Pallesen Ståle, Hamre Hilde Sofie, Lang Nina, Bjorvatn Bjørn
Department of Psychosocial Science, University of Bergen, Bergen, Norway.
Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.
SAGE Open Med Case Rep. 2020 Jun 29;8:2050313X20936079. doi: 10.1177/2050313X20936079. eCollection 2020.
The α-adrenergic antagonist prazosin has showed good effect against posttraumatic stress disorder-related nightmares in several randomized controlled trials. The α-adrenergic antagonist doxazosin, which has a longer half-live than prazosin, has received far less attention in the treatment of such nightmares. Here, we report a case of a patient suffering from severe nightmares following an erroneous medical administration of adrenaline (causing severe physiological hyper-activation) who was treated with doxazosin. Over a period of 280 days, the patient kept a nightmare diary and took 0, 4, or 8 mg doxazosin. The analyses showed that 8 mg doxazosin (55.2% nightmare-free nights) worked better (odds ratio = 28.2; 95% confidence interval = 3.7-213.9) compared to nights without doxazosin (4.3% nightmare-free nights). Except dizziness, which was not regarded as particularly bothersome by the patient, doxazosin was well tolerated. It is concluded that doxazosin may be indicated as a pharmacological treatment for patients suffering from posttraumatic stress disorder-related nightmares.
α-肾上腺素能拮抗剂哌唑嗪在多项随机对照试验中已显示出对创伤后应激障碍相关噩梦有良好疗效。α-肾上腺素能拮抗剂多沙唑嗪的半衰期比哌唑嗪长，但其在治疗此类噩梦方面受到的关注要少得多。在此，我们报告一例因肾上腺素误注（导致严重生理过度激活）而患有严重噩梦的患者，该患者接受了多沙唑嗪治疗。在280天的时间里，患者记录了噩梦日记，并服用0、4或8毫克多沙唑嗪。分析表明，与未服用多沙唑嗪的夜晚（无噩梦夜晚占4.3%）相比，8毫克多沙唑嗪（无噩梦夜晚占55.2%）效果更好（优势比=28.2；95%置信区间=3.7-213.9）。除了头晕（患者认为不是特别困扰）外，多沙唑嗪耐受性良好。结论是，多沙唑嗪可能适用于治疗患有创伤后应激障碍相关噩梦的患者。
