A literature review will be presented to the 20th European Congress of Psychiatry this week by a team from the Mayo Clinic. The group will recommend that the blood pressure medication prazosin be offered as a safe and effective treatment for nightmares stemming from the post-traumatic stress disorder.
Designed to treat hypertension, prazosin has been under scrutiny for more than a decade as a means of repressing nightmares and has been used by some Veterans Administration hospitals for that purpose. The Mayo team looked at 12 separate studies—four of them randomized controlled clinical trials—that show that not only is prazosin effective, but it also is very well tolerated, with very few side effects.
Nightmares are one of the most common symptoms among PTSD sufferers, leading to disruption of sleep accompanied by disturbing images or a replaying of the original traumatic event. In the long run, nightmares can lead to substance abuse and alcoholism, and eventually even suicidal thoughts and behaviors.
The exact mechanism of action in prazosin is unknown, but one promising hypothesis is that it operates on norepinephrine receptors in the central nervous system. Overstimulated receptors are thought to be responsible for many of the symptoms of PTSD-related nightmares, like sleep disruptions, and drugs like prazosin may block these receptors.
Source: The Mayo Clinic
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