From the Editor
It’s like the script of a movie: a doctor seeks a treatment for the nightmares so common in vets with PTSD. He finds an old blood pressure medication that seems to work. Then, after years of use and with some money from a not-for-profit, he does the definitive study, landing a big paper in one of the biggest psychiatric journals.
Dr. Murray Raskind had explained his interest in prazosin simply – he theorized that if he calms the brains of veterans, they would have fewer nightmares. To that end, he sought a medication that would block norepinephrine and found just one antihypertensive that did that, and crossed the blood-brain barrier. And so began a 20-year interest in an old antihypertensive.
But is there a twist in the plot? A new study just published in The New England Journal of Medicine suggests yes. “This 26-week trial involving military veterans with chronic PTSD failed to show a benefit of prazosin over placebo in reducing the frequency and intensity of trauma-related nightmares.”
And, by the way, the lead author of this study is Murray Raskind.
New pill, same old problem?
In this week’s Reading, we consider the Raskind et al. study. We also consider the accompanying Editorial that calls the results: “surprising and disappointing.”