Journal
JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY
Volume 16, Issue 3, Pages 165-171Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/0891988703256050
Keywords
PTSD; prazosin; nightmares; veterans; Holocaust
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Trauma-related nightmares in posttraumatic stress disorder (PTSD) rarely respond. to pharmacologic treatment. Neurobiologic data suggest that enhanced brain responsiveness to adrenergic stimulation may contribute to the pathophysiology of trauma-related nightmares in PTSD. Nine older men with chronic PTSD secondary to military or Holocaust trauma were prescribed the lipophilic alpha-1 adrenergic antagonist prazosin for treatment-resistant trauma-related nightmares. Prazosin 2 mg to 4 mg 1 hour before bedtime substantially reduced nightmares and moderately or markedly reduced overall PTSD severity in 8 of 9 subjects. Prazosin was well tolerated. These open-label results are consistent with demonstrated therapeutic efficacy of prazosin for PTSD nightmares and sleep disturbance in a recent placebo-controlled trial in Vietnam veterans.
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