• Christine Maura Daly, Michael E Doyle, Murray Radkind, Elaine Raskind, and Colin Daniels.
• Department of Psychiatry, Madigan Army Medical Center, Tacoma, WA 98431, USA.
• Mil Med. 2005 Jun 1; 170 (6): 513-5.

ObjectiveIncreased central nervous system norepinephrine outflow and alpha1-adrenergic receptor responsiveness appear to be involved in the pathophysiologic processes of trauma-related nightmares in post-traumatic stress disorder. On the basis of reports that the brain-accessible alpha1-adrenergic antagonist Prazosin substantially reduced chronic combat-related nightmares among Vietnam War veterans, we evaluated Prazosin effects on combat-related nightmares among combat soldiers returning from Operation Iraqi Freedom.MethodsTwenty-eight soldiers who self-reported distressing combat trauma-related nightmares on a postdeployment questionnaire were prescribed low-dose Prazosin before bedtime.ResultsOf the 23 soldiers for whom follow-up evaluations were available, 20 experienced marked improvement (complete elimination of nightmares), 2 experienced moderate improvement (reduced nightmare frequency or intensity), and 1 experienced no change. Prazosin was well tolerated.ConclusionsPrazosin appeared highly beneficial for combat-related nightmares characteristic of post-traumatic stress disorder among troops recently returned from Operation Iraqi Freedom. These findings provide a rationale for a placebo-controlled trial to establish efficacy in this population.

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