Medication Relief for Nightmares Associated with PTSD

For those who suffer from Post Traumatic Stress Disorder (PTSD) nightmares can render you incapacitated, or push us into a downward spiral, suicidal ideation, and fear of sleeping.

PTSD dreams are the most vivid dreams one can have. The dreams from PTSD are most often a reliving of the trauma as we sleep and dream. What adds to this is that we are powerless to stop the dream. So once again, we 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 room mate 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. I don't know if they put the man on Prazosin or not. But it is an extreme example of how torturous and vivid the nightmares can be.

What is the Difference Between PTSD Nightmares and Flashbacks

Flashbacks occur while one is awake, and they are actually 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. They are not aware of their surroundings. They are in that moment in the same time and place of the trauma. Flashbacks are not hallucinations. Hallucinations are things that are seen and heard of something that never happened in the past or at the present. Flashbacks are the reliving of the true and actual event of trauma.

Nightmares occur in our sleep. They too are vivid, reliving the moment, also hearing, seeing, smelling, and feeling all that happened during the actual trauma. But, it is a dream, and we wake up and know it is a dream.

Having experienced a PTSD dream, it is not easy to wake up and say, "Oh just a dream, not real, I'm safe." Because in the dream you are reliving the trauma, and left with the terror and emotions of the trauma. When they continue life can get pretty miserable and stressful.

The Good News

There is good news for those suffering from PTSD nightmares. First, PTSD nightmares tend to lessen as the years ago by, usually. 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. Years ago it was found to help with PTSD nightmares. Soldiers with PTSD were the first to benefit from this medication and was used often.

It seems that it is prescribed less often in private citizen patients, although I'm not sure why. A few years ago I shared with an acquaintance who was a mental health professional about the horrors of my frequent nightmares. She said to me, "You know, there is medication to help with that." I was stunned. I had been suffering from PTSD for about 10 years and not one doctor or psychiatrist every told me about this or prescribed it. The next time I saw my doctors he put me on it right away and I can vouch for the absolute effectiveness of this medication. My nightmares stopped immediately.

How Does Prazosin Work?

PTSD is an anxiety disorder. Anxiety is very intense. Because of the extreme anxiety levels, the body produces a large amount of adrenaline. According to WebMD, 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.

Possible Side Effects

Most people don't suffer many side effects from Prazosin. However, the most common side effects are:

• Hypotension (low blood pressure)
• Loss of strength
• Dizziness
• Nausea
• Palpitations (irregular heartbeats)
• Headache
• Sleepiness
• Impotence
• Priapism (sustained painful erection)
• 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. See WebMD for more details.

How Effective is Prazosin with PTSD Nightmares?

Although I had astounding results with Prazosin, not all people experience such complete relief from PTSD nightmares. However, many who take prazosin find signigicant relief. When I was taking it, I occasionally had unpleasant dreams, what I would call bad dreams, not nightmares. They were not the same vivid, gory nightmares that I had before I 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.

© Lori Colbo 2011