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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Phillipa on October 24, 2013, at 18:29:53
Am J Psychiatry. 2013 Sep 1;170(9):1003-10. doi: 10.1176/appi.ajp.2013.12081133.
A Trial of Prazosin for Combat Trauma PTSD With Nightmares in Active-Duty Soldiers Returned From Iraq and Afghanistan.
Raskind MA, Peterson K, Williams T, Hoff DJ, Hart K, Holmes H, Homas D, Hill J, Daniels C, Calohan J, Millard SP, Rohde K, O'Connell J, Pritzl D, Feiszli K, Petrie EC, Gross C, Mayer CL, Freed MC, Engel C, Peskind ER.
Abstract
OBJECTIVE The authors conducted a 15-week randomized controlled trial of the alpha-1 adrenoreceptor antagonist prazosin for combat trauma nightmares, sleep quality, global function, and overall symptoms in active-duty soldiers with posttraumatic stress disorder (PTSD) returned from combat deployments to Iraq and Afghanistan. METHOD Sixty-seven soldiers were randomly assigned to treatment with prazosin or placebo for 15 weeks. Drug was titrated based on nightmare response over 6 weeks to a possible maximum dose of 5 mg midmorning and 20 mg at bedtime for men and 2 mg midmorning and 10 mg at bedtime for women. Mean achieved bedtime doses were 15.6 mg of prazosin (SD=6.0) and 18.8 mg of placebo (SD=3.3) for men and 7.0 mg of prazosin (SD=3.5) and 10.0 mg of placebo (SD=0.0) for women. Mean achieved midmorning doses were 4.0 mg of prazosin (SD=1.4) and 4.8 mg of placebo (SD=0.8) for men and 1.7 mg of prazosin (SD=0.5) and 2.0 mg of placebo (SD=0.0) mg for women. Primary outcome measures were the nightmare item of the Clinician-Administered PTSD Scale (CAPS), the Pittsburgh Sleep Quality Index, and the change item of the Clinical Global Impressions Scale anchored to functioning. Secondary outcome measures were the 17-item CAPS, the Hamilton Depression Rating Scale, the Patient Health Questionnaire-9, and the Quality of Life Index. Maintenance psychotropic medications and supportive psychotherapy were held constant. RESULTS Prazosin was effective for trauma nightmares, sleep quality, global function, CAPS score, and the CAPS hyperarousal symptom cluster. Prazosin was well tolerated, and blood pressure changes did not differ between groups. CONCLUSIONS Prazosin is effective for combat-related PTSD with trauma nightmares in active-duty soldiers, and benefits are clinically meaningful. Substantial residual symptoms suggest that studies combining prazosin with effective psychotherapies might demonstrate further benefit.
Posted by b2chica on October 29, 2013, at 13:42:58
In reply to Prazoain Combat Related PTSD, posted by Phillipa on October 24, 2013, at 18:29:53
Caution Please
my pdoc did rx me this earlier this year, and in three days i was ready to kill myself. literally in 24 hours i started getting teary, for once i was just thinking it was circumstances, next day cried lots and next night suicidal. it happened fairly quickly. i called my pdoc and he told me that it was very likely the med and to stop it Immediatley!
withi 24 hours after stopping it, my blues and tears went away.so, although it might work, i just wanted to put a caution in there just incase you want to try it so you can keep an eye out on your mood.
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Posted by Ruby2 on November 4, 2013, at 7:16:32
In reply to Prazoain Combat Related PTSD, posted by Phillipa on October 24, 2013, at 18:29:53
Prazosin has been a huge help to me; I suffer from PTSD and have had horrific nightmares--taking prazosin has really put a stop to the nightmares. I take 5mg when I go to bed (along with 150mg of trazodone and 1mg of clonazapam). 95% of the time this cocktail works like a dream for me. Been on it for over a year, perhaps closer to two years.
Posted by Phillipa on November 4, 2013, at 19:47:44
In reply to Re: Prazoain Combat Related PTSD, posted by Ruby2 on November 4, 2013, at 7:16:32
Glad it was helpful for you!!!
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