The Experts below are selected from a list of 162 Experts worldwide ranked by ideXlab platform
Murray A Raskind - One of the best experts on this subject based on the ideXlab platform.
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pharmacology of sleep and ptsd Prazosin an alpha 1 adrenoreceptor antagonist approach to post traumatic stress disorder pharmacotherapy
2018Co-Authors: Murray A RaskindAbstract:Increased brain noradrenergic activity contributes to the pathophysiology of post-traumatic stress disorder (PTSD) in a substantial proportion of patients. Prazosin is an inexpensive, clinically available and brain active drug that reduces brain noradrenergic activity by antagonizing the effects of norepinephrine at the postsynaptic alpha-1 adrenoreceptor. This chapter reviews the neurobiologic rationale and clinical trial evidence supporting efficacy of Prazosin for PTSD trauma nightmares, distressed awakenings and day time hyperarousal symptoms; and provides suggestions for biomarker and clinical presentation characteristics that help identify those PTSD patients most likely to benefit from Prazosin treatment. It also reviews Prazosin as a potential treatment for disorders commonly comorbid with military PTSD including alcohol use disorder and post-concussion headache. Finally, suggestions are provided concerning optimizing Prazosin treatment and management of the occasional adverse drug effects.
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Prazosin for the Treatment of PTSD
Current Treatment Options in Psychiatry, 2015Co-Authors: Murray A RaskindAbstract:Prazosin is a generically available central nervous system (CNS) active alpha-1 adrenoreceptor antagonist that has been demonstrated effective in randomized controlled trials (RCTs) for posttraumatic stress disorder (PTSD) trauma nightmares, distressed awakenings, daytime hyperarousal symptoms, and global clinical function. The contribution of increased CNS noradrenergic activity to PTSD pathophysiology and the involvement of the postsynaptic alpha-1 adrenoreceptor in brain systems relevant to PTSD symptomatology provide neurobiologic rationale for Prazosin as a PTSD pharmacotherapeutic. This article reviews the clinical observations that led to the development of Prazosin therapy for PTSD in combat veterans and the subsequent RCTs that demonstrated Prazosin efficacy.
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a trial of Prazosin for combat trauma ptsd with nightmares in active duty soldiers returned from iraq and afghanistan
American Journal of Psychiatry, 2013Co-Authors: Murray A Raskind, Kris Peterson, Tammy Williams, David Hoff, Kimberly Hart, Hollie Holmes, Dallas Homas, Jeffrey Hill, Colin Daniels, Jess CalohanAbstract:ObjectiveThe authors conducted a 15-week randomized controlled trial of the alpha-1 adrenoreceptor antagonist Prazosin for combat trauma nightmares, sleep quality, global function, and overall symptoms in active-duty soldiers with posttraumatic stress disorder (PTSD) returned from combat deployments to Iraq and Afghanistan.MethodSixty-seven soldiers were randomly assigned to treatment with Prazosin or placebo for 15 weeks. Drug was titrated based on nightmare response over 6 weeks to a possible maximum dose of 5 mg midmorning and 20 mg at bedtime for men and 2 mg midmorning and 10 mg at bedtime for women. Mean achieved bedtime doses were 15.6 mg of Prazosin (SD=6.0) and 18.8 mg of placebo (SD=3.3) for men and 7.0 mg of Prazosin (SD=3.5) and 10.0 mg of placebo (SD=0.0) for women. Mean achieved midmorning doses were 4.0 mg of Prazosin (SD=1.4) and 4.8 mg of placebo (SD=0.8) for men and 1.7 mg of Prazosin (SD=0.5) and 2.0 mg of placebo (SD=0.0) mg for women. Primary outcome measures were the nightmare item o...
