Medication Relief for Nightmares Associated with PTSD
PTSD nightmares and flashbacks
For those who suffer from Post Traumatic Stress Disorder (PTSD) nightmares can render one incapacitated, or push one into a downward spiral, suicidal ideation, and fear of sleeping.
PTSD nightmares are the most vivid nightmares one can have. The nightmares from PTSD may be a reliving of the trauma or have similar elements to the trauma. 1 What adds to this is that those who have them are powerless to stop the dream. So once again, they experience the helplessness, powerlessness, and terror which seems as real as the actual experience itself.
I have an acquaintance who is a veteran with PTSD and clinical depression. Several years ago, he was in a VA mental health unit for his disorder. His roommate was a Viet Nam vet who had a wicked case of PTSD. When they went to bed at night, soon after this unfortunate gentleman went to sleep, he began tossing and turning and thrashing around. He started mumbling in a fearful way, this escalated into yelling and screaming, pretending he was shooting and actually got out of bed, still in the nightmare, and reliving his war traumas. He would slug and beat things and show intense terror, then aggression. You can imagine my friend was quite frightened to have this room mate, yet at the same time he felt great sympathy and empathy for him. It is an extreme example of how torturous and vivid the nightmares can be.
Flashbacks occur while one is awake. During a flashback the person is reliving the trauma as if it were happening in that exact moment. They feel the sensations, see the trauma, smell the smells, and hear the sounds as they once happened. Sometimes there might be a small sense of awareness of their surroundings, but often times they lose touch with reality. They are in that moment in the same time and place of the trauma. 2
Dr. Frank Orchberg explains flashbacks this way, "The flashback is a traumatic memory that takes place while you're awake and that has the sensation and the feeling that it's happening now. You don't have a time sense with a flashback...The difference between a flashback and a hallucination is that the flashback is the recreation of something that actually happened. The hallucination would be a voice that wasn't in your past and that tells you things or a smell that doesn't go back to a certain memory." 3
The Good News
There is good news for those suffering from PTSD nightmares. First, PTSD nightmares tend to lessen as the years ago by. 4 Secondly, there is medication that can intercept those nightmares before they happen. The brand name of the medication is Minipress. The pharmaceutical name is Prazosin. Prazosin is actually a blood pressure medication, but has been found to stop or reduce nightmares associated with PTSD. 5 It has been found to be very effective.
A few years ago another personal acquaintance shared with a mental health professional in a hospital about the horrors of his frequent nightmares. She said to him, "You know, there is medication to help with that." He was stunned. He had been suffering from PTSD for about 10 years and not one doctor or psychiatrist ever told him about this or prescribed it. The next time he saw his doctor he put him on it right away. He found tremendous relief.
How Prazosin works
PTSD is an anxiety disorder. Anxiety is very intense. Because of the extreme anxiety levels, the body produces a large amount of adrenaline. The way Prazosin works is that it blocks much of the effects of adrenaline. It will reduce the nightmares and allow for more restful, uninterrupted sleep, and may even reduce anxiety during wakefulness. 6
Possible side effects of Prazosin
Most people don't suffer many side effects from Prazosin. However, the most common side effects are:
- Hypotension (low blood pressure)
- Loss of strength
- Urinary frequency
- Shortness of breath
- Muscle and joint pains
If you normally have low blood pressure, caution and close monitoring are needed. Mixing Prazosin with certain medications is not advisable so check with your doctor and/or pharmacist.
A rather rare side effect is Priapism (sustained painful erection). Seek medical attention immediately.
How effective is Prazosin with PTSD nightmares?
Although many have astounding results with Prazosin, not all people experience such complete relief from PTSD nightmares. When my friend was taking it he occasionally had unpleasant dreams, what he would call bad dreams, not nightmares. They were not the same vivid, gory nightmares that he had before he started on the medication. The "bad dreams" most often were not related to the trauma. Just unpleasant life issues we all experience.
Prazosin is not a cure and it is important to work with a therapist who has experience in treating this disorder. Prazosin will allow you an easier time in your healing journey if you use it in combination with therapy.
1 U.S. Department of Veterans Affairs. (Updated 2014, January 3). PTSD: National Center for PTS. Nightmares and PTSD. Retrieved from http://www.ptsd.va.gov/public/problems/nightmares.asp
2 National Institute of Mental Health. (n.d.). Anxiety Disorders. Retrieved from http://www.nimh.nih.gov/health/publications/anxiety-disorders/index.shtml
3 JoyceGFW. (2010, November 9). Nightmares Versus Flashbacks. Retrieved from https://www.youtube.com/watch?v=dwzCHv72hmU
5 WebMD (Updated 2013, January 9). Prazaosin for PTSD. Retrieved from http://www.webmd.com/a-to-z-guides/prazosin-for-ptsd
A Soldier Speaks About PTSD
Additional Resources About PTSD and Treatments
- PRAZOSIN - ORAL (Minipress) side effects, medical uses, and drug interactions.
- NAMI | What is PTSD?
An introduction and overview of PTSD. This is the PTSD homepage on the National Alliance on Mental Illness (NAMI)website. You will find links for signs and symptoms, treatments, and research on PTSD