The ɑ<span style="font-size:12px;position:relative;top:5px;">1</span>-Adrenergic Antagonist Prazosin Ameliorates Combat Trauma Nightmares in Veterans With Posttraumatic Stress Disorder: A Report of 4 Cases
J Clin Psychiatry 2000;61(2):129-134
© Copyright 2017 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: Central nervous system (CNS)
adrenergic hyperresponsiveness may be involved in the
pathophysiology of posttraumatic stress disorder (PTSD). Two
Vietnam combat veterans with PTSD prescribed the centrally active
alpha1-adrenergic antagonist prazosin for symptoms of
benign prostatic hypertrophy unexpectedly reported elimination of
combat trauma nightmares. This observation prompted an open-label
feasibility trial of prazosin for combat trauma nightmares in
chronic combat-induced PTSD.
Method: Four consecutively identified combat
veterans with chronic DSM-IV PTSD and severe intractable combat
trauma nightmares participated in an 8-week open trial of
escalating-dose prazosin. Nightmare severity response was rated
using the nightmare item of the Clinician Administered PTSD Scale
and the Clinical Global Impressions-Change scale.
Results: The 2 patients who achieved a daily
prazosin dose of at least 5 mg were markedly improved, with
complete elimination of trauma nightmares and resumption of
normal dreaming. The 2 subjects limited to 2 mg of prazosin to
avoid excessive blood pressure reduction were moderately improved
with at least 50% reduction in nightmare severity.
Conclusion: These clinical observations,
together with neurobiological evidence for alpha1-adrenergic
regulation of CNS neurobiological systems relevant to PTSD,
provide rationale for placebo-controlled trials of prazosin for
PTSD combat trauma nightmares.