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#150551 - 04/12/07 11:39 PM PTSD medication
Ken Singer, LCSW Offline

Registered: 08/24/00
Posts: 5781
Loc: Lyons, CO USA
Study finds drug helps PTSD nightmares
SEATTLE -- A generic drug already used by millions of Americans for high blood pressure and prostate problems has been found to improve sleep and lessen trauma nightmares in veterans with posttraumatic stress disorder (PTSD).

"This is the first drug that has been demonstrated effective for PTSD nightmares and sleep disruption," said Murray A. Raskind, MD, executive director of the mental health service at the Veterans Affairs Puget Sound Health Care System and lead author of a study appearing April 15 in Biological Psychiatry.

The randomized trial of 40 veterans compared a nightly dose of prazosin (PRAISE-oh-sin) with placebo over eight weeks. Participants continued to take other prescribed medications over the course of the trial.

At the end of the study, veterans randomized to prazosin reported significantly improved sleep quality, reduced trauma nightmares, a better overall sense of well being, and an improved ability to function.

"These nighttime symptoms are heavily troublesome to veterans," said Raskind, who also is director of VA’s VISN 20 (Veterans Integrated Service Network #20) Mental Illness Research, Education and Clinical Centers program (MIRECC). "If you get the nighttime symptoms under control, veterans feel better all around."

Raskind, also a professor of psychiatry and behavioral sciences at the University of Washington, estimates that of the 10 million U.S. veterans and civilians with PTSD, about half have trauma-related nightmares that could be helped with the drug.

Participants were given 1 mg of prazosin per day for the first three days. The dose was gradually increased over the first four weeks to a maximum of 15 mg at bedtime. The average dose of prazosin in the trial was 13.3 mg. By comparison, typical prazosin doses for controlling blood pressure or treating prostate problems range from 3 mg to 30 mg per day in divided doses.

The drug did not affect blood pressure compared to placebo, though some participants reported transient dizziness when standing from a sitting position during the first weeks of prazosin titration. Other occasional side effects included nasal congestion, headache, and dry mouth, but these were all minor, according to the authors.

"This drug has been taken by many people for decades," said Raskind. "If there were serious long-term adverse side effects, it is likely we would know about them by now."

The relatively small size of the study was due to the easy availability of this generic drug, Raskind said. "If you are doing a study with a new drug, the only way people can get it is to be in the study. With prazosin, we have approximately 5,000 veterans with a PTSD diagnosis taking it already in the Northwest alone. So we had to find veterans with PTSD who were not [taking it]."

For treating PTSD, prazosin costs 10 to 30 cents a day at VA contract prices. It is not a sedating sleeping pill, emphasized Raskind. "It does not induce sleep. But once you are asleep, you sleep longer and better."

And better sleep can make a big difference. "This drug changes lives," Raskind said. "Nothing else works like prazosin."

Trauma nightmares appear to arise during light sleep or disruption in REM sleep, whereas normal dreams—both pleasant and unpleasant— occur during normal REM sleep. Prazosin works by blocking the brain’s response to the adrenaline-like neurotransmitter norepinephrine. Blocking norepinephrine normalizes and increases REM sleep. In this study, veterans taking prazosin reported that they resumed normal dreaming.

One dose of prazosin works for 6 to 8 hours. Unlike similar drugs, prazosin does not induce tolerance; people can take it for years without increasing the dose. But when veterans stop taking it, Raskind said, the trauma nightmares usually return.

Aside from the VA-funded study he just published, Raskind is working on three larger studies of prazosin. One, a VA cooperative study slated to start this month, will enroll about 300 veterans at 12 VA facilities. The second, a collaborative study with Walter Reed Army Medical Center and Madigan Army Medical Center, will enroll active-duty soldiers who have trauma nightmares. The third study, funded by the National Institute of Mental Health, will look at prazosin in the treatment of civilian trauma PTSD.

Blissfully retired after 35 years treating sexual abuse

#150764 - 04/14/07 09:03 AM Re: PTSD medication [Re: Ken Singer, LCSW]
Junyah Offline
Junior Member

Registered: 03/07/06
Posts: 52
Loc: Mississauga, Ont
As a person that sufers from PTSD, this has me really hopeful and excited, I am seeing my doctor monday and will definately be asking her about it...thanks for posting this...

"Everybody is a genius. But if you judge a fish by its ability to climb a tree, it will live its whole life believing that it is stupid."
— Albert Einstein

#150765 - 04/14/07 09:09 AM Re: PTSD medication [Re: Junyah]
duncanUK Offline

Registered: 12/24/06
Posts: 632
i have been diagnosed two times for PTSD one by another doctor and the other by the psychologist that i was seeing. No medication has come my way. perhaps i dont need it.

you dont see me. i am not really here. Its my fault.. all of it. I am to blame and no one else.

#150770 - 04/14/07 10:16 AM Re: PTSD medication [Re: duncanUK]
reality2k4 Offline

Registered: 07/06/04
Posts: 6845
Loc: Stuck between water, air, and ...
I rarely have nightmares, but do have broken sleep and really weird dreams of feeling loss of control.

I will ask my doc if this might help, as sleep gives you stamina for the day ahead,


#151212 - 04/17/07 01:18 AM Re: PTSD medication [Re: reality2k4]
Logan Offline

Registered: 04/05/03
Posts: 1368
Loc: NY
I guess its funny that you mention this now 'cause I just recently got put on this.

I have really bad Complex Type PTSD as do so many of us here.

and nightmares are a HUGE problem for me. I used to just Drink alot (alchol) before I went to sleep, but ever since I quit Dinking (4 mon. ago), I have been remembering alot more and getting flashbacks-(Wow! those are weird and Fukin' scarry)

Especially when I have them almost every night, sometimes 2 or 3 a night, I used to have to sleep with something in my mouth so that when I woke up screaming it would muffle the sound and I wouldn't wake up my nahboors. I also used to kick the wall and fall out of bed. and since there are no nightmares I don't do that either.

My--T Prescibed it and ever since Ive had only one nightmare and it wasn't that intense.

I use to have to change my t-shirt and boxers becase they were so full of sweat. and wake up shaking sometimes and I have not done either in almost a month.

Its really great and yeah, if I get a good night of sleep, I have a much better day.

the best thing about is that I don't fear going to bed anymore.

But one side effect is that make sure you have about 8 hrs to devote to sleep or else its tuff to get up in the morning.

hope this helps


p.s. Duncan I like your signature. I heard another version:
"Holding on to anger and spite is like dinking poison and expection the other person to die"

"Terrible thing to live in Fear"-Shawshank Redemption
WOR Alumnus Hope Springs 2009
"Quite a thing to live in fear, this is what is means to be a slave"
-Blade Runner

#151374 - 04/18/07 01:19 AM Re: PTSD medication [Re: Logan]
sabata Offline

Registered: 08/08/06
Posts: 1950
where can i sign up ..for the study???????????

#153137 - 04/28/07 03:10 AM Re: PTSD medication [Re: sabata]
Daniel Peter Offline

Registered: 04/21/07
Posts: 40
Loc: Canada
Wonder if the Canadian VA is doing it? I'll have to check it out, thanks!

Edited by Daniel Peter (04/28/07 03:11 AM)
He who dies with the most toys...loses them all when he dies.

He who dies having fed and cared for his brother, wins in the eyes of God...and the hearts of his brothers.

He who dies but didn't ride...well...he didn't really live anyway!


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