title: Daytime prazosin reduces psychological distress to trauma specific cues in civilian trauma posttraumatic stress disorder.
abstract: BACKGROUND
  Persons with posttraumatic stress disorder (PTSD) whose trauma-related nightmares improve or resolve with bedtime administration of the alpha-1 adrenergic antagonist prazosin often continue to experience PTSD symptoms during the day. This study addressed whether daytime prazosin compared to placebo would alleviate psychological distress provoked experimentally by a trauma-related word list included in the emotional Stroop (E-Stroop) paradigm.
  
  
  METHODS
  Eleven persons with civilian trauma PTSD who continued to experience daytime PTSD symptoms despite a stable bedtime prazosin dose that suppressed trauma-related nightmares were studied. Prazosin and placebo were administered on two different occasions in the early afternoon followed two hours later by the E-Stroop. Effects of drug on psychological distress were assessed by the Profile of Mood States (POMS).
  
  
  RESULTS
  POMS total score and an "emotional distress" POMS subscale score following trauma-related words were significantly lower in the prazosin than placebo condition. There were no treatment effects on E-Stroop completion time. In 10 subjects who continued open label daytime prazosin, there was a reduction in global PTSD illness severity at 2-week follow-up.
  
  
  CONCLUSIONS
  Daytime prazosin pretreatment reduced psychological distress specifically to trauma cues. Adding daytime prazosin to bedtime prazosin may further reduce overall PTSD illness severity and distress.
authors.affiliation: Rainier Associates, Tacoma, Washington 98467, USA. tfletcher2@uswest.net
authors.forename: Fletcher B
authors.initials: FB
authors.lastname: Taylor
authors.forename: Kathleen
authors.initials: K
authors.lastname: Lowe
authors.forename: Charles
authors.initials: C
authors.lastname: Thompson
authors.forename: Miles M
authors.initials: MM
authors.lastname: McFall
authors.forename: Elaine R
authors.initials: ER
authors.lastname: Peskind
authors.forename: Evan D
authors.initials: ED
authors.lastname: Kanter
authors.forename: Nancy
authors.initials: N
authors.lastname: Allison
authors.forename: Judi
authors.initials: J
authors.lastname: Williams
authors.forename: Patti
authors.initials: P
authors.lastname: Martin
authors.forename: Murray A
authors.initials: MA
authors.lastname: Raskind
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D002940:Circadian Rhythm; D003463:Cues; D003863:Depression / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D004325:Dreams / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011224:Prazosin / Q000494:pharmacology / Q000627:therapeutic use*; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists; D011224:Prazosin