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Thousands of people with post-traumatic stress disorder have taken the drug prazosin to ease the nightmares and disturbances that stalk their sleep.

Numerous studies have shown the drug to be effective at controlling those episodes. But a team of researchers from the Department of Veterans Affairs, seeking to collect more evidence, set out to study the sustained effectiveness of the treatment. They organized a large, lengthy, multisite trial — the most rigorous type of trial.

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  • I have PTSD and it has been a big problem in my life, as I essentially can’t have a life. I blow up at people and become abusive, but I can’t bring myself to seek help either, so I’m stuck and going nowhere. A proven drug therapy would compared to the self-medicating I do.

  • For those of us working in trauma treatment, this is not news, and while there is a place for the placebo argument, it is not with PTSD – a normal response to threatening, overwhelming and abnormal circumstances. It’s a shame when we have approaches like EMDR, which can truly heal the damage from trauma (and not just manage symptoms or put a pharmacological band-aid on it) that so much money is put into things like prazosin instead of directing people toward effective treatment.

  • Many other studies have shown that psychiatric medicines work for those who can tolerate them only because of the placebo effect. Also, many biases seem to operate in drug trials as indicated by the following study: Lancee, M., et al. (2017). Outcome reporting bias in randomized-controlled trials investigating antipsychotic drugs. Translational Psychiatry, 7, e1232].

    We also need to remember that the brain is very complex organ with billions of neurons and trillions of synapses that connect and interact in highly intricate ways – so, simply introducing drugs can mess up the natural biochemical pathways, and adversely affect the functioning of the brain in the long-term. This is what is happening with many psychiatric drugs today (I can provide several references if anyone is interested). On the other hand, practices like mindfulness appear to work very well for conditions like PTSD.

  • Thanks for this article. My husband was started on prazosin after an episode of panic & nightmares while on a road trip in WA in 2012. The excellent ER doc at Aberdeen, in consultation with psychiatry staff, started him on it. He experienced such episodes in the past & it was necessary for me to drive him or have him fly home back to his familiar environment & routine. It may be associated with dementia onset & now with the expensive & controversial addition of Namzaric, he can tolerate such travel & is less irritable. I am a nurse, case manager & now full-time caregiver. This is one drug I would never advise he discontinue.

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