;Krashin & Oates, 1999;Monnelly & Ciraulo, 1999;Monnelly, Ciraulo, Knapp, & Keane, 2003), aripiprazole (Lambert, 2006), ziprasidone (Siddiqui, Marcil, Bhatia, Ramaswamy, & Petty, 2005), and clozapine (Hamner, 1996). To date, there are only a handful of published studies examining the efficacy of atypical antipsychotics utilizing a double-blind, placebo-controlled, and randomized design, and they have focused on risperidone (Bartzokis, Lu, Turner, Mintz, & Saunders, 2005;Hamner, Faldowski, et al, 2003;Monnelly et al, 2003;Reich, Winternitz, Hennen, Watts, & Stanculescu, 2004) and olanzapine (Butterfield et al, 2001;Stein, Kline, & Matloff, 2002).…”

Pharmacologic Considerations for Youth with Posttraumatic Stress Disorder

“…[40][41][42] However, even these small, uncontrolled studies have consistently found the development of significant side effects including weight gain among treated youth. Given the risk of obesity among trauma exposed youth in both childhood and adulthood, the availability of other medications without the significant risk of weight gain, and the lack of evidence supporting the use of SGAs, there is little role in the use of SGAs among most children with PTSD.…”