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Prazosin treatment of trauma nightmares and sleep disturbance in soldiers deployed in iraq
Journal of Traumatic Stress, 2010Co-Authors: Jess Calohan, Kris Peterson, Elaine R Peskind, Murray A RaskindAbstract:Trauma nightmares and sleep disturbance impair combat soldiers' functioning. The alpha-1 adrenoreceptor antagonist Prazosin has been demonstrated effective for these symptoms in Vietnam veterans. Thirteen soldiers seeking relief from distressing trauma nightmares impairing military function in northern Iraq in 2006 received Prazosin alone or in combination with other psychotropics. Mean Prazosin dose was 4.1 (SD = 2.2) mg before bed. Six soldiers improved markedly and 3 moderately on the Clinical Global Impression of Change Ratings of distressing dreams decreased from an average of 7.0 (SD = 0.7) to 2.9 (SD = 3.0, p < .001) and those of disturbed sleep from 6.7 (SD = 0.9) to 3.7 (SD = 2.4, p < .001). Prazosin appears effective and well tolerated in the desert warfare environment.
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a parallel group placebo controlled study of Prazosin for trauma nightmares and sleep disturbance in combat veterans with post traumatic stress disorder
Biological Psychiatry, 2007Co-Authors: Murray A Raskind, David Hoff, Kimberly Hart, Hollie Holmes, Fletcher B Taylor, Elaine R Peskind, Daniel Warren, Jane B Shofer, James Oconnell, Christopher GrossAbstract:Background Excessive brain responsiveness to norepinephrine appears to contribute to post-traumatic stress disorder (PTSD), particularly at night. Prazosin, a brain active alpha-1 adrenergic receptor antagonist, significantly reduced trauma nightmares and sleep disturbance in 10 Vietnam War combat veterans in a previous placebo-controlled crossover study. The current parallel group trial in a larger sample of veterans evaluated Prazosin effects on trauma nightmares, sleep quality, global clinical status, dream characteristics, and comorbid depression. Methods Forty veterans (mean age 56 ± 9) with chronic PTSD and distressing trauma nightmares and sleep disturbance were randomized to evening Prazosin (13.3 ± 3 mg/day) or placebo for 8 weeks. Results In the evaluable sample (n = 34), primary outcome measures demonstrated that Prazosin was significantly superior to placebo for reducing trauma nightmares and improving sleep quality and global clinical status with large effect sizes. Prazosin shifted dream characteristics from those typical of trauma-related nightmares toward those typical of normal dreams. Blood pressure changes from baseline to end study did not differ significantly between Prazosin and placebo. Conclusions Prazosin is an effective and well-tolerated treatment for trauma nightmares, sleep disturbance and global clinical status in veterans with chronic PTSD.
Elaine R Peskind - One of the best experts on this subject based on the ideXlab platform.
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Prazosin treatment of trauma nightmares and sleep disturbance in soldiers deployed in iraq
Journal of Traumatic Stress, 2010Co-Authors: Jess Calohan, Kris Peterson, Elaine R Peskind, Murray A RaskindAbstract:Trauma nightmares and sleep disturbance impair combat soldiers' functioning. The alpha-1 adrenoreceptor antagonist Prazosin has been demonstrated effective for these symptoms in Vietnam veterans. Thirteen soldiers seeking relief from distressing trauma nightmares impairing military function in northern Iraq in 2006 received Prazosin alone or in combination with other psychotropics. Mean Prazosin dose was 4.1 (SD = 2.2) mg before bed. Six soldiers improved markedly and 3 moderately on the Clinical Global Impression of Change Ratings of distressing dreams decreased from an average of 7.0 (SD = 0.7) to 2.9 (SD = 3.0, p < .001) and those of disturbed sleep from 6.7 (SD = 0.9) to 3.7 (SD = 2.4, p < .001). Prazosin appears effective and well tolerated in the desert warfare environment.
