title: Preliminary findings concerning the use of prazosin for the treatment of posttraumatic nightmares in a refugee population.
abstract: Prazosin, a centrally active alpha-1 adrenergic receptor antagonist, has reduced nightmares and sleep disturbances in placebo-controlled studies involving patients with combat and civilian related posttraumatic stress disorder (PTSD). In this retrospective chart review, we analyzed data from 23 refugees diagnosed with chronic PTSD who were treated with prazosin. The recurrent distressing dreams item of the Clinician Administered PTSD Scale (CAPS) was used to quantify nightmare severity. A Clinical Global Impressions-Change (CGI-C) score assessed change in overall PTSD severity exclusive of nightmares. Using a paired-samples t-test, we found that CAPS scores decreased significantly (p <0.0005) from baseline after 8 weeks of treatment with a stable dose of prazosin. Overall PTSD severity was "markedly improved" in 6 patients, "moderately improved" in 11 patients, and "minimally improved" in 6 patients. These data provide preliminary support for the use of prazosin in targeting reduction of trauma-related nightmares and promoting improvement of global clinical status within an international sample of severely traumatized refugee patients.
authors.affiliation: University of Washington, Seattle, USA. loring@u.washington.edu
authors.forename: Lorin
authors.initials: L
authors.lastname: Boynton
authors.forename: Jacob
authors.initials: J
authors.lastname: Bentley
authors.forename: Eric
authors.initials: E
authors.lastname: Strachan
authors.forename: Anna
authors.initials: A
authors.lastname: Barbato
authors.forename: Murray
authors.initials: M
authors.lastname: Raskind
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D004325:Dreams / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D011224:Prazosin / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D012036:Refugees / Q000523:psychology*; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000317:Adrenergic alpha-Antagonists; D011224:Prazosin