Clozapine for Post-traumatic Stress Disorder: Redefining Treatment Resistance in Soldiers without Psychosis

2026/07/26 by Roshan Monaragala, Miyuru Chandradasa, K.A.L.A. Kuruppuarachchi

paper · doi:10.1177/02537176261469995

Abstract

Post-traumatic stress disorder (PTSD) often follows a chronic trajectory, with many patients failing to respond to first-line psychotherapy and SSRIs/SNRIs. This case series explores clozapine for treatment-resistant PTSD (TR-PTSD) without psychosis. Seven soldiers showed improved function and reduced aggression at doses of 125–300 mg, suggesting that clozapine warrants further investigation.

Citations

• The relationship between guilt, depression, prolonged grief, and posttraumatic stress symptoms after suicide bereavement

Related

• An Update on Psychotherapy for the Treatment of PTSD
• Meta-Analysis of the Efficacy of Treatments for Posttraumatic Stress Disorder
• Clozapine Response Rates among People with Treatment-Resistant Schizophrenia: Data from a Systematic Review and Meta-Analysis
• Examining the effectiveness of an intensive, 2‐week treatment program for military personnel and veterans with PTSD: Results of a pilot, open‐label, prospective cohort trial
• Clozapine augmentation strategies – a systematic meta-review of available evidence. Treatment options for clozapine resistance