Posted by Phidippus on December 8, 2011, at 14:34:29
In reply to Re: Effexor 450 mg? » SLS, posted by Bob on December 7, 2011, at 17:40:13
Bob,
Prazosin is a sympatholytic drug used to treat high blood pressure and Anxiety, PTSD and Panic Disorder. It belongs to the class of alpha-adrenergic blockers. Specifically, prazosin is selective for the alpha-1 receptors on vascular smooth muscle. These receptors are responsible for the vasoconstrictive action of norepinephrine, which would normally raise blood pressure and cause increase in anxiety and panic. By blocking these receptors, prazosin reduces blood pressure and reduces anxiety and panic.
From wikipedia:
Symptom management: potentially useful medication classes
SSRIs (selective serotonin reuptake inhibitors). SSRIs are considered to be a first-line drug treatment.[130][131] SSRIs for which there are data to support use include: citalopram, escitalopram,[132] fluoxetine,[133] fluvoxamine,[134] paroxetine,[135] and sertraline.[133][136]
Among the anti-depressants described in this section, bupropion and venlafaxine have the lowest patient drop-out rates. Sertraline, fluoxetine, and nefazodone have a modestly higher drop-out rate (~15%), and the heterocyclics and paroxetine have the highest rates (~20%+).[137] Where drop-out is caused or feared because of medication side-effects, it should be remembered that most patients do not experience such side-effects.[138]
Alpha-adrenergic antagonists. Prazosin ("Minipress"), in a small study of combat veterans, has shown substantial benefit in relieving or reducing nightmares.[139] Clonidine ("Catapres") can be helpful with startle, hyperarousal, and general autonomic hyperexcitability.[140]
Anti-convulsants, mood stabilizers, anti-aggression agents. Carbamazepine ("Tegretol") has likely benefit in reducing arousal symptoms involving noxious affect,[133] as well as mood or aggression.[141] Topiramate ("Topamax")[139] has been effective in achieving major reductions in flashbacks and nightmares, and no reduction of effect was seen over time.[139] Zolpidem ("Ambien") has also proven useful in treating sleep disturbances.[140]
Lamotrigine ("Lamictal") may be useful in reducing reexperiencing symptoms, as well as avoidance and emotional numbing.[139][142][143][144] Valproic acid ("Depakene") and has shown reduction of symptoms of irritability, aggression, and impulsiveness, and in reducing flashbacks.[140] Similarly, lithium carbonate has worked to control mood and aggressions (but not anxiety) symptoms.[141] Buspirone ("BuSpar") has an effect similar to that of lithium, with the additional benefit of working to reduce hyperarousal symptoms.[140]
Antipsychotics. Risperidone can be used to help with dissociation, mood issues, and aggression.[145]
Atypical antidepressants.[146] Nefazodone ("Serzone") can be effective with sleep disturbance symptoms, and with secondary depression, anxiety, and sexual dysfunction symptoms.[133] Trazodone ("Desyrel") can also reduce or eliminate problems with disturbed sleep, and with anger and anxiety.[133]
Beta blockers. Propranolol ("Inderal") has demonstrated possibilities in reducing hyperarousal symptoms, including sleep disturbances.[140][147]
Benzodiazepines. These can be used with caution for short-term anxiety relief,[145][148] hyperarousal, and sleep disturbance.[140] While benzodiazepines can alleviate acute anxiety, there is no consistent evidence that they can stop the development of PTSD, or are at all effective in the treatment of posttraumatic stress disorder. Additionally benzodiazepines may reduce the effectiveness of psychotherapeutic interventions and there is some evidence that benzodiazepines may contribute to the development and chronification of PTSD. Other drawbacks include the risk of developing a benzodiazepine dependence and withdrawal syndrome; additionally individuals with PTSD are at an increased risk of abusing benzodiazepines.[130][149]
Glucocorticoids. Additionally, post-stress high dose corticosterone administration was recently found to reduce 'PTSD-like' behaviors in a rat model of PTSD. In this study, corticosterone impaired memory performance, suggesting that it may reduce risk for PTSD by interfering with consolidation of traumatic memories.[150] The neurodegenerative effects of the glucocorticoids, however, may prove this treatment counterproductive.[151]
Heterocyclic / Tricyclic anti-depressants anti-depressants. Amitriptyline ("Elavil") has shown benefit for positive distress symptoms, and for avoidance, and Imipramine ("Tofranil") has shown benefit for intrusive symptoms.[133]
Monoamine-oxidase inhibitors (MAOIs). Phenelzine ("Nardil") has for some time been observed to be effective with hyperarousal and depression, and is especially effective with nightmares.[133]
Miscellaneous other medications. Clinical trials evaluating methylenedioxymethamphetamine (MDMA, "Ecstasy") in conjunction with psychotherapy are being conducted in Switzerland[152] and Israel.[153]
Eric
poster:Phidippus
thread:1004067
URL: http://www.dr-bob.org/babble/20111208/msgs/1004484.html