Titre du document / Document title

The α₁-adrenergic antagonist prazosin improves sleep and nightmares in civilian trauma posttraumatic stress disorder

Auteur(s) / Author(s)

TAYLOR Fletcher ^{(1 2)} ; RASKIND Murray A. ^{(2 3)} ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Rainier Associates, Tacoma, Washington, ETATS-UNIS
⁽²⁾ Department of Psychiatry and Behavioral Sciences, University of Washington, ETATS-UNIS
⁽³⁾ VA Puget Sound Health Care System Northwest Network VA Mental Illness Research, Education and Clinical Center (MIRECC), Seattle, Washington, ETATS-UNIS

Résumé / Abstract

Heightened noradrenergic reactivity may be a contributing factor in the pathophysiology of posttraumatic stress disorder (PTSD). Prazosin is an α₁-adrenoceptor antagonist commonly used as an antihypertensive agent. Because α₁-adrenergic activity has been associated with fear and startle responses, a drug that blocks central α₁-adrenergic activity may be useful in the treatment of PTSD symptoms. An outpatient who had been exposed to civilian trauma and had subsequent chronic refractory PTSD was thus prescribed prazosin. The marked reduction in PTSD symptoms, particularly sleep and nightmares, prompted the following open-label feasibility trial. Five outpatients with non-combat-related PTSD were consecutively identified and received prazosin in a 6-week open-label trial. In each case, the prazosin doses were slowly increased until optimal benefit was achieved. Change was assessed with the Clinician-Administered PTSD Scale for DSM-IV, One Week Symptom Version (CAPS-SX), the Clinical Global Impression of Change Scale (CGIC), and the Clinical Impression of Change-Nightmares (CIC-Nightmares) score. All five patients experienced moderate to marked improvement on the CGIC. The CAPS-SX PTSD nightmare and sleep PTSD categories showed at least a four-point reduction of those symptoms. All patients reported at least moderate improvement on the CIC-Nightmare score. Optimal doses of prazosin ranged from 1 to 4 mg/day. The drug was reasonably tolerated, and there were no drug discontinuations. These preliminary findings provide a rationale for blind placebo-controlled efficacy trials of the α₁ antagonist prazosin for PTSD.

Revue / Journal Title

Journal of clinical psychopharmacology   ISSN 0271-0749   CODEN JCPYDR 

Source / Source

2002, vol. 22, n^o1, pp. 82-85 (16 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS  (1981) (Revue)

Mots-clés anglais / English Keywords

Anxiety disorder ; Biological activity ; Case study ; Nightmare ; Sleep ; Chemotherapy ; Treatment ; Human ; Prazosin ; Antagonist ; α1-Adrenergic receptor ; Posttraumatic syndrome ;

Mots-clés français / French Keywords

Trouble anxieux ; Activité biologique ; Etude cas ; Cauchemar ; Sommeil ; Chimiothérapie ; Traitement ; Homme ; Prazosine ; Antagoniste ; Récepteur α1-adrénergique ; Posttraumatisme syndrome ;

Mots-clés espagnols / Spanish Keywords

Trastorno ansiedad ; Actividad biológica ; Estudio caso ; Pesadilla ; Sueño ; Quimioterapia ; Tratamiento ; Hombre ; Prazosina ; Antagonista ; Receptor α1-adrenérgico ; Posttraumatismo síndrome ;

Localisation / Location

INIST-CNRS, Cote INIST : 19145, 35400010005347.0120