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a parallel group placebo controlled study of Prazosin for trauma nightmares and sleep disturbance in combat veterans with post traumatic stress disorder
Biological Psychiatry, 2007Co-Authors: Murray A Raskind, David Hoff, Kimberly Hart, Hollie Holmes, Fletcher B Taylor, Elaine R Peskind, Daniel Warren, Jane B Shofer, James Oconnell, Christopher GrossAbstract:Background Excessive brain responsiveness to norepinephrine appears to contribute to post-traumatic stress disorder (PTSD), particularly at night. Prazosin, a brain active alpha-1 adrenergic receptor antagonist, significantly reduced trauma nightmares and sleep disturbance in 10 Vietnam War combat veterans in a previous placebo-controlled crossover study. The current parallel group trial in a larger sample of veterans evaluated Prazosin effects on trauma nightmares, sleep quality, global clinical status, dream characteristics, and comorbid depression. Methods Forty veterans (mean age 56 ± 9) with chronic PTSD and distressing trauma nightmares and sleep disturbance were randomized to evening Prazosin (13.3 ± 3 mg/day) or placebo for 8 weeks. Results In the evaluable sample (n = 34), primary outcome measures demonstrated that Prazosin was significantly superior to placebo for reducing trauma nightmares and improving sleep quality and global clinical status with large effect sizes. Prazosin shifted dream characteristics from those typical of trauma-related nightmares toward those typical of normal dreams. Blood pressure changes from baseline to end study did not differ significantly between Prazosin and placebo. Conclusions Prazosin is an effective and well-tolerated treatment for trauma nightmares, sleep disturbance and global clinical status in veterans with chronic PTSD.
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daytime Prazosin reduces psychological distress to trauma specific cues in civilian trauma posttraumatic stress disorder
Biological Psychiatry, 2006Co-Authors: Fletcher B Taylor, Kathleen Lowe, Charles E Thompson, Miles M Mcfall, Elaine R Peskind, Evan D Kanter, Nancy Allison, Judi Williams, Patti Martin, Murray A RaskindAbstract: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 (POMS). Results POMS total score and an "emotional distress" POMS 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.
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Prazosin reduces trauma related nightmares in older men with chronic posttraumatic stress disorder
Journal of Geriatric Psychiatry and Neurology, 2003Co-Authors: Elaine R Peskind, David Hoff, Lauren T Bonner, Murray A RaskindAbstract:Trauma-related nightmares in posttraumatic stress disorder (PTSD) rarely respond to pharmacologic treatment. Neurobiologic data suggest that enhanced brain responsiveness to adrenergic stimulation may contribute to the pathophysiology of trauma-related nightmares in PTSD. Nine older men with chronic PTSD secondary to military or Holocaust trauma were prescribed the lipophilic alpha-1 adrenergic antagonist Prazosin for treatment-resistant trauma-related nightmares. Prazosin 2 mg to 4 mg 1 hour before bedtime substantially reduced nightmares and moderately or markedly reduced overall PTSD severity in 8 of 9 subjects. Prazosin was well tolerated. These open-label results are consistent with demonstrated therapeutic efficacy of Prazosin for PTSD nightmares and sleep disturbance in a recent placebo-controlled trial in Vietnam veterans.
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reduction of nightmares and other ptsd symptoms in combat veterans by Prazosin a placebo controlled study
American Journal of Psychiatry, 2003Co-Authors: Murray A Raskind, David Hoff, Charles E Thompson, Elaine R Peskind, Evan D Kanter, Eric C Petrie, Allen D Radant, Dorcas J Dobie, Rebekah J Rein, Kristy StraitstrosterAbstract:OBJECTIVE: Prazosin is a centrally active α1 adrenergic antagonist. The authors’ goal was to evaluate Prazosin efficacy for nightmares, sleep disturbance, and overall posttraumatic stress disorder (PTSD) in combat veterans. METHOD: Ten Vietnam combat veterans with chronic PTSD and severe trauma-related nightmares each received Prazosin and placebo in a 20-week double-blind crossover protocol. RESULTS: Prazosin (mean dose=9.5 mg/day at bedtime, SD=0.5) was superior to placebo for the three primary outcome measures: scores on the 1) recurrent distressing dreams item and the 2) difficulty falling/staying asleep item of the Clinician-Administered PTSD Scale and 3) change in overall PTSD severity and functional status according to the Clinical Global Impression of change. Total score and symptom cluster scores for reexperiencing, avoidance/numbing, and hyperarousal on the Clinician-Administered PTSD Scale also were significantly more improved in the Prazosin condition, and Prazosin was well tolerated. CONCLUSI...
David Hoff - One of the best experts on this subject based on the ideXlab platform.
