This question of prazosin for PTSD for the treatment of PTSD among veterans is so interesting and complex. I was interested to see that Raskind has an additional article published just a month prior to the one we read for the journal club (Raskind, 2018 & Raskind et al., 2018). Although I was not able to access this other article from behind its paywall, its abstract (from which I wouldn’t want to draw firm conclusions) suggests a slightly more positive stance on the use of prazosin with this population.
What was more enlightening, in the same issue of the New England Journal of Medicine in which Raskind et al. published their results we read for the journal club (Raskind et al., 2018), there was an interesting editorial on the subject (Ressler, 2018), that argues for this research by Raskind et al. (2018) as well as other similar research to be a good case for increased research and utilization of precision medicine. As work in pharmacogenomics is on the forefront of much research and yet still in its infancy, this is a worthwhile consideration. The state of the art is not that precision medicine has yet determined prazosin’s efficacy, but it will be interesting in future years to see what we might learn and pharmacogenomics advances further.
Works Cited:
Raskind, M. A. (2018). Pharmacology of Sleep and PTSD: Prazosin - An Alpha-1 Adrenoreceptor Antagonist Approach to Post-traumatic Stress Disorder Pharmacotherapy. Sleep and Combat-Related Post Traumatic Stress Disorder, 349-359. doi:10.1007/978-1-4939-7148-0_30
Raskind, M. A., Peskind, E.R., Chow. B. (2018). Trial of prazosin for post-traumatic stress disorder in military veterans. New England Journal of Medicine, 378, 507-517.
Ressler, K. J. (2018). Alpha-Adrenergic Receptors in PTSD — Failure or Time for Precision Medicine? New England Journal of Medicine, 378(6), 575-576. doi:10.1056/nejme1716724