Promising Treatment for PTSD

PTSD nightmares may be reduced by taking blood pressure medication

April 5, 2012 / Author:  / Reviewed by: Joseph V. Madia, MD

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Post-traumatic stress disorder (PTSD) affects people who have experienced traumatic events and the symptoms can interfere with daily life.  Natural disasters, combat situations, physical or sexual assault, and witnessing crimes are all traumatic events that, in some cases, result in PTSD.

Laurence French, Ph.D., author of "War Trauma and its Aftermath: An International Perspective on the Balkan and Gulf Wars" (University Press of America, 2012), stated in a video interview that the emotional effects of experiencing a traumatic event are on a continuum and that “post-traumatic stress is at the end of the continuum.”

What are the Symptoms of PTSD?

  • Reliving the traumatic event – Usually this symptom is triggered by something in the environment. When a person comes into contact with something that is a reminder of the event, they relive the event. Sometimes known as flashbacks.
  • Having disturbing nightmares – These are scary and often violent dreams that are distressing and interrupt sleep.
  • Avoiding situations that are reminders of the traumatic event – Many people with PTSD will stay away from places that serve as reminders. For example, if a person’s trauma was a near-drowning experience, he or she may stay away from water – maybe even refuse to bathe.
  • Feeling nervous – Some people with PTSD will report feeling jittery or restless even when there is no reason to feel that way.
  • Feeling numb in daily life – PTSD sufferers may experience loss of emotions about daily life.  They may stop feeling either happy or sad in response to normal life events.

These symptoms can begin after many different types of events like natural disasters, combat experience, sexual or physical assault, or major accidents.  The symptoms experienced are different for every sufferer.

Other problems are often associated with PTSD. Depression, drug addiction, relationship problems, and employment problems are common for people with PTSD.

Why are the nightmares a problem?

Nightmares can happen to anyone.  People with PTSD can experience intense and distressing nightmares.  Reports estimate that between 50 – 70% of people with PTSD experience disturbing nightmares.

For about half of people with PTSD nightmares, the dreams are a replay of the trauma. For the other half, the nightmares are not specific to the trauma but replay the emotions or emotional experience of the trauma.  In either case, PTSD nightmares interfere with normal sleep and can be emotionally distressing.  People with PTSD nightmares report being unable to return to sleep - sometimes being awake for hours feeling uneasy and upset. Interrupted sleep is also linked to many other problems like weight gain, difficulty coping, and loss of job-performance.

Who gets PTSD?

Whether or not a person develops this disorder after a traumatic event depends on many different factors like how intensely the event affected the person, how much control the person had during the event, and how much emotional support the person has after the event. Only a small number of people experiencing a traumatic event will develop PTSD.

How is PTSD diagnosed?

PTSD is diagnosed by a clinical psychologist or psychiatrist. These professionals conduct an interview with the patient to ask questions about the nature of the traumatic event, the symptoms that are experienced by the person, and the way the symptoms are interfering with daily life. 

How is PTSD treated?

The Veterans Affairs National Center for PTSD reports that cognitive-behavioral therapy and eye movement desensitization and reprocessing therapy are effective therapies that do not involve medication. Selective serotonin reuptake inhibitors (SSRI) – medications used to treat depression – are also helpful for some people with PTSD.  These treatments show promise in improving many of the symptoms of PTSD, but none of them directly address the symptom of nightmares specifically.

New research has shown that the drug known as Pressin or Vasoflex (prazosin) used in the treatment of high blood pressure can reduce the disturbing nightmares in patients with PTSD.   Psychiatrists from the Mayo Clinic examined the 12 published research articles where prazosin was shown to reduce nightmares. At a presentation at the 20th European Congress of Psychiatry, they reported that the results of their review support the use of this treatment for reducing the number and frequency of nightmares associated with PTSD.

Why does Prazosin help reduce nightmares?

Prazosin acts on the neurotransmitter norephinephrine to reduce blood pressure. One theory is that overactive norephinephrine receptors in the brain causes disrupted sleep and nightmares.  This may be the avenue through with prazosin can relieve nightmares for people with PTSD. Prazosin has few side-effects and is well-tolerated by most people.

Reviewed by: 
Review Date: 
March 29, 2012
Last Updated:
July 11, 2013