Health & Safety

June 19, 2014

Old drug, new promise for PTSD nightmares

Christine Creenan-Jones

BETHESDA, Md. — Every day, thousands of American service members relive the trauma of war in their sleep. They hear explosions, see the carnage of battle erupt around them and feel the crushing weight of a painful combat memory resurface in their dreams.

Unfortunately, frequent nightmares are common among service members with post-traumatic stress disorder. Moreover, they disrupt sleep, which can magnify the daytime symptoms of PTSD and stymie the recovery process significantly.

“Although psychotherapy is the best treatment for PTSD, it’s less impactful when a patient is tired, irritable, anxious or unable to concentrate because recurring nightmares continuously disrupt their sleep,” said Army Lt. Col. Jess Calohan, program director for the Psychiatric Mental Health Nurse Practitioner Program at the Daniel K. Inouye Graduate School of Nursing, part of the Uniformed Services University of the Health Sciences here.

In 2005, Calohan began working with Dr. Murray Raskind, who discovered that a largely obsolete blood pressure medication called prazosin appeared to be effective for treating PTSD-related nightmares. In his own practice, Raskind, director of the Northwest Network Mental Illness Research Education and Clinical Center at Veterans Affairs, used prazosin to treat Vietnam War veterans with PTSD.

Theoretically, the drug blocks the effects of adrenaline in areas of the brain thought to be responsible for causing nightmares during sleep. Raskind found that prazosin was tremendously successful at improving sleep quality and other PTSD-related symptoms.

Still, Raskind wondered if prazosin also would work on active duty service members. Their combat experiences were different, and they weren’t as far removed from the fight as the Vietnam War-era patients in his study.

Raskind, Calohan and colleagues partnered to investigate prazosin’s crossover efficacy. In two separate studies funded by the Veterans Affairs Department, active-duty soldiers with PTSD reported experiencing better, more restful sleep while taking prazosin. Furthermore, in many cases, the combat-related nightmares that amplified other PTSD symptoms were eliminated altogether. This led to vast improvements in overall PTSD treatment for the soldiers Calohan treated at Joint Base Lewis-McChord in Washington state and at frontline clinics in Iraq and Afghanistan.

“Before our research, prazosin was a level C on the strength of recommendation scale on the [VA and Defense Department] clinical practice guidelines, a system that measures the quality and consistency of evidence for using a medical intervention,” Calohan said. “Now, it’s a level B, but we fully expect prazosin will move up to a level A soon.”

Level A is the highest rating on the strength of recommendation scale. It’s reserved for interventions validated by high-quality, evidence-based studies. The team’s work is reaching for the top of the scale through research results and professional accolades. In fact, their study was the most-read article in last year’s September issue of the American Journal of Psychiatry. It also was lauded as the No. 1 innovation in psychiatry for 2013 by the New England Journal of Medicine.

In an effort to continue improving patient care, Calohan is using his expertise to shape the way rising military health care providers deliver care to service members with PTSD.

“Now that I’m here at USU, I’m able to review the prazosin literature and its application in clinical practice with my students,” he said. “It is definitely a good thing, because I’m educating providers about an effective method for treating sleep disturbances related to PTSD.”




All of this week's top headlines to your email every Friday.


 
 

 
DoD

DoD takes steps to aid absentee voters

WASHINGTON – As the Nov. 4 midterm election nears, Defense Department officials are taking steps to ensure absentee voting is even easier for service members, their families and overseas citizens via FVAP.gov. In coordination with the military services and State Department, Absentee Voting Week begins today, aiming to raise awareness and remind voters of important...
 
 

New EPR challenges status quo

LUKE AIR FORCE BASE, Ariz. – The enlisted performance report is going to drastically change. These changes seek to combat inflated ratings, which have been a prevalent complaint from Airmen over the years. The change is right around the corner and many Airmen are asking themselves, “How will it affect future promotions, and what can I do...
 
 

55th Rescue Squadron returns home

(U.S. Air Force photo by Senior Airman Camilla Elizeu) U.S. Air Force Maj. Stephanie Harley, 355th Aerospace Medicine Squadron Bio Engineering Flight commander, and son welcome home Capt. Colin Harley, 55th Rescue Squadron HH-60 Pavehawk pilot, at Davis-Monthan, Oct. 11. Capt. Harley has just returned from a five-month deployment to Afghanistan.
 

 

AF to implement TDY policy changes

JOINT BASE PEARL HARBOR-HICKAM, Hawaii (AFNS) — Recently, the Air Force started implementing two temporary duty policy changes that will impact travel reimbursements for Airmen. The first change, which took effect Oct. 1, made changes to the Joint Travel Regulations, Reimbursable and Incidental Expense Policy. The second will be a change in long-term TDY per...
 
 

OPSEC: Everyone’s responsibility

NELLIS AIR FORCE BASE, Nev. – Everyone who’s been around the military has heard the term Operations Security, or OPSEC, but do they really know what it means? Many people think OPSEC is all about classified information, when the opposite is true; OPSEC targets critical and sensitive unclassified information. OPSEC is a fundamental principle of the Air...
 




0 Comments


Be the first to comment!


Leave a Reply

Your email address will not be published. Required fields are marked *

You may use these HTML tags and attributes: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <cite> <code> <del datetime=""> <em> <i> <q cite=""> <strike> <strong>


Directory powered by Business Directory Plugin