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BP and Prostate Problems Drug Effective in Treating PTSD Nightmares

ough some participants reported transient dizziness when standing from a sitting position during the first weeks of prazosin titration. Other occasional side effects included nasal congestion, headache, and dry mouth, but these were all minor, according to the authors.

"This drug has been taken by many people for decades," said Raskind. "If there were serious long-term adverse side effects, it is likely we would know about them by now."

The relatively small size of the study was due to the easy availability of this generic drug, Raskind said. "If you are doing a study with a new drug, the only way people can get it is to be in the study. With prazosin, we have approximately 5,000 veterans with a PTSD diagnosis taking it already in the Northwest alone. So we had to find veterans with PTSD who were not [taking it]."

For treating PTSD, prazosin costs 10 to 30 cents a day at VA contract prices. It is not a sedating sleeping pill, emphasized Raskind. "It does not induce sleep. But once you are asleep, you sleep longer and better."

And better sleep can make a big difference. "This drug changes lives," Raskind said. "Nothing else works like prazosin."

Trauma nightmares appear to arise during light sleep or disruption in REM sleep, whereas normal dreams—both pleasant and unpleasant— occur during normal REM sleep. Prazosin works by blocking the brain’s response to the adrenaline-like neurotransmitter norepinephrine. Blocking norepinephrine normalizes and increases REM sleep. In this study, veterans taking prazosin reported that they resumed normal dreaming.

One dose of prazosin works for 6 to 8 hours. Unlike similar drugs, prazosin does not induce tolerance; people can take it for years without increasing the dose. But when veterans stop taking it, Raskind said, the trauma nightmares usually return.

Aside from the VA-funded study he just published, Raskind is working on three large
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