Management of Post-Traumatic Nightmares: a Review of Pharmacologic and Nonpharmacologic Treatments Since 2013

  title={Management of Post-Traumatic Nightmares: a Review of Pharmacologic and Nonpharmacologic Treatments Since 2013},
  author={Scott H Waltman and David S. Shearer and Bret A. Moore},
  journal={Current Psychiatry Reports},
Purpose of ReviewPost-traumatic nightmares (PTN) are a common and enduring problem for individuals with post-traumatic stress disorder (PTSD) and other clinical presentations. PTN cause significant distress, are associated with large costs, and are an independent risk factor for suicide. Pharmacological and non-pharmacological treatment options for PTN exist. A previous review in this journal demonstrated that Prazosin, an alpha blocker, was a preferred pharmacological treatment for PTN and… 

Pharmacological Management of Nightmares Associated with Posttraumatic Stress Disorder

A narrative review aimed to critically appraise proven as well as novel pharmacological agents used in the treatment of Post-traumatic nightmares, showing promising results.

Exposure, Relaxation, and Rescripting Therapy for Trauma-Related Nightmares With Psychiatric Inpatients: A Case Series

Some preliminary support is offered for the provision of ERRT for the treatment of trauma-related nightmares for psychiatric inpatients in a private acute care inpatient psychiatric hospital setting.

Demographic Variation in the Use of Prazosin for Treatment of Sleep Disturbance in Combat Veterans with PTSD.

Prazosin is prescribed for PTSD-SD to a diverse clinical population with multiple comorbidities and concurrent medications and is characterized by poor adherence and sub-optimal dosing.

The Many Faces of Sleep Disorders in Post-Traumatic Stress Disorder: An Update on Clinical Features and Treatment

Whether early sleep interventions exert a preventive effect on the development of PTSD remains to be clarified in future studies, and there is little empirical evidence on the effectiveness of long-term drug treatment for insomnia and nightmares.

Work-related post-traumatic stress disorder: report of five cases

It is concluded that PTSD can develop even in professional categories generally considered to be at low risk, in such cases, a correct interdisciplinary diagnostic approach is fundamental for addressing therapy and for medico-legal actions.

Imagery rehearsal therapy and/or mianserin in treatment of refugees diagnosed with PTSD: Results from a randomized controlled trial

Add‐on treatment with imagery rehearsal therapy (IRT) and/or mianserin against treatment as usual (TAU) alone in a sample of trauma‐affected refugees with PTSD at 8–12 months follow-up did not find IRT or mianerin to be superior to TAU.

Clinical Therapeutic Strategy and Neuronal Mechanism Underlying Post-Traumatic Stress Disorder (PTSD)

The neuronal circuits and novel therapeutic strategies for PTSD symptoms are addressed and it is reported that ω3 long-chain polyunsaturated fatty acid (LCPUFA) supplements can suppress the development of PTSD symptoms.

Evaluation of Low Dose Divalproex Sodium in Night Terror in Adults – A Pilot Study in Indian Patients

It is concluded that a short six-month course of low dose of Divalproex sodium is effective in giving long term relief in adult patients with night terror.



Management of Post-Traumatic Nightmares: A Review of Pharmacologic and Nonpharmacologic Treatments Since 2010

Pharmacologically, the medication prazosin is showing robust clinical effects with minimal side effects and Psychologically, imagery rehearsal therapy commands the greater portion of the nightmare literature due to its established efficacy.

Doomed to Repeat History: The Burden of Trauma-Related Nightmares in Military Personnel.

A retrospective review of 493 active duty military members, sleep intake questionnaires, electronic medical records, and polysomnography were used to delineate features of sleep disturbances among those with and without nightmares, as well as trauma-related nightmares (TRN).

Best practice guide for the treatment of nightmare disorder in adults.

  • R. AuroraR. Zak T. Morgenthaler
  • Psychology, Medicine
    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
  • 2010
Prazosin is recommended for treatment of Posttraumatic Stress Disorder (PTSD)-associated nightmares. Level A. Image Rehearsal Therapy (IRT) is recommended for treatment of nightmare disorder. Level

Treatment of posttraumatic stress disorder with nefazodone

Nefazodone was associated with clinical improvement in this population of patients with PTSD, and now needs to be studied in double-blind, placebo controlled, protocols.

Pilot Study: Brief Posttrauma Nightmare Treatment for Persons With Bipolar Disorder

Previous research on an efficacious cognitive-behavioral treatment for posttrauma nightmares and sleep disturbances (exposure, relaxation, and rescripting therapy; ERRT) has not tested the treatment

Use of Prazosin for Pediatric PTSD-Associated Nightmares and Sleep Disturbances: A Retrospective Chart Review

Prazosin treatment was well-tolerated and associated with improvements in nightmares and sleep in youth with PTSD and Adverse events were consistent with the known side-effect profile of prazoin and included dizziness and nausea.

The Use of a Synthetic Cannabinoid in the Management of Treatment‐Resistant Nightmares in Posttraumatic Stress Disorder (PTSD)

  • G. Fraser
  • Psychology, Medicine
    CNS neuroscience & therapeutics
  • 2009
The results of this study indicate the potential benefits of nabilone, a synthetic cannabinoid, in patients with PTSD experiencing poor control of nightmares with standard pharmacotherapy.

Position Paper for the Treatment of Nightmare Disorder in Adults: An American Academy of Sleep Medicine Position Paper.

The American Academy of Sleep Medicine (AASM) position regarding various treatments of nightmare disorder in adults is provided and the following therapies are recommended for the treatment of PTSD-associated nightmares and nightmare disorder.

Open-label topiramate as primary or adjunctive therapy in chronic civilian posttraumatic stress disorder: a preliminary report.

Topiramate appeared effective as add-on or monotherapy for chronic PTSD and demonstrated a rapid onset of action and minimally serious, dose-related side effects without the development of tolerance.