Prazosin treatment of trauma nightmares and sleep disturbance in soldiers deployed in Iraq

Madigan Army Medical Center and VA Northwest Network Mental Illness, VA Puget Sound Health Care System, 1660 S. Columbian Way, Seattle, WA 98108, USA.
Journal of Traumatic Stress (Impact Factor: 2.72). 10/2010; 23(5):645-8. DOI: 10.1002/jts.20570
Source: PubMed


Trauma nightmares and sleep disturbance impair combat soldiers' functioning. The alpha-1 adrenoreceptor antagonist prazosin has been demonstrated effective for these symptoms in Vietnam veterans. Thirteen soldiers seeking relief from distressing trauma nightmares impairing military function in northern Iraq in 2006 received prazosin alone or in combination with other psychotropics. Mean prazosin dose was 4.1 (SD = 2.2) mg before bed. Six soldiers improved markedly and 3 moderately on the Clinical Global Impression of Change Ratings of distressing dreams decreased from an average of 7.0 (SD = 0.7) to 2.9 (SD = 3.0, p < .001) and those of disturbed sleep from 6.7 (SD = 0.9) to 3.7 (SD = 2.4, p < .001). Prazosin appears effective and well tolerated in the desert warfare environment.

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    • "Total CAPS score decrease remained significantly greater in the prazosin group (p ¼ 0.04) even after removing the nightmare item. Similar open label prazosin beneficial effects with good tolerability have been reported in soldiers performing combat operations in the dehydrating Iraq desert warfare environment (Calohan et al., 2010), and in elderly World War II Veterans and Holocaust survivors (Peskind et al., 2003). "
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