Story of Prazosin Use in PTSD
1/n🧵
Think back to your childhood and recall some of your strongest memories. Most are emotional in nature. Notice, however, that while the memories remain vivid, they no longer carry the same emotional intensity.
2/n
The theory is that REM-sleep dreaming does the work of palliative dissolving of emotion from experience. We can therefore learn and usefully recall salient life events without being crippled by the emotional baggage that those painful experiences originally carried.
3/n
In a randomized fMRI study, healthy young adults viewed emotional images and rated their feelings. Twelve hours later, they viewed the same images again. Participants who slept between sessions reported significantly lower emotional intensity.
4/n
Sleep to heal!
It was not, therefore, time per se that healed all wounds, but instead it was time spent in dream sleep that provided emotional convalescence.
5/n
Cartwright found out that her patients required a very specific type of dreaming for resolving emotional pasts
6/n
Then PTSD comes into the picture- we already knew that REM sleep is disrupted in it. There was also evidence suggesting that PTSD patients had higher-than-normal levels of noradrenaline released by their nervous system. So,👇 building on this...
7/n
The theory was that a contributing mechanism underlying PTSD is the excessively high levels of noradrenaline within the brain that block the ability of these patients to enter and maintain normal REM-sleep dreaming. Their brain cannot strip away the emotion at night.
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Now comes Dr. Murray Raskind into the picture...
In his PTSD clinic, Raskind had been treating his war veteran patients with a generic drug called prazosin to manage their high blood pressure.
9/n
It had a far more powerful yet entirely unexpected benefit within the brain: it alleviated the recurring nightmares in his PTSD patients. After only a few
weeks of treatment, his patients would return to the clinic and, with puzzled amazement...
10/n
Prazosin was gradually lowering the harmful high tide of noradrenaline within the brain, giving these patients healthier REM sleep quality.
With REM sleep came a reduction in the patients’ clinical symptoms and, most critically, a decrease in the frequency of nightmares!
11/n
Reference - Why we Sleep
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