Researcher Albert Sattin has had extensive experience treating veterans with post-traumatic stress disorder (PTSD) in the U.S. Department of Veteran’s Affairs medical system. He believes that what is known as “treatment resistance” is really under-treatment, and he described his recommended regimen for thorough treatment of PTSD at the 2015 meeting of the Society of Biological Psychiatry in May.
One of the key elements in the regimens he prescribes for patients with PTSD is prazosin, an alpha-1 antagonist drug used to treat hypertension. Extensive placebo-controlled data by another researcher, Murray Raskind, and colleagues supports the use of prazosin in PTSD. It is typically used to prevent nightmares, but Raskind, Sattin, and others find it has a broad range of positive effects in most domains of PTSD.
Sattin’s key insight is that prazosin should be administered three times a day because of its short half-life. This allows for the treatment of daytime as well as sleep-related PTSD symptoms.