Reduction of Nightmares and Other PTSD Symptoms in Combat Veterans by Prazosin: A Placebo-Controlled Study

University of California, San Diego, San Diego, California, United States
American Journal of Psychiatry (Impact Factor: 12.3). 03/2003; 160(2):371-3. DOI: 10.1176/appi.ajp.160.2.371
Source: PubMed


Prazosin is a centrally active alpha(1) adrenergic antagonist. The authors' goal was to evaluate prazosin efficacy for nightmares, sleep disturbance, and overall posttraumatic stress disorder (PTSD) in combat veterans.
Ten Vietnam combat veterans with chronic PTSD and severe trauma-related nightmares each received prazosin and placebo in a 20-week double-blind crossover protocol.
Prazosin (mean dose=9.5 mg/day at bedtime, SD=0.5) was superior to placebo for the three primary outcome measures: scores on the 1) recurrent distressing dreams item and the 2) difficulty falling/staying asleep item of the Clinician-Administered PTSD Scale and 3) change in overall PTSD severity and functional status according to the Clinical Global Impression of change. Total score and symptom cluster scores for reexperiencing, avoidance/numbing, and hyperarousal on the Clinician-Administered PTSD Scale also were significantly more improved in the prazosin condition, and prazosin was well tolerated.
These data support the efficacy of prazosin for nightmares, sleep disturbance, and other PTSD symptoms.

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    • "The first RCT was a double-blind placebo-controlled crossover study performed in 10 veterans (Raskind et al., 2003). Prazosin or placebo in random order were begun at an initial dose of 1 mg at bedtime and titrated upward for 3 weeks to a dose that eliminated trauma nightmares or to a maximum dose of 10 mg HS. "
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