A Pilot Trial of Prazosin, an Alpha-1 Adrenergic Antagonist, for Comorbid Alcohol Dependence and Posttraumatic Stress Disorder
A Pilot Trial of Prazosin, an Alpha-1 Adrenergic Antagonist, for Comorbid Alcohol Dependence and Posttraumatic Stress Disorder
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DOI：
10.1111/acer.12703
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发表时间：
2015-05-01
影响因子：
3.2
通讯作者：
Saxon, Andrew J.
中科院分区：
文献类型：
--
作者：
Simpson, Tracy L.;Malte, Carol A.;Saxon, Andrew J.
背景创伤后应激障碍（PTSD）和酒精依赖（AD）通常共同发生，并且与单独的任何一种疾病相比，与更严重的症状和更大的费用相关。没有发现药物干预可以降低酒精使用和PTSD症状的严重程度。哌唑嗪，α-1肾上腺素能受体拮抗剂，已被证明是有效的，减少PTSD和AD症状的个人与一个或其他疾病，并可能是有用的，在解决共病PTSD/AD。MethodsPrazosin和匹配的安慰剂进行了比较的背景下，门诊6周的双盲随机对照试验，涉及30个人共病PTSD/AD。在第2周结束时，将药物滴定至4 mg qam、4 mg qpm和8 mg qhs。两种情况下的参与者都接受了5次医疗管理会议。关于酒精使用，渴望，和PTSD的信息收集每天使用电话互动语音应答system.ResultsParticipants随机哌唑嗪有更大的减少百分比天每周饮酒和百分比天每周大量饮酒之间的基线和第6周比安慰剂参与者。从第1周至第6周，两组内或两组间的PTSD症状变化无显著差异。参与者在哌唑嗪条件下报告嗜睡的日子比那些在安慰剂condition. ConclusionsConsistently与现存的研究评估药物共病PTSD/AD，哌唑嗪目前的评价也发现减少酒精的消耗，但没有药物治疗效果PTSD patiatology。
BackgroundPosttraumatic stress disorder (PTSD) and alcohol dependence (AD) commonly co-occur and are associated with greater symptom severity and costs than either disorder alone. No pharmacologic interventions have been found to decrease both alcohol use and PTSD symptom severity relative to matched placebo. Prazosin, an alpha-1 adrenoreceptor antagonist, has demonstrated the efficacy of reducing PTSD and AD symptoms among individuals with one or the other disorder and may be useful in addressing comorbid PTSD/AD.MethodsPrazosin and matched placebo were compared in the context of an outpatient 6-week double-blind randomized controlled pilot trial involving 30 individuals with comorbid PTSD/AD. Medication was titrated to 4mgqam, 4mgqpm and 8mg qhs by the end of week 2. Participants in both conditions received 5 medical management sessions. Information regarding alcohol use, craving, and PTSD was gathered daily using a telephone interactive voice response system.ResultsParticipants randomized to prazosin had a greater reduction in percent days drinking per week and percent days heavy drinking per week between baseline and week 6 than did placebo participants. No significant differences were detected within or between groups in change from weeks 1 to 6 in total PTSD symptoms. Participants in the prazosin condition reported drowsiness on significantly more days than those in the placebo condition.ConclusionsConsistent with the extant research evaluating medications for comorbid PTSD/AD, the current evaluation of prazosin also found decreased alcohol consumption but no medication effect on PTSD symptomatology.