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A parallel group placebo controlled study of prazosin for trauma nightmares and sleep disturbance in combat veterans with post-traumatic stress disorder.
Biol Psychiatry. 2007 Apr 15; 61(8):928-34.BP

Abstract

BACKGROUND

Excessive brain responsiveness to norepinephrine appears to contribute to post-traumatic stress disorder (PTSD), particularly at night. Prazosin, a brain active alpha-1 adrenergic receptor antagonist, significantly reduced trauma nightmares and sleep disturbance in 10 Vietnam War combat veterans in a previous placebo-controlled crossover study. The current parallel group trial in a larger sample of veterans evaluated prazosin effects on trauma nightmares, sleep quality, global clinical status, dream characteristics, and comorbid depression.

METHODS

Forty veterans (mean age 56 +/- 9) with chronic PTSD and distressing trauma nightmares and sleep disturbance were randomized to evening prazosin (13.3 +/- 3 mg/day) or placebo for 8 weeks.

RESULTS

In the evaluable sample (n = 34), primary outcome measures demonstrated that prazosin was significantly superior to placebo for reducing trauma nightmares and improving sleep quality and global clinical status with large effect sizes. Prazosin shifted dream characteristics from those typical of trauma-related nightmares toward those typical of normal dreams. Blood pressure changes from baseline to end study did not differ significantly between prazosin and placebo.

CONCLUSIONS

Prazosin is an effective and well-tolerated treatment for trauma nightmares, sleep disturbance and global clinical status in veterans with chronic PTSD.

Authors+Show Affiliations

Veterans Affairs Northwest Network Mental Illness Research, Education and Clinical Center (MIRECC), University of Washington, Seattle, Washington, USA. murray.raskind@med.va.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

17069768

Citation

Raskind, Murray A., et al. "A Parallel Group Placebo Controlled Study of Prazosin for Trauma Nightmares and Sleep Disturbance in Combat Veterans With Post-traumatic Stress Disorder." Biological Psychiatry, vol. 61, no. 8, 2007, pp. 928-34.
Raskind MA, Peskind ER, Hoff DJ, et al. A parallel group placebo controlled study of prazosin for trauma nightmares and sleep disturbance in combat veterans with post-traumatic stress disorder. Biol Psychiatry. 2007;61(8):928-34.
Raskind, M. A., Peskind, E. R., Hoff, D. J., Hart, K. L., Holmes, H. A., Warren, D., Shofer, J., O'Connell, J., Taylor, F., Gross, C., Rohde, K., & McFall, M. E. (2007). A parallel group placebo controlled study of prazosin for trauma nightmares and sleep disturbance in combat veterans with post-traumatic stress disorder. Biological Psychiatry, 61(8), 928-34.
Raskind MA, et al. A Parallel Group Placebo Controlled Study of Prazosin for Trauma Nightmares and Sleep Disturbance in Combat Veterans With Post-traumatic Stress Disorder. Biol Psychiatry. 2007 Apr 15;61(8):928-34. PubMed PMID: 17069768.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A parallel group placebo controlled study of prazosin for trauma nightmares and sleep disturbance in combat veterans with post-traumatic stress disorder. AU - Raskind,Murray A, AU - Peskind,Elaine R, AU - Hoff,David J, AU - Hart,Kimberly L, AU - Holmes,Hollie A, AU - Warren,Daniel, AU - Shofer,Jane, AU - O'Connell,James, AU - Taylor,Fletcher, AU - Gross,Christopher, AU - Rohde,Kirsten, AU - McFall,Miles E, Y1 - 2006/10/25/ PY - 2006/02/16/received PY - 2006/06/14/revised PY - 2006/06/20/accepted PY - 2006/10/31/pubmed PY - 2007/6/2/medline PY - 2006/10/31/entrez SP - 928 EP - 34 JF - Biological psychiatry JO - Biol Psychiatry VL - 61 IS - 8 N2 - BACKGROUND: Excessive brain responsiveness to norepinephrine appears to contribute to post-traumatic stress disorder (PTSD), particularly at night. Prazosin, a brain active alpha-1 adrenergic receptor antagonist, significantly reduced trauma nightmares and sleep disturbance in 10 Vietnam War combat veterans in a previous placebo-controlled crossover study. The current parallel group trial in a larger sample of veterans evaluated prazosin effects on trauma nightmares, sleep quality, global clinical status, dream characteristics, and comorbid depression. METHODS: Forty veterans (mean age 56 +/- 9) with chronic PTSD and distressing trauma nightmares and sleep disturbance were randomized to evening prazosin (13.3 +/- 3 mg/day) or placebo for 8 weeks. RESULTS: In the evaluable sample (n = 34), primary outcome measures demonstrated that prazosin was significantly superior to placebo for reducing trauma nightmares and improving sleep quality and global clinical status with large effect sizes. Prazosin shifted dream characteristics from those typical of trauma-related nightmares toward those typical of normal dreams. Blood pressure changes from baseline to end study did not differ significantly between prazosin and placebo. CONCLUSIONS: Prazosin is an effective and well-tolerated treatment for trauma nightmares, sleep disturbance and global clinical status in veterans with chronic PTSD. SN - 0006-3223 UR - https://www.unboundmedicine.com/medline/citation/17069768/A_parallel_group_placebo_controlled_study_of_prazosin_for_trauma_nightmares_and_sleep_disturbance_in_combat_veterans_with_post_traumatic_stress_disorder_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0006-3223(06)00862-6 DB - PRIME DP - Unbound Medicine ER -