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使用哌唑嗪治疗创伤后应激障碍及其关联:一项系统评价。

Using Prazosin to Treat Posttraumatic Stress Disorder and Associations: A Systematic Review.

作者信息

Paiva Henrique Soares, Filho Idiberto José Zotarelli, Cais Carlos Filinto da Silva

机构信息

Department of Forensic Psychiatry, Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil.

Faceres Medical School of Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil.

出版信息

Psychiatry Investig. 2021 May;18(5):365-372. doi: 10.30773/pi.2020.0411. Epub 2021 May 14.

Abstract

OBJECTIVE

A central adrenergic hyperactivation is described in the neurobiology of posttraumatic stress disorder (PTSD) with probable variable symptomatic impact. Few studies have evaluated using the alpha-1 adrenergic antagonist prazosin for such symptoms; however, given the likely pathophysiology involved, this drug may play an important role in the pharmacological approach to PTSD.

METHODS

This study assessed articles already published on the use of prazosin through a systematic review along a timeline in view of the symptomatic target of difficult access by standardized treatments. The impact of using this medication for the general symptoms of PTSD is also discussed. Several databases were searched for articles in the literature on the use of prazosin to treat PTSD.

RESULTS

A total of 168 articles were found containing search terms in the title or abstract. Overall, 85 articles met the criteria described, and 48 studies were explored to conduct the present systematic review. Most articles showed some improvement after prazosin administration, especially in relation to sleep symptoms (nightmares and night waking). Only one article demonstrated no improvement after the use of this drug. More randomized studies are needed.

CONCLUSION

Several clinical studies demonstrated the relevant role of prazosin for treating PTSD symptoms. Prazosin is an affordable and cost-effective pharmacological option compared to other drugs used to treat PTSD.

摘要

目的

创伤后应激障碍(PTSD)的神经生物学研究表明存在中枢肾上腺素能系统过度激活,其对症状的影响可能存在差异。很少有研究评估使用α-1肾上腺素能拮抗剂哌唑嗪治疗此类症状;然而,鉴于可能涉及的病理生理学机制,这种药物可能在PTSD的药物治疗方法中发挥重要作用。

方法

本研究通过系统回顾已发表的关于哌唑嗪使用的文章,并按照时间线进行梳理,以标准化治疗难以解决的症状为目标。还讨论了使用这种药物对PTSD一般症状的影响。在多个数据库中检索了关于使用哌唑嗪治疗PTSD的文献。

结果

共发现168篇文章在标题或摘要中包含检索词。总体而言,85篇文章符合所述标准,48项研究被纳入进行本系统评价。大多数文章显示哌唑嗪给药后有一定改善,尤其是在睡眠症状(噩梦和夜间觉醒)方面。只有一篇文章显示使用该药物后无改善。需要更多的随机对照研究。

结论

多项临床研究证明了哌唑嗪在治疗PTSD症状方面的重要作用。与用于治疗PTSD的其他药物相比,哌唑嗪是一种经济实惠且性价比高的药物选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2460/8169333/427e2b51b34b/pi-2020-0411f1.jpg

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