Titre du document / Document title

Prazosin reduces nightmares in combat veterans with posttraumatic stress disorder

Auteur(s) / Author(s)

RASKIND Murray A. ⁽¹⁾ ; THOMPSON Charles ⁽¹⁾ ; PETRIE Eric C. ⁽¹⁾ ; DOBIE Dorcas J. ⁽¹⁾ ; REIN Rebekah J. ⁽¹⁾ ; HOFF David J. ⁽¹⁾ ; MCFALL Miles E. ⁽¹⁾ ; PESKIND Elaine R. ⁽¹⁾ ; M ⁽¹⁾ ;

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

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

Résumé / Abstract

Background: Preclinical and clinical observations suggest that the centrally active α₁-adrenergic antagonist prazosin might alleviate trauma content nightmares and other symptoms in combat veterans with chronic posttraumatic stress disorder (PTSD). Method: In this retrospective chart review study, we analyzed data from 59 consecutive combat veterans with previously treatment-resistant chronic PTSD (DSM-IV criteria) and severe intractable trauma content nightmares to whom prazosin had been prescribed. Nightmare severity was quantified using the recurrent distressing dreams item of the Clinician Administered PTSD Scale (CAPS). Change in overall PTSD severity exclusive of nightmares was estimated by assigning a Clinical Global Impressions-Change scale (CGI-C) score based on chart review. Results: Mean ± SEM recurrent distressing dreams item scores improved significantly (7.0 ± 0.2 to 3.5 ± 0.3, p <.0001) in the 36 patients who completed at least 8 weeks of prazosin treatment at their maximum titrated dose. The mean maximum prazosin dose achieved in these 36 patients was 9.6 ± 0.9 mg/day. Recurrent distressing dreams scores also improved in the total group who filled their prazosin prescriptions (N = 51) (7.1 ± 0.2 to 4.2 ± 0.3, p <.0001). In a comparison group of 8 patients who did not fill their prazosin prescriptions but continued in outpatient treatment, there was no significant change in CAPS recurrent distressing dreams score (6.8 ± 0.5 to 6.7 ± 0.4). There also was at least some improvement in CGI-C ratings of overall PTSD severity exclusive of nightmares in a substantial majority of patients receiving prazosin, but not in the 8 comparison subjects. There were no serious adverse effects attributable to prazosin. Conclusion: These observations suggest that prazosin may relieve symptomatic distress in PTSD, and they provide rationale for placebo-controlled trials of prazosin for PTSD trauma content nightmares and other PTSD symptoms.

Revue / Journal Title

The Journal of clinical psychiatry   ISSN 0160-6689 

Source / Source

2002, vol. 63, n^o7, pp. 565-568 (26 ref.)

Langue / Language

Anglais

Editeur / Publisher

Physicians Postgraduate Press, Memphis, TN, ETATS-UNIS  (1978) (Revue)

Mots-clés anglais / English Keywords

Vasodilator agent ; Antihypertensive agent ; Mood disorder ; Anxiety disorder ; Human ; Retrospective ; Toxicity ; Treatment efficiency ; Psychotropic ; Tranquillizer ; Alpha blocking agent ; α1-Adrenergic receptor ; Antagonist ; Prazosin ; Chemotherapy ; Treatment ; Treatment resistance ; Depression ; Nightmare ; Symptomatology ; Veteran ; Chronic ; Stress ; Posttraumatic syndrome ;

Mots-clés français / French Keywords

Vasodilatateur ; Antihypertenseur ; Trouble humeur ; Trouble anxieux ; Détresse psychologique ; Homme ; Rétrospective ; Toxicité ; Efficacité traitement ; Psychotrope ; Tranquillisant ; Bloquant α-adrénergique ; Récepteur α1-adrénergique ; Antagoniste ; Prazosine ; Chimiothérapie ; Traitement ; Résistance traitement ; Etat dépressif ; Cauchemar ; Symptomatologie ; Ancien combattant ; Chronique ; Stress ; Posttraumatisme syndrome ;

Mots-clés espagnols / Spanish Keywords

Vasodilatador ; Antihipertensivo ; Trastorno humor ; Trastorno ansiedad ; Hombre ; Retrospectiva ; Toxicidad ; Eficacia tratamiento ; Psicotropo ; Tranquilizante ; Bloqueador α-adrenérgico ; Receptor α1-adrenérgico ; Antagonista ; Prazosina ; Quimioterapia ; Tratamiento ; Resistencia tratamiento ; Estado depresivo ; Pesadilla ; Sintomatología ; Veterano ; Crónico ; Estrés ; Posttraumatismo síndrome ;

Localisation / Location

INIST-CNRS, Cote INIST : 9069, 35400010895721.0040