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a trial of Prazosin for combat trauma ptsd with nightmares in active duty soldiers returned from iraq and afghanistan
American Journal of Psychiatry, 2013Co-Authors: Murray A Raskind, Kris Peterson, Tammy Williams, David Hoff, Kimberly Hart, Hollie Holmes, Dallas Homas, Jeffrey Hill, Colin Daniels, Jess CalohanAbstract:ObjectiveThe authors conducted a 15-week randomized controlled trial of the alpha-1 adrenoreceptor antagonist Prazosin for combat trauma nightmares, sleep quality, global function, and overall symptoms in active-duty soldiers with posttraumatic stress disorder (PTSD) returned from combat deployments to Iraq and Afghanistan.MethodSixty-seven soldiers were randomly assigned to treatment with Prazosin or placebo for 15 weeks. Drug was titrated based on nightmare response over 6 weeks to a possible maximum dose of 5 mg midmorning and 20 mg at bedtime for men and 2 mg midmorning and 10 mg at bedtime for women. Mean achieved bedtime doses were 15.6 mg of Prazosin (SD=6.0) and 18.8 mg of placebo (SD=3.3) for men and 7.0 mg of Prazosin (SD=3.5) and 10.0 mg of placebo (SD=0.0) for women. Mean achieved midmorning doses were 4.0 mg of Prazosin (SD=1.4) and 4.8 mg of placebo (SD=0.8) for men and 1.7 mg of Prazosin (SD=0.5) and 2.0 mg of placebo (SD=0.0) mg for women. Primary outcome measures were the nightmare item o...
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a parallel group placebo controlled study of Prazosin for trauma nightmares and sleep disturbance in combat veterans with post traumatic stress disorder
Biological Psychiatry, 2007Co-Authors: Murray A Raskind, David Hoff, Kimberly Hart, Hollie Holmes, Fletcher B Taylor, Elaine R Peskind, Daniel Warren, Jane B Shofer, James Oconnell, Christopher GrossAbstract:Background Excessive brain responsiveness to norepinephrine appears to contribute to post-traumatic stress disorder (PTSD), particularly at night. Prazosin, a brain active alpha-1 adrenergic receptor antagonist, significantly reduced trauma nightmares and sleep disturbance in 10 Vietnam War combat veterans in a previous placebo-controlled crossover study. The current parallel group trial in a larger sample of veterans evaluated Prazosin effects on trauma nightmares, sleep quality, global clinical status, dream characteristics, and comorbid depression. Methods Forty veterans (mean age 56 ± 9) with chronic PTSD and distressing trauma nightmares and sleep disturbance were randomized to evening Prazosin (13.3 ± 3 mg/day) or placebo for 8 weeks. Results In the evaluable sample (n = 34), primary outcome measures demonstrated that Prazosin was significantly superior to placebo for reducing trauma nightmares and improving sleep quality and global clinical status with large effect sizes. Prazosin shifted dream characteristics from those typical of trauma-related nightmares toward those typical of normal dreams. Blood pressure changes from baseline to end study did not differ significantly between Prazosin and placebo. Conclusions Prazosin is an effective and well-tolerated treatment for trauma nightmares, sleep disturbance and global clinical status in veterans with chronic PTSD.
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Prazosin reduces trauma related nightmares in older men with chronic posttraumatic stress disorder
Journal of Geriatric Psychiatry and Neurology, 2003Co-Authors: Elaine R Peskind, David Hoff, Lauren T Bonner, Murray A RaskindAbstract:Trauma-related nightmares in posttraumatic stress disorder (PTSD) rarely respond to pharmacologic treatment. Neurobiologic data suggest that enhanced brain responsiveness to adrenergic stimulation may contribute to the pathophysiology of trauma-related nightmares in PTSD. Nine older men with chronic PTSD secondary to military or Holocaust trauma were prescribed the lipophilic alpha-1 adrenergic antagonist Prazosin for treatment-resistant trauma-related nightmares. Prazosin 2 mg to 4 mg 1 hour before bedtime substantially reduced nightmares and moderately or markedly reduced overall PTSD severity in 8 of 9 subjects. Prazosin was well tolerated. These open-label results are consistent with demonstrated therapeutic efficacy of Prazosin for PTSD nightmares and sleep disturbance in a recent placebo-controlled trial in Vietnam veterans.
