Effects of Prazosin on Nightmares in Adults with Posttraumatic Stress Disorder

The Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association [APA], 2000) estimates that in the United States, Posttraumatic Stress Disorder (PTSD) affects 8% of adults at some point during their life. Nightmares have a severe impact and can cause great distress for individuals with PTSD (Ohayon & Shapiro, 2000). Spoormaker and Montgomery (2008) suggested that sleep problems may be more of a risk factor for PTSD then a symptom of the disorder. Either way, it is evident that sleep needs to be addressed in those with this diagnosis. Posttraumatic nightmares are seldom the topic of PTSD studies utilizing medication management (Spoormaker & Montgomery) even though the rates of this symptom can be high. According to Friedman (2002), the use of psychiatric medication has shown minimal positive results in improving sleep issues. It has been suggested that prazosin may be beneficial in decreasing posttraumatic nightmares (VA, 2010). A literature review was completed to determine the effectiveness prazosin had on decreasing posttraumatic nightmares compared to a placebo, no medication, or psychotropic medications. Other studies including qualitative research were incorporated to show other responses related to the medication. These studies all shared results indicating that prazosin is effective at decreasing the quantity and intensity of nightmares in the adult populations studied. This information was disseminated through a presentation to mental health staff on an inpatient psychiatric unit. Discussion and review allowed for feedback from the staff. They gave examples of cases they’ve experienced and agreed that prazosin can be a useful medication in the treatment of posttraumatic nightmares