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Prazosin PTSD

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https://www.readbyqxmd.com/read/29489046/suicidal-ideation-in-military-veterans-with-alcohol-dependence-and-ptsd-the-role-of-hostility
#1
Lorig K Kachadourian, Erin Gandelman, Elizabeth Ralevski, Ismene L Petrakis
BACKGROUND AND OBJECTIVES: Suicide is a significant public health problem among US military Veterans with rates exceeding civilian samples. Alcohol dependence (AD) and posttraumatic stress disorder (PTSD) are both associated with increases in suicidality. Given that risk of suicide is higher among those with both disorders, the study of relevant risk factors among those in this group is important. The current investigation focused on one such factor, hostility, and examined both overt hostility (ie, hostility that is more behavioral in nature and directed outwardly) and covert hostility (ie, hostility that is cognitive in nature and introspective) and their relationships to suicidal ideation...
March 2018: American Journal on Addictions
https://www.readbyqxmd.com/read/29414272/trial-of-prazosin-for-post-traumatic-stress-disorder-in-military-veterans
#2
RANDOMIZED CONTROLLED TRIAL
Murray A Raskind, Elaine R Peskind, Bruce Chow, Crystal Harris, Anne Davis-Karim, Hollie A Holmes, Kimberly L Hart, Miles McFall, Thomas A Mellman, Christopher Reist, Jennifer Romesser, Robert Rosenheck, Mei-Chiung Shih, Murray B Stein, Robert Swift, Theresa Gleason, Ying Lu, Grant D Huang
BACKGROUND: In randomized trials, prazosin, an α1 -adrenoreceptor antagonist, has been effective in alleviating nightmares associated with post-traumatic stress disorder (PTSD) in military veterans. METHODS: We recruited veterans from 13 Department of Veterans Affairs medical centers who had chronic PTSD and reported frequent nightmares. Participants were randomly assigned to receive prazosin or placebo for 26 weeks; the drug or placebo was administered in escalating divided doses over the course of 5 weeks to a daily maximum of 20 mg in men and 12 mg in women...
February 8, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29038221/prazosin-during-threat-discrimination-boosts-memory-of-the-safe-stimulus
#3
Philipp Homan, Qi Lin, James W Murrough, Laili Soleimani, Dominik R Bach, Roger L Clem, Daniela Schiller
The α-1 adrenoreceptor antagonist prazosin has shown promise in the treatment of post-traumatic stress disorder (PTSD) symptoms, but its mechanisms are not well understood. Here we administered prazosin or placebo prior to threat conditioning (day 1) and tested subsequent extinction (day 2) and reextinction (day 3) in healthy human participants. Prazosin did not affect threat conditioning but augmented stimulus discrimination during extinction and reextinction, via lower responding to the safe stimulus. These results suggest that prazosin during threat acquisition may have influenced encoding or consolidation of safety processing in particular, subsequently leading to enhanced discrimination between the safe and threatening stimuli...
November 2017: Learning & Memory
https://www.readbyqxmd.com/read/29018563/pharmacotherapy-of-post-traumatic-stress-disorder-going-beyond-the-guidelines
#4
EDITORIAL
Jonathan Davidson
SUMMARY: This article discusses the study of Harpaz-Rotem and associates, who examined patterns of medication use in first-diagnosed veterans with post-traumatic stress disorder (PTSD). It considers the difference between practice guidelines and actual prescribing; selectively identifies issues with antidepressants, antipsychotics, benzodiazepines and prazosin; and reviews the possible impact of new medications in the pipeline. DECLARATION OF INTERESTS: In the past 36 months, J...
November 2016: BJPsych Open
https://www.readbyqxmd.com/read/28953506/psychotropic-medication-prescribing-in-iraq-afghanistan-veterans-and-vietnam-era-veterans-with-posttraumatic-stress-disorder
#5
COMPARATIVE STUDY
Dolores Vojvoda, Elina A Stefanovics, Robert A Rosenheck
A new generation of veterans from Iraq/Afghanistan wars is seeking psychotropic pharmacotherapy for posttraumatic stress disorder (PTSD) from the Veterans Health Administration, but little is known about differences in prescribing practices between this group and Vietnam era veterans with the same diagnosis. The Veterans Health Administration administrative data for fiscal year 2012 were used to compare prescribing for 155,631 Iraq/Afghanistan veterans and for 327,634 Vietnam era veterans diagnosed with PTSD...
