Background
Prazosin, a central nervous system (CNS) active α-1 adrenoreceptor antagonist, has
reduced nightmares and sleep disturbance in placebo-controlled studies of combat-related
posttraumatic stress disorder (PTSD). We evaluated objective sleep parameters and
PTSD symptoms in a placebo-controlled prazosin trial for civilian trauma-related PTSD.
Methods
Thirteen outpatients with chronic civilian trauma PTSD, frequent nightmares, and sleep
disturbance participated in a randomized placebo-controlled crossover trial of prazosin.
Sleep parameters were quantified at home with the REMView (Respironics, Pittsburgh,
Pennsylvania). The PTSD symptoms were quantified with the Clinician Administered PTSD
Scale (CAPS) “recurrent distressing dreams” and “disturbed sleep” items, a non-nightmare
distressed awakenings scale, the PTSD Dream Rating Scale (PDRS), the PTSD Checklist-Civilian
(PCL-C), and the Clinical Global Impression of Improvement (CGI-I).
Results
Prazosin compared with placebo significantly increased total sleep time by 94 min;
increased rapid eye movement (REM) sleep time and mean REM period duration without
altering sleep onset latency; significantly reduced trauma-related nightmares, distressed
awakenings, and total PCL scores; significantly improved CGI-I scores; and changed
PDRS scores toward normal dreaming.
Conclusions
Prazosin reductions of nighttime PTSD symptoms in civilian trauma PTSD are accompanied
by increased total sleep time, REM sleep time, and mean REM period duration in the
absence of a sedative-like effect on sleep onset latency.
Key Words
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Article info
Publication history
Published online: September 17, 2007
Accepted:
July 3,
2007
Received in revised form:
June 19,
2007
Received:
March 27,
2007
Identification
Copyright
© 2008 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
