Management of Post-Traumatic Nightmares: a Review of Pharmacologic and Nonpharmacologic Treatments Since 2013.
Current Psychiatry Reports October 11, 2018 Scott H Waltman, David Shearer, Bret A Moore
Post-traumatic nightmares are a common and distressing problem for people with PTSD and other conditions, linked to high costs and an independent risk of suicide. An updated review finds that Prazosin, previously a preferred pharmacological treatment, has been downgraded by the American Academy of Sleep Medicine and the Veterans Health Administration/Department of Defense following a recent New England Journal of Medicine study. In Canada, Nabilone, a synthetic cannabinoid, appears promising. Non-pharmacological options like imagery rescripting therapy and exposure, relaxation, and rescripting therapy remain preferred, with recent evidence supporting their use in inpatient settings, with German combat veterans, via virtual technology, and with children and individuals with bipolar disorder. Combining cognitive behavior therapy for insomnia with these therapies may improve outcomes.