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J. Clin. Med. 2016, 5(12), 117; doi:10.3390/jcm5120117

Treatment of Post-Traumatic Stress Disorder Nightmares at a Veterans Affairs Medical Center

1
Staff Psychiatrist, Veterans Affairs Medical Center, Salem, VA 24153, USA
2
Department Psychiatry, Edward via College of Osteopathic Medicine, Blacksburg, VA 24060, USA
3
Virginia Tech-Carilion Clinic Psychiatry Residency Program, Roanoke, VA 24014, USA
4
Geriatric Research Group, Veterans Affairs Medical Center, Salem, VA 24153, USA
5
Emergency Department, Veterans Affairs Medical Center, Salem, VA 24153, USA
6
Attending Physician, Veterans Affairs Medical Ce.nter, Syracuse, NY 13210, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Jane Grant-Kels
Received: 21 July 2016 / Revised: 28 October 2016 / Accepted: 9 December 2016 / Published: 16 December 2016
(This article belongs to the Special Issue Post-Traumatic Stress Disorder 2016)
View Full-Text   |   Download PDF [291 KB, uploaded 16 December 2016]

Abstract

The effectiveness of medications for PTSD in general has been well studied, but the effectiveness of medicatio.ns prescribed specifically for post-traumatic stress disorder (PTSD) nightmares is less well known. This retrospective chart review examined the efficacy of various medications used in actual treatment of PTSD nightmares at one Veteran Affairs Hospital. Records at the Salem, VA Veterans Affairs Medical Center (VAMC) were examined from 2009 to 2013 to check for the efficacy of actual treatments used in comparis.on with treatments suggested in three main review articles. The final sample consisted of 327 patients and 478 separate medication trials involving 21 individual medications plus 13 different medication combinations. The three most frequently utilized medications were prazosin (107 trials), risperidone (81 trials), and quetiapine (72 trials). Five medications had 20 or more trials with successful results (partial to full nightmare cessation) in >50% of trials: risperidone (77%, 1.0–6.0 mg), clonidine (63%, 0.1–2.0 mg), quetiapine (50%, 12.5–800.0 mg), mirtazapine (50%; 7.5–30.0 mg), and terazosin (64%, 50.0–300.0 mg). Notably, olanzapine (2.5–10.0) was successful (full remission) in all five prescription trials in five separate patients. Based on the clinical results, the use of risperidone, clonidine, terazosin, and olanzapine warrants additional investigation in clinically controlled trials as medications prescribed specifically for PTSD nightmares. View Full-Text
Keywords: veterans; post-traumatic stress disorder; nightmares; pharmacotherapy; combat; soldiers veterans; post-traumatic stress disorder; nightmares; pharmacotherapy; combat; soldiers
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Detweiler, M.B.; Pagadala, B.; Candelario, J.; Boyle, J.S.; Detweiler, J.G.; Lutgens, B.W. Treatment of Post-Traumatic Stress Disorder Nightmares at a Veterans Affairs Medical Center. J. Clin. Med. 2016, 5, 117.

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