A non-randomized pilot trial of the use of prazosin in the prevention of transition from acute stress disorder to post-traumatic stress disorder.
Eur J Psychotraumatol
; 14(2): 2251250, 2023.
Article
de En
| MEDLINE
| ID: mdl-38154074
ABSTRACT
BACKGROUND:
Following a traumatic event, 40-80% of the patients with acute stress disorder (ASD) will develop post-traumatic stress disorder (PTSD), 67% at 6 months. Alpha1-blockers are effective in treating some symptoms of PTSD but their usefulness in acute stress situations remains unclear. We hypothesized that reducing noradrenergic hyperactivity with an alpha1-blocker during the acute phase after a traumatic event could prevent the transition to PTSD in patients with ASD.OBJECTIVE:
To investigate the efficacy and safety of a 1-month course of alpha1-blocker (prazosin) to prevent the transition to PTSD in patients with ASD at 6 months.METHOD:
In a monocentric open-label prospective pilot study, 15 patients with ASD were included within 3-7â days of exposure to a traumatic event. After enrolment, they received prazosin LP at home at bedtime at 2.5â mg/day for 7â days and then 5â mg/day for 21 days. Incidence of PTSD was assessed at 6 months using the Clinician Administrated PTSD Scale (CAPS).RESULTS:
At 6 months, 22% of patients who completed the study (2/9) met the diagnostic criteria for PTSD. This rate was significantly lower than that observed in previous studies (67%; p = .047). The treatment was well tolerated and there were no serious adverse events.CONCLUSIONS:
These preliminary findings indicating the safety of prazosin and suggesting its potential to prevent the development of PTSD in ASD require to be replicated in large-scale randomized placebo-controlled studies.Trial registration The study was pre-registered on a public database (www.clinicalTrials.gov identifier NCT03045016).
Alpha1-blockers are safe and well tolerated in patients with acute stress disorder.The use of alpha1-blockers 37 days after traumatic exposure is worthy of study.Alpha1-blockers could prevent the transition to PTSD in ASD patients at 6 months.
Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Troubles de stress post-traumatique
/
Troubles de stress traumatique aigus
Limites:
Humans
Langue:
En
Journal:
Eur J Psychotraumatol
/
European journal of psychotraumatology
Année:
2023
Type de document:
Article
Pays d'affiliation:
France
Pays de publication:
États-Unis d'Amérique