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Re: New diagnosis: Borderline PD (SLS, your thoughts?)

Posted by SLS on December 24, 2016, at 21:12:39

In reply to Re: New diagnosis: Borderline PD (SLS, your thoughts?) zonked, posted by SLS on December 24, 2016, at 21:03:34


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Therapeutic Advances in Psychopharmacology February 2014 4: 43-47, first published on August 16, 2013

High-dose prazosin for the treatment of posttraumatic stress disorder

1. Maju Mathew Koola
1. Clinical Research Program, Sheppard Pratt Health System and Department of
Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
2. Sajoy P. Varghese
1. Department of Mental Health, Captain James A. Lovell, Federal Health Care
Center, Department of Psychiatry and Behavioral Sciences, Rosalind Franklin
University of Medicine and Science, 3333 Green Bay Road, North Chicago, IL
60064, USA
3. Jan A. Fawcett
1. Department of Psychiatry, University of New Mexico School of Medicine, Albuquerque,
NM, USA
1. sajoy.varghese{at}va.gov

Abstract
Patients with post-traumatic stress disorder (PTSD) are frequently symptomatic despite being on
medications currently approved by the US Food and Drug Administration for PTSD. There is
evidence to support the notion that prazosin is effective for PTSD nightmares. However, PTSD related nightmares often do not resolve completely on a low dose of prazosin. The capacity of
prazosin to treat daytime symptoms of PTSD which are distressing to patients has not been well
studied. Clinicians are reluctant to increase the dose of prazosin due to side effect concerns. To
date, the highest reported dose of prazosin used for PTSD is 16 mg daily. We illustrate two case
reports using high-dose (up to 30 and 45 mg) prazosin for PTSD with comorbid treatment resistant mood disorders. We report that high-dose prazosin was safe, tolerable and effective for
PTSD in adults. To our knowledge, this is the first case series to highlight the importance of
using high-dose prazosin for the treatment of PTSD. In patients with partial response to currently
available medications for PTSD, greater utilization of high-dose prazosin for the management of
PTSD may lead to better outcomes.

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Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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