Reduction of nightmares and other PTSD symptoms in combat veterans by prazosin: a placebo-controlled study.
OBJECTIVE
Prazosin is a centrally active alpha(1) adrenergic antagonist. The authors' goal was to evaluate prazosin efficacy for nightmares, sleep disturbance, and overall posttraumatic stress disorder (PTSD) in combat veterans.


METHODS
Ten Vietnam combat veterans with chronic PTSD and severe trauma-related nightmares each received prazosin and placebo in a 20-week double-blind crossover protocol.


RESULTS
Prazosin (mean dose=9.5 mg/day at bedtime, SD=0.5) was superior to placebo for the three primary outcome measures: scores on the 1) recurrent distressing dreams item and the 2) difficulty falling/staying asleep item of the Clinician-Administered PTSD Scale and 3) change in overall PTSD severity and functional status according to the Clinical Global Impression of change. Total score and symptom cluster scores for reexperiencing, avoidance/numbing, and hyperarousal on the Clinician-Administered PTSD Scale also were significantly more improved in the prazosin condition, and prazosin was well tolerated.


CONCLUSIONS
These data support the efficacy of prazosin for nightmares, sleep disturbance, and other PTSD symptoms.
Raskind
Murray A
MA
Northwest Network VISN 20 Mental Illness Research, Eduation, and Clinical Center, VA Puget Sound Healthcare System, Seattle, USA. murray.raskind@med.va.gov
Peskind
Elaine R
ER
Kanter
Evan D
ED
Petrie
Eric C
EC
Radant
Allen
A
Thompson
Charles E
CE
Dobie
Dorcas J
DJ
Hoff
David
D
Rein
Rebekah J
RJ
Straits-Tröster
Kristy
K
Thomas
Ronald G
RG
McFall
Miles M
MM
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D003130:Combat Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D018592:Cross-Over Studies; D004325:Dreams / Q000187:drug effects* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011224:Prazosin / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome; D014728:Veterans / Q000523:psychology
D000317:Adrenergic alpha-Antagonists; D010919:Placebos; D011224:Prazosin