Daytime prazosin reduces psychological distress to trauma specific cues in civilian trauma posttraumatic stress disorder.
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.
Taylor
Fletcher B
FB
Rainier Associates, Tacoma, Washington 98467, USA. tfletcher2@uswest.net
Lowe
Kathleen
K
Thompson
Charles
C
McFall
Miles M
MM
Peskind
Elaine R
ER
Kanter
Evan D
ED
Allison
Nancy
N
Williams
Judi
J
Martin
Patti
P
Raskind
Murray A
MA
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
D058668:Adrenergic alpha-1 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists; D011224:Prazosin