Davit Khachatryan1, Dianne Groll2, Linda Booij3, Amir A Sepehry4, Christian G Schütz5. 1. Queen's University Department of Psychiatry, Providence Care, Mental Health Services, 752 King Street West, Postal Bag 603, Kingston, ON, K7L 7X3, Canada. Electronic address: d.khachatryan@queensu.ca. 2. Queen's University Department of Psychiatry, Providence Care, Mental Health Services, 752 King Street West, Postal Bag 603, Kingston, ON, K7L 7X3, Canada. Electronic address: Dianne.groll@queensu.ca. 3. University of Concordia, Department of Psychology Richard J. Renaud Science Complex, 7141 Sherbrooke W. Electronic address: linda.booij@concordia.ca. 4. University of British Columbia, Department of Psychiatry Detwiller Pavilion, 2255 Wesbrook Mall, Vancouver, BC, Canada, V6T 2A1. Electronic address: sepehryaa@alumni.ubc.ca. 5. University of British Columbia, Department of Psychiatry Detwiller Pavilion, 2255 Wesbrook Mall, Vancouver, BC, Canada, V6T 2A1. Electronic address: christian.schutz@ubc.ca.
Abstract
OBJECTIVE: Posttraumatic stress disorder (PTSD) is a disorder with significant sleep morbidity and limited treatment options. Prazosin may constitute a novel management approach and has been tested recently in a number of trials. We conducted a meta-analysis to examine the effectiveness of prazosin for nightmares and other sleep disturbances in adults with PTSD. METHOD: A systematic review of databases for randomized, double-blind, placebo-controlled trials of adults diagnosed with PTSD and reporting sleep disturbances that were treated with prazosin was conducted in January 2015. No limitations were placed on language or year of publication. RESULTS: Six randomized controlled trials of prazosin for sleep disturbances in patients with PTSD were included (sample n=240). We found that prazosin was statistically significantly more effective than placebo in improving sleep quality [g=0.987, 95% confidence interval (CI): 0.324-1.651] and in reducing overall PTSD symptoms (g=0.699, 95% CI: 0.139-1.260) and sleep disturbances in particular (g=0.799, 95% CI: 0.391-1.234). CONCLUSIONS: Prazosin showed medium-to-large and statistically significant effects on PTSD symptoms in general and sleep disturbances in particular. While promising, results should be interpreted with caution given the limited total number of participants and the limitations induced by the majority of participants being male and noncivilian.
OBJECTIVE:Posttraumatic stress disorder (PTSD) is a disorder with significant sleep morbidity and limited treatment options. Prazosin may constitute a novel management approach and has been tested recently in a number of trials. We conducted a meta-analysis to examine the effectiveness of prazosin for nightmares and other sleep disturbances in adults with PTSD. METHOD: A systematic review of databases for randomized, double-blind, placebo-controlled trials of adults diagnosed with PTSD and reporting sleep disturbances that were treated with prazosin was conducted in January 2015. No limitations were placed on language or year of publication. RESULTS: Six randomized controlled trials of prazosin for sleep disturbances in patients with PTSD were included (sample n=240). We found that prazosin was statistically significantly more effective than placebo in improving sleep quality [g=0.987, 95% confidence interval (CI): 0.324-1.651] and in reducing overall PTSD symptoms (g=0.699, 95% CI: 0.139-1.260) and sleep disturbances in particular (g=0.799, 95% CI: 0.391-1.234). CONCLUSIONS:Prazosin showed medium-to-large and statistically significant effects on PTSD symptoms in general and sleep disturbances in particular. While promising, results should be interpreted with caution given the limited total number of participants and the limitations induced by the majority of participants being male and noncivilian.
Authors: Chadi G Abdallah; Lynnette A Averill; Teddy J Akiki; Mohsin Raza; Christopher L Averill; Hassaan Gomaa; Archana Adikey; John H Krystal Journal: Annu Rev Pharmacol Toxicol Date: 2018-09-14 Impact factor: 13.820
Authors: Jay S Balachandran; Carey C Thomson; Dezmond B Sumter; Anita V Shelgikar; Philippe Lachapelle; Sushmita Pamidi; Michael Fall; Chitra Lal; Ridhwan Y Baba; Neomi Shah; Barry G Fields; Kathleen Sarmiento; Matthew P Butler; Steven A Shea; Janelle V Baptiste; Katherine M Sharkey; Tisha Wang Journal: Ann Am Thorac Soc Date: 2016-04
Authors: Ye Zhang; Rong Ren; Larry D Sanford; Linghui Yang; Yuenan Ni; Junying Zhou; Jihui Zhang; Yun-Kwok Wing; Jie Shi; Lin Lu; Xiangdong Tang Journal: Sleep Med Date: 2019-06-22 Impact factor: 3.492
Authors: Peter J Colvonen; Laura D Straus; Carl Stepnowsky; Michael J McCarthy; Lizabeth A Goldstein; Sonya B Norman Journal: Curr Psychiatry Rep Date: 2018-06-21 Impact factor: 5.285