Case Reports in Psychiatry,
Год журнала:
2022,
Номер
2022, С. 1 - 5
Опубликована: Авг. 3, 2022
Posttraumatic
stress
disorder
(PTSD)
is
a
debilitating
occurring
in
the
context
of
traumatic
event
and
characterized
by
intrusive
avoidance
symptoms,
negative
alterations
cognition
mood,
arousal
reactivity
changes.
Despite
its
representation
throughout
literature,
pathophysiology
PTSD
remains
incompletely
understood,
thus
contributing
to
broad,
variable,
at
times,
experimental
treatment
options.
The
authors
present
first
documented
case
rapid
successful
management
using
valproic
acid
twice
daily
dosing
prazosin
aimed
targeting
symptoms
hyperarousal
both
nightly
flashbacks
nightmares,
respectively.
also
discuss
postulations
underlying
mechanisms
action
responsible
for
such
symptom
alleviation.
Further
investigation
needed
expand
upon
our
knowledge
use
agents
improve
existing
clinical
guidelines,
especially
acute
setting,
providing
better
overall
prognosis.
Case Reports in Psychiatry,
Год журнала:
2024,
Номер
2024(1)
Опубликована: Янв. 1, 2024
Nightmares
and
flashbacks
are
common
debilitating
symptoms
of
posttraumatic
stress
disorder
(PTSD)
that
can
disrupt
daily
functioning.
Prazosin,
an
alpha‐1
adrenergic
antagonist,
has
been
commonly
used
off‐label
for
the
treatment
these
intrusion
symptoms,
although
its
short
half‐life
makes
it
so
often
multiple
doses
needed.
Doxazosin,
another
is
starting
to
be
investigated
in
PTSD‐related
nightmares
due
lesser
side
effect
profile
longer
half‐life.
In
our
case
series,
we
present
three
cases
patients
with
who
were
successfully
treated
doxazosin
following
a
relapse
after
discontinuation
prazosin
various
reasons.
The
success
immediate
release
warrants
further
studies
into
efficacy
use
as
alternative
prazosin.
Addiction,
Год журнала:
2024,
Номер
119(7), С. 1224 - 1225
Опубликована: Май 17, 2024
Combination
pharmacological
targets
for
alcohol
use
disorder
may
play
a
role
in
improving
mental
health
and
post-traumatic
stress
symptoms.
Alcohol
is
leading
risk
factor
global
burden
of
disease,
contributing
to
over
5%
disease
injury
nearly
3
million
deaths
annually
[1].
Medications
key
(AUD)
treatment
approaches,
but
there
are
only
three
approved
medications
the
existing
repertoire,
with
few
advances
[2].
Therefore,
combination
approach
proposed
by
Aubin
colleagues
[3],
who
report
on
first
trial
α-1b
blocker
prazosin
5HT-2A
cyproheptadine,
represents
significant
innovation
targeting
different
pathways
concurrently.
These
authors
found
effect
high-dose
change
total
consumption
individuals
AUD,
which
raises
range
questions
considering
external
validity
extrapolation
study
findings
broader
populations.
A
point
interest
this
potential
comorbidity
driving
response,
through
improvement
symptoms
that
underpin
use.
Untreated
contribute
substantially
precipitation
perpetuation
AUD.
For
large
proportion
treatment-seeking
course
their
illness
attempts
at
recovery
from
complicated
comorbid
disorders
[4].
Comorbidity
presents
major
clinical
challenge,
associated
an
even
higher
degree
impairment,
poorer
prognosis
attrition
[5].
This
particularly
case
(PTSD),
estimated
be
prevalent
up
one
two
seek
AUD
Treatment
substance
typically
less
effective
without
concurrent
management
PTSD,
as
untreated
(nightmares,
sleep
dysfunction
emotion
dysregulation)
precipitate
relapse
The
[3]
uses
have
evidence
base
PTSD
trauma-related
dysfunction.
Prazosin,
antagonist,
has
shown
some
promise
individual
observational
studies
six
RCTs
nightmares
[6].
There
also
several
reports
suggesting
5HT2-A
blocker,
improve
[7].
blockade
these
mechanistic
could
potentially
ameliorate
both
However,
presence
was
not
measured
study,
no
prevalence
or
remains
common
gap
across
literature,
despite
acceptance
high
rates
within
populations
worldwide.
Important
considerations
raised
need
further
explored.
specifically
include
interaction
heavy
sedative
medications,
cumulative
sedation
therapeutic
dose
ranges
overdose.
Self-reported
reported
10%
participants
active
medication
although
over-time
evolution
scores
comparable
between
placebo,
low
groups.
populations,
context
other
drug
will
enhance
orthostatic
hypotension,
known
adverse
effects
dizziness,
light-headedness
falls;
risks
relevant
cyproheptadine.
partially
mitigated
extended-release
formulation
prazosin,
<10%
affected
hypotension;
however,
extended
release
formulations
widely
available
internationally,
immediate
requiring
careful,
gradual
titration
routine
practice.
Weight
gain
consideration
future
studies.
recognised
weight
groups
compared
placebo
(mean
2.5
kg
lower
dose,
2.4
3-month
period).
Finally,
it
important
investigate
diversion
aberrant
Nonetheless,
do
show
recoupling
noradrenergic
serotonergic
systems
simultaneously
blocking
α-agonist
receptors,
ameliorating
process.
It
well
under-prescribed
under-used
response
so
brings
much-needed
field.
We
look
forward
phase
trials
approach.
Shalini
Arunogiri
prepared
draft
commentary.
Kirsten
C.
Morley
contributed
edits
final
article.
Open
access
publishing
facilitated
Monash
University,
part
Wiley
-
University
agreement
via
Council
Australian
Librarians.
None.
funders
report.
Case Reports in Psychiatry,
Год журнала:
2022,
Номер
2022, С. 1 - 5
Опубликована: Авг. 3, 2022
Posttraumatic
stress
disorder
(PTSD)
is
a
debilitating
occurring
in
the
context
of
traumatic
event
and
characterized
by
intrusive
avoidance
symptoms,
negative
alterations
cognition
mood,
arousal
reactivity
changes.
Despite
its
representation
throughout
literature,
pathophysiology
PTSD
remains
incompletely
understood,
thus
contributing
to
broad,
variable,
at
times,
experimental
treatment
options.
The
authors
present
first
documented
case
rapid
successful
management
using
valproic
acid
twice
daily
dosing
prazosin
aimed
targeting
symptoms
hyperarousal
both
nightly
flashbacks
nightmares,
respectively.
also
discuss
postulations
underlying
mechanisms
action
responsible
for
such
symptom
alleviation.
Further
investigation
needed
expand
upon
our
knowledge
use
agents
improve
existing
clinical
guidelines,
especially
acute
setting,
providing
better
overall
prognosis.
