Doxazosin XL Reduces Symptoms of Posttraumatic Stress Disorder in Veterans With PTSD

Rodgman, Christopher; Verrico, Christopher D.; Holst, Manuela; Thompson-Lake, Daisy G.Y.; Haile, Colin N.; Garza, Richard De La; Raskind, Murray A.; Newton, Thomas F.

doi:10.4088/jcp.14m09681

Cited by 34 publications

(35 citation statements)

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“…As this study suggests a dose-dependent effect, it is possible that higher doses would have produced even better outcome, and studies have shown that dosages up to 16 mg per day seem to be tolerated well. 13 This study lasted for 280 days and the effects of doxazosin did not seem to wear off by time, indicating no development of tolerance. It should be noted that no placebo was used in this study and that the patient partly experimented with different dosages by herself, hence the results may have been influenced by expectations on behalf of the patient.…”

Section: Discussionmentioning

confidence: 84%

Doxazosin for the treatment of nightmare disorder: A diary-based case study

Pallesen

Hamre

Lang

et al. 2020

SAGE Open Medical Case Reports

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The α1-adrenergic antagonist prazosin has showed good effect against posttraumatic stress disorder–related nightmares in several randomized controlled trials. The α1-adrenergic antagonist doxazosin, which has a longer half-live than prazosin, has received far less attention in the treatment of such nightmares. Here, we report a case of a patient suffering from severe nightmares following an erroneous medical administration of adrenaline (causing severe physiological hyper-activation) who was treated with doxazosin. Over a period of 280 days, the patient kept a nightmare diary and took 0, 4, or 8 mg doxazosin. The analyses showed that 8 mg doxazosin (55.2% nightmare-free nights) worked better (odds ratio = 28.2; 95% confidence interval = 3.7–213.9) compared to nights without doxazosin (4.3% nightmare-free nights). Except dizziness, which was not regarded as particularly bothersome by the patient, doxazosin was well tolerated. It is concluded that doxazosin may be indicated as a pharmacological treatment for patients suffering from posttraumatic stress disorder–related nightmares.

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Section: Discussionmentioning

confidence: 84%

Doxazosin for the treatment of nightmare disorder: A diary-based case study

Pallesen

Hamre

Lang

et al. 2020

SAGE Open Medical Case Reports

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“…Previous clinical studies, described in more detail in the Introduction section, support the ability of doxazosin to reduce PTSD symptoms [13,54,55], although they are based on small sample sizes. A proof-ofconcept study found preliminary support for the ability of doxazosin to reduce alcohol consumption among individuals with AUD and high (versus low) family history density of alcoholism [28].…”

Section: Discussionmentioning

confidence: 99%

“…The dose was selected based on previous research [32,54,55]. Study medication and matching placebo are encapsulated in standard-sized gelatin capsules and are of sufficient opacity and color so as not to reveal contents inside or disclose any possible difference between placebo and active capsules.…”

Section: Methodsmentioning

confidence: 99%

“…Depression severity, as measured by the Montogmery-Asberg Depression Scale [77] also significantly decreased from baseline to end of treatment (score at baseline = 25 vs. end of treatment = 19). More recently, a small randomized controlled study ( N = 8 male veterans) demonstrated that doxazosin (16 mg/day) was effective in significantly reducing self-report PTSD symptoms as measured by the PTSD Checklist – Military Version (PCL-5; [7,71]) and a trend for reduction on the CAPS hyperarousal scale was observed [54,55]. However, both studies are limited by small samples sizes and require replication with larger samples.…”

Section: Introductionmentioning

confidence: 99%

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Doxazosin for the treatment of co-occurring PTSD and alcohol use disorder: Design and methodology of a randomized controlled trial in military veterans

Back¹,

Flanagan²,

Jones³

et al. 2018

Contemporary Clinical Trials

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Posttraumatic stress disorder (PTSD) and alcohol use disorders (AUD) are two of the most common mental health disorders affecting civilians as well as military populations. If left untreated, individuals with co-occurring PTSD/AUD are at increased risk for developing other mental health problems (e.g., depression, anxiety), physical health problems, reduced resiliency and military readiness, and vocational and social impairment. Substantial gaps in the treatment of co-occurring PTSD/AUD exist and there is a critical need to develop more effective pharmacological treatments. The current study addresses this gap in the literature by testing the efficacy and safety of doxazosin, a long-acting and selective alpha-1 adrenergic antagonist, as compared to placebo in reducing PTSD and AUD severity among U.S. military veterans. Noradrenergic dysregulation has been implicated in the development and maintenance of PTSD and AUD, and pilot studies examining doxazosin in PTSD-only or AUD-only samples have shown promise. This is the first study, however, to evaluate doxazosin in a comorbid PTSD/AUD sample. This paper describes the rationale, design and methodology of a randomized, double-blind, placebo-controlled trial of doxazosin (16 mg/day) delivered over 12 weeks among military veterans with current PTSD and AUD. In addition, functional magnetic resonance imaging (fMRI) is applied at pre- and post-treatment to investigate the underlying pathophysiology of comorbid PTSD/AUD and identify prognostic indicators of treatment outcome. This study is designed to accelerate research on co-occurring PTSD/AUD and provide empirical evidence to inform clinical practice.

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“…After 4 days of treatment with 16 mg/day of doxazosin, there was a significant improvement in PTSD symptoms. 6 In a retrospective chart review of patients with PTSD, 7 51 received treatment with doxazosin. Forty-six of the 51 patients continued doxazosin for 12 weeks, and there was a significant decrease in nightmares within the 12-week period.…”

Section: Evidence For Use Of Doxazosin In Ptsdmentioning

confidence: 99%

Evidence for Using Doxazosin in the Treatment of Posttraumatic Stress Disorder

Smith¹,

Koola²

2016

Psychiatric Annals

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There is evidence that doxazosin is effective in the treatment of posttraumatic stress disorder (PTSD). Doxazosin is a “me-too” drug of prazosin. Doxazosin has an improved absorption profile and this likely minimizes the risk for unintended adverse hypotensive effects. The availability of doxazosin in the gastrointestinal therapeutic system (GITS) form permits a higher initial daily dose (4 mg/day) while avoiding significant first-dose side effects. The treatment of PTSD with prazosin has several disadvantages due to its short duration of action (6–8 hours), which results in multiple doses being required. Prazosin may wear off and this may lead to nightmares in the latter half of the sleep. Doxazosin has significant advantages over prazosin in clinical practice because it has a long half-life and requires only once-daily dosing. This may lead to better adherence and greater effectiveness in the treatment of PTSD.

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Doxazosin XL Reduces Symptoms of Posttraumatic Stress Disorder in Veterans With PTSD

Abstract: ClinicalTrials.gov Identifier:NCT02308202.

Cited by 34 publications

References 0 publications

Doxazosin for the treatment of nightmare disorder: A diary-based case study

Doxazosin for the treatment of nightmare disorder: A diary-based case study

Doxazosin for the treatment of co-occurring PTSD and alcohol use disorder: Design and methodology of a randomized controlled trial in military veterans

Evidence for Using Doxazosin in the Treatment of Posttraumatic Stress Disorder

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