Breen Annamarie, Blankley Kory, Fine Julie
Department of Advanced Practice Nursing, Indiana State University, Terre Haute, Indiana.
J Am Assoc Nurse Pract. 2017 Feb;29(2):65-69. doi: 10.1002/2327-6924.12432. Epub 2016 Dec 15.
Nightmares associated with posttraumatic stress disorder (PTSD) are a hallmark symptom among U.S. military veterans who have seen combat. Management of combat-related nightmares can be difficult and current pharmacologic options are limited and tend to have adverse side effects. The aim of this review is to explore recent literature regarding the efficacy of prazosin for the treatment of nightmare disorder in the veteran population.
Recent literature consisting of three systematic reviews was reviewed, as well as current clinical guidelines published by The Department of Veterans Affairs (VA) and The Department of Defense (DoD) and the American Academy of Sleep Medicine (AASM).
Prazosin has been shown to be effective in the treatment of PTSD trauma-related nightmares. As a result of its low side effect profile and abilities to improve both sleep and reduce trauma nightmares, prazosin has been recommended as an adjunct therapy.
Prazosin should be initiated as an adjunctive treatment to promote sleep in those suffering from PTSD nightmares. It should be initiated at 1 mg and then titrated upward until absence or desired reduction of nightmares is achieved, with a maximum dosage recommendation of 20 mg at bedtime and 5 mg midmorning.
与创伤后应激障碍（PTSD）相关的噩梦是经历过战斗的美国退伍军人的标志性症状。与战斗相关的噩梦管理可能很困难，目前的药物选择有限且往往有不良副作用。本综述的目的是探讨近期有关哌唑嗪治疗退伍军人噩梦障碍疗效的文献。
回顾了由三项系统评价组成的近期文献，以及退伍军人事务部（VA）、国防部（DoD）和美国睡眠医学学会（AASM）发布的当前临床指南。
哌唑嗪已被证明对治疗PTSD创伤相关噩梦有效。由于其副作用小，且能改善睡眠并减少创伤性噩梦，哌唑嗪已被推荐作为辅助治疗。
哌唑嗪应作为辅助治疗开始使用，以促进患有PTSD噩梦的患者的睡眠。应从1毫克开始，然后逐渐增加剂量，直至噩梦消失或减少至理想程度，睡前最大推荐剂量为20毫克，上午中段为5毫克。
