Improved sleep and rehabilitation in a post-traumatic stress disorder patient after commencement of prazosin

Abstract

Background: First-line treatment of post-traumatic stress disorder (PTSD) is trauma-focused psychotherapy. If drug treatment is indicated, then selective serotonin reuptake inhibitors are the first choice. Other drugs studied include prazosin, antipsychotics and anti-seizure medications. Aim: A case report of the marked improvement in the patient's rehabilitation following appropriately treating PTSD symptoms with prazosin. Clinical details: A 28-year-old man was admitted to the Rehabilitation Ward, at Redcliffe Hospital, with a right quadricep tendon rupture which had been repaired 3 months previously. The patient was not able to weight-bear and was admitted in a wheelchair. Past medical history included epilepsy and PTSD treated with quetiapine to assist sleep. Since quetiapine was not managing the PTSD symptoms it was ceased and prazosin was commenced to decrease PTSD nightmares. Outcomes: Sleep quality and decreased trauma nightmares were significantly improved after commencement of prazosin. The patient progressed from being wheelchair-bound to being more ambulant on discharge. Conclusion: Prazosin is effective for enhanced sleep quality, reduction in trauma nightmares and marked reduction in PTSD symptoms. Better control of PTSD symptoms may have an impact on recovery and rehabilitation.