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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by ChicagoKat on January 21, 2013, at 11:01:43
I suffer from treatment-resistant depression and anxiety, and if this is Scott reading, I believe you once mentioned that you believed I have developmental PTSD from the maternal emotional abuse I experienced as a child. Now, on top of that, I have been told by my therapist and others that I also suffer PTSD from the trauma of my very physically abusive first marriage; I even had knives pulled on me at the time.
So my question, which is basically for Scott - but anyone else is free to chime in - would I benefit from the addition of Prazosin to my current regimen of Ritalin and Tegretol and Elavil for sleep? My understanding is that Prazosin is usually used as a sleep med, to help those with hypervigilance (me!) to fall asleep, but don't you, Scott, take it during the day? And if I'm not prying, why is that? Is there a benfit to taking it during the day?
With me, hypotension would obviously not be a problem b/c I have baseline HTN, not to mention what the Ritalin does to my BP.
If you don't mind sharing more, Scott, I'd really appreciate it, as I have a pdoc appt in a week and I want to be well ready for it. Thanks so much!
Kat
Posted by Phillipa on January 21, 2013, at 12:01:20
In reply to PTSD/Prazosin-----SLS?, posted by ChicagoKat on January 21, 2013, at 11:01:43
Kat not Scott but isn't minipress the other name for prazosin. I will leave the rest for Scott who this was intended for. Phillipa
Posted by ChicagoKat on January 21, 2013, at 12:47:13
In reply to Re: PTSD/Prazosin-----SLS? » ChicagoKat, posted by Phillipa on January 21, 2013, at 12:01:20
> Kat not Scott but isn't minipress the other name for prazosin. I will leave the rest for Scott who this was intended for. Phillipa
Yes, Minipress is the brand name.
Kat
Posted by SLS on January 21, 2013, at 13:50:03
In reply to PTSD/Prazosin-----SLS?, posted by ChicagoKat on January 21, 2013, at 11:01:43
Hi Kat.
I will start off by saying that the stuff works for me big time. It acts like a potent and steady antidepressant night and day. For PTSD, it was discovered serendipitously at a VA hospital that prazosin acts to reduce nightmares and disturbed sleep. However, it was quite a while before someone had the bright idea to try it for the daytime anxiety and depression that can accompany PTSD.
Because prazosin has such a short half-life, it is best to take it three times a day. I take 15 mg/day divided into 5 mg t.i.d.
- Scott------------------------------------------
http://www.ncbi.nlm.nih.gov/pubmed/16460691
Biol Psychiatry. 2006 Apr 1;59(7):577-81. Epub 2006 Feb 7.
Daytime prazosin reduces psychological distress to trauma specific cues in civilian trauma posttraumatic stress disorder.Taylor FB, Lowe K, Thompson C, McFall MM, Peskind ER, Kanter ED, Allison N, Williams J, Martin P, Raskind MA.
BACKGROUND:
Persons with posttraumatic stress disorder (PTSD) whose trauma-related nightmares improve or resolve with bedtime administration of the alpha-1 adrenergic antagonist prazosin often continue to experience PTSD symptoms during the day. This study addressed whether daytime prazosin compared to placebo would alleviate psychological distress provoked experimentally by a trauma-related word list included in the emotional Stroop (E-Stroop) paradigm.
METHODS:
Eleven persons with civilian trauma PTSD who continued to experience daytime PTSD symptoms despite a stable bedtime prazosin dose that suppressed trauma-related nightmares were studied. Prazosin and placebo were administered on two different occasions in the early afternoon followed two hours later by the E-Stroop. Effects of drug on psychological distress were assessed by the Profile of Mood States (P*MS).
RESULTS:
P*MS total score and an "emotional distress" P*MS subscale score following trauma-related words were significantly lower in the prazosin than placebo condition. There were no treatment effects on E-Stroop completion time. In 10 subjects who continued open label daytime prazosin, there was a reduction in global PTSD illness severity at 2-week follow-up.
CONCLUSIONS:
Daytime prazosin pretreatment reduced psychological distress specifically to trauma cues. Adding daytime prazosin to bedtime prazosin may further reduce overall PTSD illness severity and distress.
PMID:
16460691
[PubMed - indexed for MEDLINE]------------------------------------------
http://www.nimh.nih.gov/about/advisory-boards-and-groups/namhc/2006/september/director-report.pdf
Blood Pressure Medication Relieves Daytime PTSD Symptoms
Current treatments for post-traumatic stress disorder (PTSD) are reported to be only minimally effective in reducing both nighttime and daytime re-experiencing and intrusion symptoms; many people with PTSD self-medicate with drugs or alcohol. Recent studies have demonstrated that prazosin (Minipress), a generically available alpha-1 adrenergic antagonist, can reduced night time PTSD symptoms.
A new study by Fletcher B. Taylor, of the Veteran Health Care System and University of Washington, and colleagues suggests that daytime administration of prazosin also may bring relief from anxiety, nervousness, and fear. The results suggest that daytime administration will not interfere with routine daytime tasks and skills, indicating that prazosin may be an effective addition to current treatments.
Taylor FB, Lowe K, Thompson C, McFall MM, Peskind ER, Kanter ED, Allison N, Williams J, Martin P, Raskind MA
Daytime prazosin reduces psychological distress to trauma specific cues in civilian trauma posttraumatic stress disorder. Biol Psychiatry. 2006 Apr 1;59(7):577-81.
------------------------------------------
Posted by ChicagoKat on January 21, 2013, at 15:33:24
In reply to Re: PTSD/Prazosin-----SLS? » ChicagoKat, posted by SLS on January 21, 2013, at 13:50:03
Thanks for all the info Scott! I plan to share it with my pdoc on monday.
