The Relative Effects of Prazosin on Individual PTSD Symptoms: Evidence for Pathophysiologically-Related Clustering.
nightmares
noradrenaline
posttraumatic stress disorder
prazosin
symptom clusters
Journal
Chronic stress (Thousand Oaks, Calif.)
ISSN: 2470-5470
Titre abrégé: Chronic Stress (Thousand Oaks)
Pays: United States
ID NLM: 101701229
Informations de publication
Date de publication:
Historique:
received:
23
10
2020
accepted:
19
11
2020
entrez:
24
2
2021
pubmed:
25
2
2021
medline:
25
2
2021
Statut:
epublish
Résumé
The α In a Prazosin showed the largest effect for distressing dreams, anhedonia, difficulty falling or staying asleep, difficulty concentrating, and hypervigilance. These items were also (a) of higher baseline severity in the underlying population, and (b) more related in how they fluctuated at the level of individual subjects. Covariance analysis did not support a clear cutoff between highly prazosin responsive items and those showing a smaller, not statistically significant response. In this data set, twice daily prazosin substantially reduced not only nightmares and sleep disruption, but the majority of hyperarousal symptoms, with some evidence of efficacy for avoidance symptoms. The relationship of baseline symptom distribution to which symptoms showed significant response to prazosin reinforces the possibility that differences in a clinical trial's participant populations may significantly influence trial outcome. The pattern of symptom endorsement at the level of individual subjects was consistent with prazosin-responsive items sharing a common pathophysiologic mechanism.
Sections du résumé
BACKGROUND
BACKGROUND
The α
METHODS
METHODS
In a
RESULTS
RESULTS
Prazosin showed the largest effect for distressing dreams, anhedonia, difficulty falling or staying asleep, difficulty concentrating, and hypervigilance. These items were also (a) of higher baseline severity in the underlying population, and (b) more related in how they fluctuated at the level of individual subjects. Covariance analysis did not support a clear cutoff between highly prazosin responsive items and those showing a smaller, not statistically significant response.
CONCLUSIONS
CONCLUSIONS
In this data set, twice daily prazosin substantially reduced not only nightmares and sleep disruption, but the majority of hyperarousal symptoms, with some evidence of efficacy for avoidance symptoms. The relationship of baseline symptom distribution to which symptoms showed significant response to prazosin reinforces the possibility that differences in a clinical trial's participant populations may significantly influence trial outcome. The pattern of symptom endorsement at the level of individual subjects was consistent with prazosin-responsive items sharing a common pathophysiologic mechanism.
Identifiants
pubmed: 33623856
doi: 10.1177/2470547020979780
pii: 10.1177_2470547020979780
pmc: PMC7876758
doi:
Types de publication
Journal Article
Langues
eng
Pagination
2470547020979780Subventions
Organisme : CSRD VA
ID : IK2 CX001774
Pays : United States
Informations de copyright
© The Author(s) 2021.
Déclaration de conflit d'intérêts
Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr. Raskind is a paid advisory board member of Pfizer Laboratories, Merck, and Takeda Pharmaceuticals. Dr. Peskind is a paid advisory board member for Lilly, Takeda, Merck, and Avanir pharmaceuticals. All other authors report no financial relationships with commercial interests. The views expressed are those of the authors and do not reflect the official policy of the Department of Veterans Affairs or the U.S. Government. The investigators have adhered to the policies for protection of human participants as prescribed in 45 CFR 46.
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