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.


 
 

 
(U.S. Air Force Illustration by Airman 1st Class Cheyenne Morigeau)

Don’t become a target

Considering recent threats against Americans and the exponential growth of social media use, becoming a target of an adversary is easier than ever. Operations Security is a process that identifies unclassified, critical informa...
 
 
BreastCancerAwareness_pict

An Airman’s story: My mother didn’t fight alone

MOODY AIR FORCE BASE, Ga. – His green eyes frantically searched the crowd for his dying mother. During his final pass and review at basic military training (BMT) he saw her in the stands, cheering him on. A year later, ...
 
 

Fire Prevention Week 2014

(U.S. Air Force photo by Airman 1st Class Chris Drzazgowski) Sparky the Fire Dog, National Fire Protection Association spokesdog, and members from the 355th Fire Emergency Services flight taught children from the Child Development Center how to stop, drop and roll at Davis-Monthan, Oct. 8. The 355th FES conducted several events in conjunction with Fire...
 

 

Troops to Teachers helps Airmen serve after separation

NELLIS AIR FORCE BASE, Nev. – For many service members who are separating from the military, finding employment that utilizes prior training or skills gained while serving can be difficult. For Airmen who are honorably discharged from their military commitment and have an interest in ‘serving’ again as an educational instructor, the Troops to Teachers program is...
 
 

Military Tuition Assistance Program implements changes for FY15

HOLLOMAN AIR FORCE BASE, N.M. – Air Force active duty Airmen who want to take advantage of the military assistance programs for voluntary education in the coming academic year can expect several changes that were implemented on Oct. 1, 2014. The new Air Force Credentialing Opportunities Online, also referred to as AF COOL, will take the place...
 




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