November 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28755207/use-of-prazosin-for-pediatric-ptsd-associated-nightmares-and-sleep-disturbances-a-retrospective-chart-review
#6
Brooks R Keeshin, Qian Ding, Angela P Presson, Steven J Berkowitz, Jeffrey R Strawn
INTRODUCTION: Youth exposed to trauma have an increased risk for developing posttraumatic stress disorder (PTSD) and associated sleep disturbances and nightmares. The alpha-1 antagonist prazosin reduces sleep disturbances and nightmares in adults with PTSD; however, its use in youth with PTSD has not been systematically evaluated. We retrospectively examined the tolerability and clinical outcomes associated with prazosin treatment in youth with PTSD-related nightmares and dysomnias. METHOD: A retrospective chart review identified youth with PTSD (N = 40) treated with prazosin between 2014 and 2016 in a trauma clinic...
December 2017: Neurology and Therapy
https://www.readbyqxmd.com/read/28551590/higher-pretreatment-blood-pressure-is-associated-with-greater-alcohol-drinking-reduction-in-alcohol-dependent-individuals-treated-with-doxazosin
#7
Carolina L Haass-Koffler, Kimberly Goodyear, William H Zywiak, Molly Magill, Sarah E Eltinge, Paul M Wallace, Victoria M Long, Nitya Jayaram-Lindström, Robert M Swift, George A Kenna, Lorenzo Leggio
BACKGROUND: Preclinical and clinical research suggest that the α1 receptor antagonist prazosin reduces alcohol consumption. Furthermore, clinical studies indicate a role for prazosin in treating Post-Traumatic Stress Disorder (PTSD) symptoms and a recent trial suggested that pre-treatment blood pressure (BP) predicts therapeutic response for prazosin in PTSD patients. Whether pre-treatment BP may predict response to α1 blockers in alcohol-dependent (AD) patients is unknown. We previously reported a randomized controlled trial (RCT) where doxazosin, an α1 receptor antagonist with a more favorable pharmacokinetic profile than prazosin, reduced drinks per week (DPW) and heavy drinking days (HDD) in AD patients with a high family history density of alcoholism...
August 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28277828/cultivating-change-door-to-door-educational-outreach-to-improve-prescribing-practices-in-rural-veterans-with-posttraumatic-stress-disorder
#8
Macgregor Montaño, Nancy C Bernardy, Kathleen Sherrieb
BACKGROUND: Clinical guidelines for the management of posttraumatic stress disorder (PTSD) recommend against the use of benzodiazepines. Benzodiazepines and PTSD are both associated with addiction-related risks. The Department of Veterans Affairs (VA) prescribing trends show continued use of benzodiazepines and polysedative use in veterans with PTSD, particularly in rural areas. The authors examine the use of an educational intervention to improve pharmacologic management of veterans with PTSD in rural clinics...
April 2017: Substance Abuse
https://www.readbyqxmd.com/read/28106623/symptom-presentation-and-prescription-of-sleep-medications-for-veterans-with-posttraumatic-stress-disorder
#9
Mark A Greenbaum, Thomas C Neylan, Craig S Rosen
This study tested whether sleep medications prescribed to veterans diagnosed with posttraumatic stress disorder (PTSD) are being targeted to patients who report more severe insomnia or nightmares. Secondary analysis of survey and pharmacy data was conducted in samples of veterans from two periods: from 2006 to 2008 and from 2009 to 2013. Logistic regression tested associations between self-reported insomnia and nightmare severity, and being prescribed trazodone, prazosin, zolpidem, and benzodiazepines, controlling for PTSD severity and other covariates...
February 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/27999253/treatment-of-post-traumatic-stress-disorder-nightmares-at-a-veterans-affairs-medical-center
#10
Mark B Detweiler, Bhuvaneshwar Pagadala, Joseph Candelario, Jennifer S Boyle, Jonna G Detweiler, Brian W Lutgens
The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio.ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis...
