Oxcarbazepine for Treatment of Posttraumatic Stress Disorder and Alcohol Dependence: A Case Series

Abstract

Objective: To report 2 cases that examine the use of oxcarbazepine as treatment for individuals with posttraumatic stress disorder (PTSD) and comorbid alcohol dependence. Case Summaries: A 59-year-old male with a past psychiatric history significant for PTSD and alcohol dependence underwent alcohol detoxification and was subsequently prescribed oxcarbazepine 300 mg twice daily, which was titrated to 600 mg twice daily prior to discharge. He experienced significant reduction in PTSD symptoms including anxiety, nightmares, flashbacks, racing thoughts, and avoidance behaviors. Over time, he also experienced a reduction in alcohol cravings and decreased daily alcohol intake. A 62-year-old male with a past psychiatric history of PTSD and alcohol dependence was treated in the outpatient clinic. He experienced almost complete resolution of PTSD symptoms and any craving for alcohol within 4 months of starting oxcarbazepine treatment, which was initiated at 150 mg twice daily and increased to 600 mg/day during that time. Discussion: Both patients appeared to receive excellent symptomatic relief from their PTSD symptoms. Recurring symptoms, including nightmares and flashbacks, seemed to be particularly responsive to the treatment. Additionally, in both cases, it is possible that oxcarbazepine had a secondary beneficial effect by decreasing alcohol cravings, although this was not formally measured. Conclusions: Our experience with these patients suggests that oxcarbazepine could be an effective treatment for the symptoms of PTSD and may decrease alcohol cravings and consumption in patients with co-occurring alcohol dependence. Controlled studies examining the effectiveness of oxcarbazepine for treatment of patients with PTSD, including those with complicating alcohol dependence, are warranted.