TY - JOUR
T1 - Doxazosin XL reduces symptoms of posttraumatic stress disorder in veterans with PTSD
T2 - A pilot clinical trial
AU - Rodgman, Christopher
AU - Verrico, Christopher D.
AU - Holst, Manuela
AU - Thompson-Lake, Daisy
AU - Haile, Colin N.
AU - De Garza, Richard La
AU - Raskind, Murray A.
AU - Newton, Thomas F.
N1 - Funding Information:
This study was conducted at and funded by a grant from the Michael E. DeBakey VA Medical Center. NIH grant R25DA028976 also provided financial support.
Publisher Copyright:
© Copyright 2016 Physicians Postgraduate Press, Inc.
PY - 2016/5
Y1 - 2016/5
N2 - Background: Serotonin and norepinephrine reuptake inhibitors are effective first-line agents for the treatment of posttraumatic stress disorder (PTSD), but treatment is associated with a range of side effects that limit treatment adherence. Prazosin, an α1-noradrenergic antagonist with a half-life of roughly 2-3 hours, has shown promise in the treatment of sleep disturbance and nightmares. Doxazosin extended release (XL) is also an α1-noradrenergic antagonist but with a half-life of approximately 15-19 hours. Methods: We conducted a double-blind, placebocontrolled, within-subjects trial to characterize the impact of doxazosin XL on PTSD symptoms. Participants (N = 8) were diagnosed using DSM-IV criteria. They completed the study twice, once during treatment with doxazosin XL and once during treatment with matched placebo, with a 2-week washout separating the 2 episodes. Doxazosin XL was titrated from 4 mg/d to 16 mg/d over 12 days. After 4 days of treatment at 16 mg/d or the equivalent number of placebo capsules, PTSD symptoms were assessed using the Clinician-Administered PTSD Scale (CAPS17) and the PTSD Checklist-Military version (PCL-M). Repeated measures analysis of variance were used to evaluate effects of treatment, time, and treatment . time. This study was run from November 20, 2013, to June 31, 2014. Results: Doxazosin XL treatment was associated with a nonsignificant treatment . time reduction in ratings on the CAPS hyperarousal subscale (P < .10) (but not on the CAPS Total score) and with significant treatment . time reductions in PCL-M ratings (P = .002). Conclusions: Doxazosin XL may be an effective alternative to prazosin for the treatment of some PTSD symptoms.
AB - Background: Serotonin and norepinephrine reuptake inhibitors are effective first-line agents for the treatment of posttraumatic stress disorder (PTSD), but treatment is associated with a range of side effects that limit treatment adherence. Prazosin, an α1-noradrenergic antagonist with a half-life of roughly 2-3 hours, has shown promise in the treatment of sleep disturbance and nightmares. Doxazosin extended release (XL) is also an α1-noradrenergic antagonist but with a half-life of approximately 15-19 hours. Methods: We conducted a double-blind, placebocontrolled, within-subjects trial to characterize the impact of doxazosin XL on PTSD symptoms. Participants (N = 8) were diagnosed using DSM-IV criteria. They completed the study twice, once during treatment with doxazosin XL and once during treatment with matched placebo, with a 2-week washout separating the 2 episodes. Doxazosin XL was titrated from 4 mg/d to 16 mg/d over 12 days. After 4 days of treatment at 16 mg/d or the equivalent number of placebo capsules, PTSD symptoms were assessed using the Clinician-Administered PTSD Scale (CAPS17) and the PTSD Checklist-Military version (PCL-M). Repeated measures analysis of variance were used to evaluate effects of treatment, time, and treatment . time. This study was run from November 20, 2013, to June 31, 2014. Results: Doxazosin XL treatment was associated with a nonsignificant treatment . time reduction in ratings on the CAPS hyperarousal subscale (P < .10) (but not on the CAPS Total score) and with significant treatment . time reductions in PCL-M ratings (P = .002). Conclusions: Doxazosin XL may be an effective alternative to prazosin for the treatment of some PTSD symptoms.
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U2 - 10.4088/JCP.14m09681
DO - 10.4088/JCP.14m09681
M3 - Article
C2 - 27249080
AN - SCOPUS:84973513813
SN - 0160-6689
VL - 77
SP - e561-e565
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
IS - 5
ER -