December 16, 2016: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/27977074/the-efficacy-of-prazosin-for-the-treatment-of-posttraumatic-stress-disorder-nightmares-in-u-s-military-veterans
#11
REVIEW
Annamarie Breen, Kory Blankley, Julie Fine
BACKGROUND AND PURPOSE: Nightmares associated with posttraumatic stress disorder (PTSD) are a hallmark symptom among U.S. military veterans who have seen combat. Management of combat-related nightmares can be difficult and current pharmacologic options are limited and tend to have adverse side effects. The aim of this review is to explore recent literature regarding the efficacy of prazosin for the treatment of nightmare disorder in the veteran population. METHODS: Recent literature consisting of three systematic reviews was reviewed, as well as current clinical guidelines published by The Department of Veterans Affairs (VA) and The Department of Defense (DoD) and the American Academy of Sleep Medicine (AASM)...
February 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/27930498/prazosin-in-children-and-adolescents-with-posttraumatic-stress-disorder-who-have-nightmares-a-systematic-review
#12
REVIEW
Adefolake Akinsanya, Raman Marwaha, Rajesh R Tampi
BACKGROUND: The aim of this systematic review was to identify published articles that evaluated the use of prazosin for treating nightmares in children and adolescents who have posttraumatic stress disorder (PTSD). PROCEDURES: A literature search was conducted of PubMed, MEDLINE, EMBASE, Cochrane Collaboration, and PsycINFO databases for published articles in any language that evaluated the use of prazosin for treating nightmares in the context of PTSD in children and adolescents using the following key words: PTSD, nightmares, prazosin, children, adolescents, trauma, and sleep...
February 2017: Journal of Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27828694/efficacy-of-prazosin-in-posttraumatic-stress-disorder-a-systematic-review-and-meta-analysis
#13
REVIEW
Balwinder Singh, Andrew J Hughes, Gaurav Mehta, Patricia J Erwin, Ajay K Parsaik
OBJECTIVE: To consolidate the evidence from the literature to evaluate the role of prazosin in the treatment of posttraumatic stress disorder (PTSD). DATA SOURCES: Major databases, including PubMed, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Ovid PsycINFO, and Scopus, were searched through August 2015 for studies reporting the role of prazosin in the treatment of PTSD with no language constraints...
July 28, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27822278/prazosin-for-trauma-nightmares-and-sleep-disturbances-in-combat-veterans-with-post-traumatic-stress-disorder
#14
Habibolah Khazaie, Marzie Nasouri, Mohammad Rasoul Ghadami
BACKGROUND: Prazosin is significantly effective to reduce sleep disturbance and trauma nightmare in patients with post-traumatic stress disorder (PTSD); however, results of different studies were evaluated. OBJECTIVES: The current randomized clinical trial aimed to assess the effects of prazosin on sleep parameters and nightmares among veterans with chronic PTSD. MATERIALS AND METHODS: Thirty-two veterans with chronic war-induced PTSD and distressing nightmares were randomized into prazosin and placebo groups for eight weeks...
September 2016: Iranian Journal of Psychiatry and Behavioral Sciences
https://www.readbyqxmd.com/read/27703791/initiation-of-pharmacotherapy-for-post-traumatic-stress-disorder-among-veterans-from-iraq-and-afghanistan-a-dimensional-symptom-cluster-approach
#15
Ilan Harpaz-Rotem, Robert Rosenheck, Somaia Mohamed, Robert Pietrzak, Rani Hoff
BACKGROUND: The pharmacological treatment of post-traumatic stress disorder (PTSD) is extremely challenging, as no specific agent has been developed exclusively to treat this disorder. Thus, there are growing concerns among the public, providers and consumers associated with its use as the efficacy of some agents is still in question. AIMS: We applied a dimensional and symptom cluster-based approach to better understand how the heterogeneous phenotypic presentation of PTSD may relate to the initiation of pharmacotherapy for PTSD initial episode...
