title: Putative dopamine agonist (KB220Z) attenuates lucid nightmares in PTSD patients: role of enhanced brain reward functional connectivity and homeostasis redeeming joy.
abstract: BACKGROUND
  Lucid dreams are frequently pleasant and training techniques have been developed to teach dreamers to induce them. In addition, the induction of lucid dreams has also been used as a way to ameliorate nightmares. On the other hand, lucid dreams may be associated with psychiatric conditions, including Post-Traumatic Stress Disorder (PTSD) and Reward Deficiency Syndrome-associated diagnoses. In the latter conditions, lucid dreams can assume an unpleasant and frequently terrifying character.
  
  
  METHODS
  We present two cases of dramatic alleviation of terrifying lucid dreams in patients with PTSD. In the first case study, a 51-year-old, obese woman, diagnosed with PTSD and depression, had attempted suicide and experienced terrifying lucid nightmares linked to sexual/physical abuse from early childhood by family members including her alcoholic father. Her vivid "bad dreams" remained refractory in spite of 6 months of treatment with Dialectical Behavioral Therapy (DBT) and standard pharmaceutical agents which included prazosin, clonidie and Adderall. The second 39-year-old PTSD woman patient had also suffered from lucid nightmares.
  
  
  RESULTS
  The medication visit notes reveal changes in the frequency, intensity and nature of these dreams after the complex putative dopamine agonist KB220Z was added to the first patient's regimen. The patient reported her first experience of an extended period of happy dreams. The second PTSD patient, who had suffered from lucid nightmares, was administered KB220Z to attenuate methadone withdrawal symptoms and incidentally reported dreams full of happiness and laughter.
  
  
  CONCLUSIONS
  These cases are discussed with reference to the known effects of KB220Z including enhanced dopamine homeostasis and functional connectivity of brain reward circuitry in rodents and humans. Their understanding awaits intensive investigation involving large-population, double-blinded studies.
authors.affiliation: Center for Psychiatric Medicine , North Andover, MA , USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: McLaughlin
authors.forename: Kenneth
authors.initials: K
authors.lastname: Blum
authors.forename: Marlene
authors.initials: M
authors.lastname: Oscar-Berman
authors.forename: Marcelo
authors.initials: M
authors.lastname: Febo
authors.forename: Gozde
authors.initials: G
authors.lastname: Agan
authors.forename: James L
authors.initials: JL
authors.lastname: Fratantonio
authors.forename: Thomas
authors.initials: T
authors.lastname: Simpatico
authors.forename: Mark S
authors.initials: MS
authors.lastname: Gold
mesh_terms: D000328:Adult; D002395:Catecholamines / Q000627:therapeutic use*; D017579:Domestic Violence / Q000523:psychology; D018491:Dopamine Agonists / Q000627:therapeutic use*; D004325:Dreams / Q000187:drug effects* / Q000523:psychology; D005260:Female; D006240:Happiness; D006801:Humans; D008875:Middle Aged; D008995:Monoamine Oxidase / Q000627:therapeutic use*; D015260:Neprilysin / Q000627:therapeutic use*; D012201:Reward; D012742:Sex Offenses / Q000523:psychology; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy* / Q000523:psychology; D016896:Treatment Outcome
chemical_list: D002395:Catecholamines; D018491:Dopamine Agonists; C000601005:KB220Z; D008995:Monoamine Oxidase; D015260:Neprilysin
keywords: KB220Z; Post-Traumatic Stress Disorder (PTSD); functional brain connectivity; lucid nightmares; parasomnia; putative complex dopamine agonist