Journal
JOURNAL OF PSYCHIATRIC PRACTICE
Volume 15, Issue 6, Pages 454-459Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.pra.0000364287.63210.92
Keywords
posttraumatic stress disorder; prazosin; nightmares; refugees; global concern
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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. (Journal of Psychiatric Practice 2009;15:454-459)
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