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reduction of nightmares and other ptsd symptoms in combat veterans by Prazosin a placebo controlled study
American Journal of Psychiatry, 2003Co-Authors: Murray A Raskind, David Hoff, Charles E Thompson, Elaine R Peskind, Evan D Kanter, Eric C Petrie, Allen D Radant, Dorcas J Dobie, Rebekah J Rein, Kristy StraitstrosterAbstract:OBJECTIVE: Prazosin is a centrally active α1 adrenergic antagonist. The authors’ goal was to evaluate Prazosin efficacy for nightmares, sleep disturbance, and overall posttraumatic stress disorder (PTSD) in combat veterans. METHOD: Ten Vietnam combat veterans with chronic PTSD and severe trauma-related nightmares each received Prazosin and placebo in a 20-week double-blind crossover protocol. RESULTS: Prazosin (mean dose=9.5 mg/day at bedtime, SD=0.5) was superior to placebo for the three primary outcome measures: scores on the 1) recurrent distressing dreams item and the 2) difficulty falling/staying asleep item of the Clinician-Administered PTSD Scale and 3) change in overall PTSD severity and functional status according to the Clinical Global Impression of change. Total score and symptom cluster scores for reexperiencing, avoidance/numbing, and hyperarousal on the Clinician-Administered PTSD Scale also were significantly more improved in the Prazosin condition, and Prazosin was well tolerated. CONCLUSI...
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Prazosin reduces nightmares in combat veterans with posttraumatic stress disorder
The Journal of Clinical Psychiatry, 2002Co-Authors: Murray A Raskind, David Hoff, Charles E Thompson, Eric C Petrie, Dorcas J Dobie, Rebekah J Rein, Miles Mcfall, Elaine R PeskindAbstract:BACKGROUND Preclinical and clinical observations suggest that the centrally active alpha1-adrenergic antagonist Prazosin might alleviate trauma content nightmares and other symptoms in combat veterans with chronic posttraumatic stress disorder (PTSD). METHOD In this retrospective chart review study, we analyzed data from 59 consecutive combat veterans with previously treatment-resistant chronic PTSD (DSM-IV criteria) and severe intractable trauma content nightmares to whom Prazosin had been prescribed. Nightmare severity was quantified using the recurrent distressing dreams item of the Clinician Administered PTSD Scale (CAPS). Change in overall PTSD severity exclusive of nightmares was estimated by assigning a Clinical Global Impressions-Change scale (CGI-C) score based on chart review. RESULTS Mean +/- SEM recurrent distressing dreams item scores improved significantly (7.0 +/- 0.2 to 3.5 +/- 0.3, p <.0001) in the 36 patients who completed at least 8 weeks of Prazosin treatment at their maximum titrated dose. The mean maximum Prazosin dose achieved in these 36 patients was 9.6 +/- 0.9 mg/day. Recurrent distressing dreams scores also improved in the total group who filled their Prazosin prescriptions (N = 51) (7.1 +/- 0.2 to 4.2 +/- 0.3, p <.0001). In a comparison group of 8 patients who did not fill their Prazosin prescriptions but continued in outpatient treatment, there was no significant change in CAPS recurrent distressing dreams score (6.8 +/- 0.5 to 6.7 +/- 0.4). There also was at least some improvement in CGI-C ratings of overall PTSD severity exclusive of nightmares in a substantial majority of patients receiving Prazosin, but not in the 8 comparison subjects. There were no serious adverse effects attributable to Prazosin. CONCLUSION These observations suggest that Prazosin may relieve symptomatic distress in PTSD, and they provide rationale for placebo-controlled trials of Prazosin for PTSD trauma content nightmares and other PTSD symptoms.
Christopher Reist - One of the best experts on this subject based on the ideXlab platform.
