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Study shows drug commonly prescribed to veterans could be making suicidal thoughts worse

Kathleen Jacob | Fox 17

NASHVILLE, Tenn. (WZTV) — A FOX 17 News investigation found a drug treating PTSD in our veterans could be killing them. Prazosin is a blood pressure medication commonly prescribed to treat PTSD nightmares. Only two drugs are approved by the FDA to treat PTSD, and Prazosin is not one of them.

Retired Sgt. Allen Chapman said he takes 10 pills a day to treat depression, PTSD, and all the other side effects that come with working in a war zone overseas.

“I’ve got so many medications, it takes a while to take them all in the morning,” Sgt. Chapman said.

He served in the 230th Signal Company of the National Guard. He spent time in Afghanistan from 2011-2012.

“When you get back, you’re used to all that high-speed stuff and then people here, people are just slow,” Sgt. Chapman said.

It's one of the reasons readjusting is so hard, and why Sgt. Chapman went to the VA for help.

“I was referred to a psychiatrist and we tried different medication, but it took a while to find the right balance, to find the right medication,” Sgt. Chapman said.

One of those medications is Prazosin, a blood pressure medication that a VA doctor prescribed him to help with nightmares.

“I didn’t wanna go to sleep. There are times I didn’t wanna lie down. I just didn’t want to go to sleep,” Sgt. Chapman said.

Over time, he realized his nightmares weren't getting any better. In fact, he said they got worse.

“I was killing people, and cutting up body parts, and chopping up their body, and it was always with a knife,” Sgt. Chapman said, describing his nightmares.

Finally, Sgt. Chapman took himself off the medication, too afraid of the side effects.

Dr. Vaughn McCall of Augusta University recently did a study on the drug. He found responses like Sgt. Chapman's aren't uncommon.

"We found that not only did the Prazosin not seem to do much as an advantage to the suicidal ideation, it seemed to reduce the degree of improvement that we see in the nightmares and the general sleep disturbance," Dr. McCall said.

He said patients who took a placebo saw more of an improvement.

“It makes me pause and, at a minimum, I would hesitate giving Prazosin to a suicidal patient with PTSD,” Dr. McCall said.

The VA declined an interview but sent FOX 17 News a statement saying, “Prazosin may not be as effective as we once thought and that it should no longer be routinely prescribed for PTSD nightmares, but that it could still benefit certain patients.”

The VA responded to Dr. McCall's study by saying, "While it adds to evidence that Prazosin may not be effective for PTSD nightmares, it should not raise any significant safety concerns."

However for Sgt. Chapman, the idea of increased suicidal thoughts certainly seems like a safely concern.

The VA/DoD Clinical Practice Guideline for The Management of PTSD and Acute Stress Disorder was updated in 2017 to reflect the most recent literature which shows prazosin may not be as effective for PTSD nightmares as originally found in early studies. While it should no longer be routinely prescribed for PTSD nightmares, experience and research shows it may still be beneficial in certain patients. Results from the study published by McCall and colleagues in December 2018 adds to evidence that prazosin may be not be effective for PTSD nightmares but should not raise significant safety concerns. The study included Veterans with PTSD experiencing suicidal thoughts but there was no evidence that prazosin worsened this particular symptom. Larger studies would be needed to be more certain that prazosin could be responsible for worsening nightmares or insomnia.”- Chris Vadnais, U.S. Department of Veterans Affairs

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