Boynton Lorin, Bentley Jacob, Strachan Eric, Barbato Anna, Raskind Murray
University of Washington, Seattle, USA.
J Psychiatr Pract. 2009 Nov;15(6):454-9. doi: 10.1097/01.pra.0000364287.63210.92.
Prazosin, a centrally active alpha-1 adrenergic receptor antagonist, has reduced nightmares and sleep disturbances in placebo-controlled studies involving patients with combat and civilian related posttraumatic stress disorder (PTSD). In this retrospective chart review, we analyzed data from 23 refugees diagnosed with chronic PTSD who were treated with prazosin. The recurrent distressing dreams item of the Clinician Administered PTSD Scale (CAPS) was used to quantify nightmare severity. A Clinical Global Impressions-Change (CGI-C) score assessed change in overall PTSD severity exclusive of nightmares. Using a paired-samples t-test, we found that CAPS scores decreased significantly (p <0.0005) from baseline after 8 weeks of treatment with a stable dose of prazosin. Overall PTSD severity was "markedly improved" in 6 patients, "moderately improved" in 11 patients, and "minimally improved" in 6 patients. These data provide preliminary support for the use of prazosin in targeting reduction of trauma-related nightmares and promoting improvement of global clinical status within an international sample of severely traumatized refugee patients.
哌唑嗪是一种具有中枢活性的α-1肾上腺素能受体拮抗剂，在涉及战斗相关和 civilian 相关创伤后应激障碍（PTSD）患者的安慰剂对照研究中，它减少了噩梦和睡眠障碍。在这项回顾性图表审查中，我们分析了23名被诊断为慢性PTSD的难民的数据，这些难民接受了哌唑嗪治疗。临床医生管理的PTSD量表（CAPS）中的反复痛苦梦境项目用于量化噩梦严重程度。临床总体印象变化（CGI-C）评分评估了不包括噩梦在内的PTSD总体严重程度的变化。使用配对样本t检验，我们发现，在使用稳定剂量的哌唑嗪治疗8周后，CAPS评分从基线显著下降（p<0.0005）。6名患者的PTSD总体严重程度“显著改善”，11名患者“中度改善”，6名患者“轻度改善”。这些数据为在严重受创伤的难民患者国际样本中使用哌唑嗪来减少与创伤相关的噩梦和促进整体临床状况改善提供了初步支持。 （注：原文中“civilian”可能有误，推测可能为“civilian-related”，这里按原文翻译）