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Prazosin for treatment of post traumatic stress disorder a systematic review and meta analysis
Cns Spectrums, 2020Co-Authors: Christopher Reist, Elani Streja, Cynthia Crystal Tang, Bryan B Shapiro, Jim Mintz, Michael HollifieldAbstract:Background. Prazosin has been an accepted treatment for patients with post-traumatic stress disorder (PTSD) who experience sleep disturbances, including nightmares. Results of a recent large randomized control trial did not find benefit of Prazosin vs placebo in improving such outcomes. A meta-analysis that includes this most recent trial was conducted to examine the pooled effect of Prazosin vs placebo on sleep disturbances and overall PTSD symptoms in patients with PTSD. Methods. A systematic review of the published literature on trials comparing Prazosin vs placebo for improvement of overall PTSD scores, nightmares, and sleep quality was conducted. Hedges' g standardized mean differences (SMD) between Prazosin and placebo were calculated for each outcome across studies. Results. Six randomized placebo-controlled studies representing 429 patients were included in the analysis, including two studies with a crossover design. Results showed Prazosin significantly improved overall PTSD scores (SMD = -0.31; 95% confidence intervals [CI]: -0.62, -0.01), nightmares (SMD = -0.75; 95% CI: -1.24, -0.27), and sleep quality (SMD = -0.57; 95% CI: -1.02, -0.13). In the largest trial, Prazosin showed a reduction in clinical outcome measures similar to past studies, but a relatively large placebo effect size, particularly for nightmares, contributed to no treatment differences. Conclusions. Despite the results of a recent, large randomized study, pooled effect estimates show that Prazosin has a statistically significant benefit on PTSD symptoms and sleep disturbances. Limitations that should be considered include heterogeneity of study design and study populations as well as the small number of studies conducted and included in this meta-analysis.
Jess Calohan - One of the best experts on this subject based on the ideXlab platform.
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a trial of Prazosin for combat trauma ptsd with nightmares in active duty soldiers returned from iraq and afghanistan
American Journal of Psychiatry, 2013Co-Authors: Murray A Raskind, Kris Peterson, Tammy Williams, David Hoff, Kimberly Hart, Hollie Holmes, Dallas Homas, Jeffrey Hill, Colin Daniels, Jess CalohanAbstract:ObjectiveThe authors conducted a 15-week randomized controlled trial of the alpha-1 adrenoreceptor antagonist Prazosin for combat trauma nightmares, sleep quality, global function, and overall symptoms in active-duty soldiers with posttraumatic stress disorder (PTSD) returned from combat deployments to Iraq and Afghanistan.MethodSixty-seven soldiers were randomly assigned to treatment with Prazosin or placebo for 15 weeks. Drug was titrated based on nightmare response over 6 weeks to a possible maximum dose of 5 mg midmorning and 20 mg at bedtime for men and 2 mg midmorning and 10 mg at bedtime for women. Mean achieved bedtime doses were 15.6 mg of Prazosin (SD=6.0) and 18.8 mg of placebo (SD=3.3) for men and 7.0 mg of Prazosin (SD=3.5) and 10.0 mg of placebo (SD=0.0) for women. Mean achieved midmorning doses were 4.0 mg of Prazosin (SD=1.4) and 4.8 mg of placebo (SD=0.8) for men and 1.7 mg of Prazosin (SD=0.5) and 2.0 mg of placebo (SD=0.0) mg for women. Primary outcome measures were the nightmare item o...
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Prazosin treatment of trauma nightmares and sleep disturbance in soldiers deployed in iraq
Journal of Traumatic Stress, 2010Co-Authors: Jess Calohan, Kris Peterson, Elaine R Peskind, Murray A RaskindAbstract:Trauma nightmares and sleep disturbance impair combat soldiers' functioning. The alpha-1 adrenoreceptor antagonist Prazosin has been demonstrated effective for these symptoms in Vietnam veterans. Thirteen soldiers seeking relief from distressing trauma nightmares impairing military function in northern Iraq in 2006 received Prazosin alone or in combination with other psychotropics. Mean Prazosin dose was 4.1 (SD = 2.2) mg before bed. Six soldiers improved markedly and 3 moderately on the Clinical Global Impression of Change Ratings of distressing dreams decreased from an average of 7.0 (SD = 0.7) to 2.9 (SD = 3.0, p < .001) and those of disturbed sleep from 6.7 (SD = 0.9) to 3.7 (SD = 2.4, p < .001). Prazosin appears effective and well tolerated in the desert warfare environment.
