Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Mar 31;11(2):45-49.
doi: 10.9740/mhc.2021.03.045. eCollection 2021 Mar.

Evaluation of low dose prazosin for PTSD-associated nightmares in children and adolescents

Nancy Hudson  1 , Steven Burghart  2 , Jill Reynoldson  3 , Dennis Grauer  4
Affiliations

Evaluation of low dose prazosin for PTSD-associated nightmares in children and adolescents

Nancy Hudson et al. Ment Health Clin. .

Abstract

Introduction: Knowledge about fundamental sleep disorders and dysregulation that occurs in children with PTSD is limited. Prazosin is an alpha-1 receptor antagonist often used off label for the treatment of PTSD-associated nightmares in adults; however, evaluation of its use in pediatrics and adolescents is limited. The primary objective of this study was to assess the impact of prazosin on nightmares associated with PTSD in this population. Secondary objectives included assessing side effects, changes in blood pressure, and 30-day readmission rates.

Methods: This was a retrospective, single-center chart review of inpatients diagnosed with PTSD nightmares from January 1, 2017, to July 31, 2019. Patients 4 to 18 years old with a PTSD diagnosis, experiencing nightmares, and initiating any dose of prazosin were assessed to determine efficacy and tolerance.

Results: Forty-two patients were evaluated to determine symptom improvement after initiation of prazosin for PTSD nightmares in children and adolescents. Of the 42 patients, 24 (57.1%) reported improvement in nightmares (average dose 1.05 mg). For secondary results, 38 (90.5%) patients continued prazosin at discharge, and 2 (5%) were readmitted within 30 days for reasons other than PTSD-associated nightmares. Thirty-four (81%) reported having no adverse effects to prazosin. There was no significant difference in systolic (P = .1883) or diastolic (P = .2777) blood pressure preinitiation and postinitiation of prazosin.

Discussion: Despite the limitations of this retrospective study, the data suggests that prazosin may be associated with an improvement in nightmares in children and adolescents with PTSD. Adverse events were rarely reported, and there was no significant change in blood pressure with initiation of prazosin.

Keywords: PTSD; adolescent; children; nightmares; prazosin.

PubMed Disclaimer

Conflict of interest statement

Disclosures: No investigators claim any conflict of interest involved with the design or application of this study.

References

    1. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):593–602. DOI: 10.1001/archpsyc.62.6.593 PubMed PMID: 15939837. - DOI - PubMed
    1. Neylan TC, Marmar CR, Metzler TJ, Weiss DS, Zatzick DF, Delucchi KL, et al. Sleep disturbances in the Vietnam generation: findings from a nationally representative sample of male Vietnam veterans. Am J Psychiatry. 1998;155(7):929–33. DOI: 10.1176/ajp.155.7.929 PubMed PMID: 9659859. - DOI - PubMed
    1. Woodward SH, Arsenault NJ, Murray C, Bliwise DL. Laboratory sleep correlates of nightmare complaint in PTSD inpatients. Biol Psychiatry. 2000;48(11):1081–7. DOI: 10.1016/s0006-3223(00)00917-3 PubMed PMID: 11094141. - DOI - PubMed
    1. Kovachy B, O'Hara R, Hawkins N, Gershon A, Primeau MM, Madej J, et al. Sleep disturbance in pediatric PTSD: current findings and future directions. J Clin Sleep Med. 2013;9(5):501–10. DOI: 10.5664/jcsm.2678 PubMed PMID: 23674943 PubMed Central PMCID: PMC3629326. - DOI - PMC - PubMed
    1. National Institute of Mental Health [Internet] Post-traumatic stress disorder. NIMH Strategic Plan for Research. 2019 [cited 2019 Dec 1] Available from: https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-pt....

LinkOut - more resources