If you get a chance, though, can you tell me, does taking prazosin during the day make you sleepy, or do you develop tolerance to that? And how does it seem to help your mood? Does it just make you feel more positive in general, or does it make you more able to avoid negative thoughts/PTSD triggers? Thanks so much if you have the time to answer my questions! I'm feeling SO much better since tegretol was added to my therapy, but I want to see if I can go from feeling OK, to feeling really good! :)
Kat
Posted by Hugh on January 21, 2013, at 16:04:43
In reply to PTSD/Prazosin-----SLS?, posted by ChicagoKat on January 21, 2013, at 11:01:43
Prazosin has been showing lots of promise for treating PTSD. I tried taking it for insomnia, but couldn't tolerate it. But I'm very sensitive to lots of medicines and supplements. Another drug to consider taking for PTSD is the beta blocker propranolol. This quote is from The Atlantic:
He and his colleagues administered propranolol 75 minutes before the reactivation of frightening memories in 40 patients. "It really did wonders," he told me. "After six sessions, 70 percent of patients no longer met the clinical criteria for PTSD."
The whole article is here:
This story about using propranolol to treat PTSD was shown on 60 Minutes several years ago:
Part one: http://www.youtube.com/watch?v=AhK0EX4G018&feature=related
Posted by ChicagoKat on January 21, 2013, at 16:21:58
In reply to Re: PTSD/Prazosin-----SLS?, posted by Hugh on January 21, 2013, at 16:04:43
thanks for all the info Hugh!
Kat
Posted by Hugh on January 21, 2013, at 21:11:30
In reply to Re: PTSD/Prazosin-----SLS? » Hugh, posted by ChicagoKat on January 21, 2013, at 16:21:58
> thanks for all the info Hugh!
> KatYou're welcome. And here's some more. David Berceli is a therapist who travels to war-torn regions and to natural disaster sites around the world, teaching a technique he calls TRE (Tension and Trauma Releasing Exercises). There are TRE instructors all over the world, and the website sells instructional DVDs. But you can get a pretty good idea how to do it from watching YouTube videos.
Posted by ChicagoKat on January 27, 2013, at 9:42:53
In reply to Re: PTSD/Prazosin-----SLS?, posted by Hugh on January 21, 2013, at 21:11:30
> > thanks for all the info Hugh!
> > Kat
>
> You're welcome. And here's some more. David Berceli is a therapist who travels to war-torn regions and to natural disaster sites around the world, teaching a technique he calls TRE (Tension and Trauma Releasing Exercises). There are TRE instructors all over the world, and the website sells instructional DVDs. But you can get a pretty good idea how to do it from watching YouTube videos.
>
> http://traumaprevention.com/
>
>
> Thanks again for providing lots of info, Hugh :)
Sorry for the late response; I somehow missed your post until today.
My therapist is trying EMDR on me...have you ever heard of it? I'm a little skeptical about it, non-traditional treatments are not my thing, but I figure it can't hurt.
Posted by SLS on January 27, 2013, at 16:24:49
In reply to Re: PTSD » Hugh, posted by ChicagoKat on January 27, 2013, at 9:42:53
> My therapist is trying EMDR on me...have you ever heard of it? I'm a little skeptical about it, non-traditional treatments are not my thing, but I figure it can't hurt.
Good luck with the EMDR. I look forward to seeing how you respond to it. Some people report robust results with it.
Have you brought up prazosin with your doctor?
- Scott
Posted by ChicagoKat on January 29, 2013, at 7:22:02
In reply to Re: PTSD » ChicagoKat, posted by SLS on January 27, 2013, at 16:24:49
> > My therapist is trying EMDR on me...have you ever heard of it? I'm a little skeptical about it, non-traditional treatments are not my thing, but I figure it can't hurt.
>
> Good luck with the EMDR. I look forward to seeing how you respond to it. Some people report robust results with it.
>
> Have you brought up prazosin with your doctor?
>
>
> - ScottMy therapist has already started some EMDR on me, but I have to admit, following her fingers back and forth with my eyes, I just can't help but think it's kind of hokey. Even though I know there is research out there that shows it can really help with PTSD. I'm afraid my negativity about it is destroying any help it might do me. She said it wouldn't, but I don't know, we'll see.
The prazosin I completely forgot to ask about...I blame it on the ect lol...it's nice to have a scapegoat :) I'll be sure to ask next time, in a month.
And Scott, I've asked often how you are doing, and I want an answer buster!!
Kat
Posted by SLS on January 29, 2013, at 8:07:07
In reply to Re: PTSD, posted by ChicagoKat on January 29, 2013, at 7:22:02
> And Scott, I've asked often how you are doing, and I want an answer buster!!
Ack!
I give up! I give up!
Now that I have reestablished my proper treatment regime (I forgot to take minocycline for a week), I am doing quite a bit better. I am happy with what I am feeling. This has brought back some optimism that I will eventually achieve remission.
You resilience is amazing. Never give up!
- Scott
Posted by ChicagoKat on January 29, 2013, at 11:04:17
In reply to Re: PTSD » ChicagoKat, posted by SLS on January 29, 2013, at 8:07:07
> > And Scott, I've asked often how you are doing, and I want an answer buster!!
>
> Ack!
>
> I give up! I give up!
>
> Now that I have reestablished my proper treatment regime (I forgot to take minocycline for a week), I am doing quite a bit better. I am happy with what I am feeling. This has brought back some optimism that I will eventually achieve remission.
>
> You resilience is amazing. Never give up!
>
>
> - ScottLOL thanks for giving up and sharing with me the good news that you are doing so well :) It makes me happy and it gives me hope. I could say the same for you, I know you've been fighting the beast for a long time too, and you never gave up either! Nor will I, you can be sure of that! Thanks for the post Scott, it really cheered me up :)
Kat
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