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Armando Gonzalez
Biology1105
D.M. Coggins
Critique: A Parallel Group Placebo Controlled Study of Prazosin
for Trauma Nightmares and
Sleep Disturbance in Combat Veterans With Post-Traumatic Stress
Disorders
Thesis
Nightmares and sleep disturbances are some of the most treatment
resistant symptoms of
post-traumatic stress disorders (PTSD). Pharmacological
treatments are rarely effective.
Prazosin, a drug that has been safely for many years and is
inexpensive, has been
anecdotally reported to substantially reduce trauma-nightmares
in Vietnam veterans with
chronic PTSD. It has been hypothesized that prazosin would be
more effective than a
placebo in reducing trauma-nightmares and improving sleep
quality.
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Methods Used
40 US military veterans, including 38 men and 2 women ages 47 to
65. 27 participants
were whites, 11 blacks, one Asian, one Hispanic and one Native
American. 32 were
veterans of the Vietnam War, 3 of the Korean War, one of the
Panama invasions and two
of the Persian Gulf War. All participants were objectively
diagnosed with PTSD by
qualified persons. Participants had been free from alcohol and
other substances for at
least three months prior to the study. None had histories of
psychotic disorders although
20 participants had been, and continued to receive, one or more
psychotropic
medications, 13 of which were selective serotonin reuptake
inhibitors (SSRI).
Participants were administered either Prazosin or placebo using
a double blind method.
Effectiveness of the study
The methods used by the authors of the study appear to generate
accurate concise data
that is organizes in a manner conductive to good interpretation
and analysis.
Weaknesses in the methods used by the study
Although this study is a good start, it is not comprehensive
enough to encompass a
sufficient demographic of persons suffering from PTSD. It fails
to take into consideration
millions of sufferers such as, first responders (police, EMT,
firefighters), violence victims
of all ages, rape victims, veterans from recent conflicts and
younger suffers of PTSD.
Other variables which seem to have an effect in mental health
were also not taken into
consideration such as, support network (religious counseling,
family, peers), alcohol and
substance abuse. These factors that have been anecdotally
reported to have beneficial
effects in alleviating PTSD symptoms.
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Works Cited
Murray A. Raskind, Elaine R. Peskind, David J. Hoff, Kimberly L.
Hart, Hollie A. Holmes, Daniel Warren,
Jane Shofer, James OConnell, Fletcher Taylor, Christopher Gross,
Kirsten Rohde, Miles E. McFall. "AParallel Group Placebo Controlled
Study of Prazosin for Trauma Nightmares and Sleep Disturbance
in
Combat Veterans with Post-Traumatic Stress Disorder,."
Biological Psychiatry (2006): 928-934.
