Prazosin reduces trauma-related nightmares in older men with chronic posttraumatic stress disorder.
Trauma-related nightmares in posttraumatic stress disorder (PTSD) rarely respond to pharmacologic treatment. Neurobiologic data suggest that enhanced brain responsiveness to adrenergic stimulation may contribute to the pathophysiology of trauma-related nightmares in PTSD. Nine older men with chronic PTSD secondary to military or Holocaust trauma were prescribed the lipophilic alpha-1 adrenergic antagonist prazosin for treatment-resistant trauma-related nightmares. Prazosin 2 mg to 4 mg 1 hour before bedtime substantially reduced nightmares and moderately or markedly reduced overall PTSD severity in 8 of 9 subjects. Prazosin was well tolerated. These open-label results are consistent with demonstrated therapeutic efficacy of prazosin for PTSD nightmares and sleep disturbance in a recent placebo-controlled trial in Vietnam veterans.
Peskind
Elaine R
ER
Department of Veterans Affairs Northwest Network Mental Illness Research, Education and Clinical Center, Seattle, Washington, USA.
Bonner
Lauren T
LT
Hoff
David J
DJ
Raskind
Murray A
MA
D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000187:drug effects; D002908:Chronic Disease; D004325:Dreams / Q000187:drug effects*; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D008875:Middle Aged; D011224:Prazosin / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000188:drug therapy*
D000317:Adrenergic alpha-Antagonists; D011224:Prazosin