September 2016: BJPsych Open
https://www.readbyqxmd.com/read/27667865/evidence-for-using-doxazosin-in-the-treatment-of-posttraumatic-stress-disorder
#16
Cherish Smith, Maju Mathew Koola
There is evidence that doxazosin is effective in the treatment of posttraumatic stress disorder (PTSD). Doxazosin is a "me-too" drug of prazosin. Doxazosin has an improved absorption profile and this likely minimizes the risk for unintended adverse hypotensive effects. The availability of doxazosin in the gastrointestinal therapeutic system (GITS) form permits a higher initial daily dose (4 mg/day) while avoiding significant first-dose side effects. The treatment of PTSD with prazosin has several disadvantages due to its short duration of action (6-8 hours), which results in multiple doses being required...
2016: Psychiatric Annals
https://www.readbyqxmd.com/read/27432823/treatment-of-post-traumatic-stress-disorders-with-the-alpha-1-adrenergic-antagonist-prazosin
#17
REVIEW
Philippe Yves Rémy Simon, Pierre-François Rousseau
OBJECTIVE: The present review aims to assess the clinical efficacy and safety of the α-1-adrenergic antagonist prazosin as primary pharmacologic treatment for post-traumatic stress disorder (PTSD). METHOD: A systematic review was performed using keywords (i.e., prazosin, α-1-adrenergic antagonist, α-1-blocker, post-traumatic stress disorder) in the databases PubMed/Medline (1966-May 2016), Embase (1966-May 2016), ScienceDirect (1823-May 2016), OvidSP (1946-May 2016) and Nature (1845-May 2016)...
March 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/27320368/higher-pretreatment-blood-pressure-is-associated-with-greater-posttraumatic-stress-disorder-symptom-reduction-in-soldiers-treated-with-prazosin
#18
RANDOMIZED CONTROLLED TRIAL
Murray A Raskind, Steven P Millard, Eric C Petrie, Kris Peterson, Tammy Williams, David J Hoff, Kimberly Hart, Hollie Holmes, Jeffrey Hill, Colin Daniels, Rebecca Hendrickson, Elaine R Peskind
BACKGROUND: In a previously reported positive randomized controlled trial of the α1-adrenoreceptor (α1AR) antagonist prazosin for combat posttraumatic stress disorder (PTSD) in 67 active duty soldiers, baseline symptoms did not predict therapeutic response. If increased brain α1AR activation in PTSD is the target of prazosin treatment action, higher brain α1AR activation should predict greater prazosin efficacy. Although brain α1AR activation is not measurable, coregulated peripheral α1AR activation could provide an estimate of brain α1AR activation...
November 15, 2016: Biological Psychiatry
https://www.readbyqxmd.com/read/27276365/doxazosin-an-%C3%AE-1-adrenergic-receptor-antagonist-for-nightmares-in-patients-with-posttraumatic-stress-disorder-and-or-borderline-personality-disorder-a-chart-review
#19
Stefan Roepke, Heidi Danker-Hopfe, Dimitris Repantis, Behnoush Behnia, Florian Bernard, Marie-Luise Hansen, Christian Otte
Objective: Centrally active α-1-adrenergic-receptor antagonists such as prazosin are effective in the treatment of nightmares in patients with posttraumatic stress disorder (PTSD). A pharmacological alternative is doxazosin, which has a longer half-life and fewer side effects. However, doxazosin is currently being used without solid empirical evidence. Furthermore, no study so far has assessed the effects of α-1-antagonists on nightmares in patients with borderline personality disorder (BPD). We retrospectively assessed the effectiveness of doxazosin on nightmares in PTSD and BPD...
January 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/27249080/doxazosin-xl-reduces-symptoms-of-posttraumatic-stress-disorder-in-veterans-with-ptsd-a-pilot-clinical-trial
#20
Christopher Rodgman, Christopher D Verrico, Manuela Holst, Daisy Thompson-Lake, Colin N Haile, Richard De La Garza, Murray A Raskind, Thomas F Newton
BACKGROUND: Serotonin and norepinephrine reuptake inhibitors are effective first-line agents for the treatment of posttraumatic stress disorder (PTSD), but treatment is associated with a range of side effects that limit treatment adherence. Prazosin, an α1-noradrenergic antagonist with a half-life of roughly 2-3 hours, has shown promise in the treatment of sleep disturbance and nightmares. Doxazosin extended release (XL) is also an α1-noradrenergic antagonist but with a half-life of approximately 15-19 hours...
May 2016: Journal of Clinical Psychiatry
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