title: Re-emergence of posttraumatic stress disorder nightmares with nursing home admission: treatment with prazosin.
abstract: Seniors with a history of emotional trauma decades earlier can experience a recurrence of posttraumatic stress disorder symptoms when transitioning to a nursing home. We present the case of an 86-year-old male Holocaust survivor admitted to a nursing home for physical therapy and rehabilitation 6 weeks after the death of his wife; the patient was expressing a persistent death wish. Despite the multiple risk factors for depression, his distress was specifically related to the reemergence of nightly posttraumatic nightmares. Over the course of 1 week of treatment with 1 mg prazosin at bedtime, his nightmares and his death wish completely resolved. He achieved his rehabilitation goals and was discharged to a community setting. This report highlights the importance of considering posttraumatic stress disorder in nursing home residents with a history of emotional trauma, and understanding how to address these symptoms pharmacologically and nonpharmacologically.
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
authors.forename: Kim G
authors.initials: KG
authors.lastname: Johnson
authors.forename: Jules
authors.initials: J
authors.lastname: Rosen
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000627:therapeutic use*; D000369:Aged, 80 and over; D004325:Dreams / Q000523:psychology*; D017767:Holocaust / Q000523:psychology; D006801:Humans; D008297:Male; D009735:Nursing Homes; D011224:Prazosin / Q000627:therapeutic use*; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy* / Q000523:psychology*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D011224:Prazosin