Dealing with Posttraumatic Nightmares

Posttraumatic nightmares (PTN) are a frequent symptom of posttraumatic stress disorder, with prevalence up to 96%, and are an independent risk factor for suicide. The two main current treatments are Imagery Rehearsal Therapy (IRT), a cognitive-behavioral intervention that helps patients change nightmare content, and prazosin, an alpha-adrenergic receptor antagonist. However, prazosin has not shown significant differences compared to placebo. Emerging evidence suggests nabilone, a synthetic cannabinoid, may be helpful; a Canadian clinical trial found that 72% of patients experienced complete disappearance or important reduction of PTN. More research is needed for an effective treatment.

Study at a glance

Abstract

Introduction Posttraumatic nightmares are one of the most frequent symptoms in posttraumatic stress disorder. Prevalence can be up to 96%. These nightmares evoke the experienced traumatic event, causing a negative impact. Besides, they are and independent risk for suicide. There are different pharmacological and non-pharmacological options for PTN, despite is no optimal treatment. Objectives To analyse the different treatment options for PTN. Methods This was a narrative literature review. Results The two main treatments for PTN nowadays are the Imagery Rehearsal Therapy (IRT) and prazosin. IRT is a cognitive-behavioral intervention, that helps the patient to change the content of the nightmare to a “happier ending”. Prazosin is an alpha-adrenergic receptor antagonist that blocks the stress response in the central nervous system receptors. Although it was a promising drug, significant differences compared to placebo have not been found. There is growing data that suggests nabilone, a synthetic cannabinoid, could be helpful in PTN treatment. A clinical trial made in Canada revealed that 72% of patients experienced a complete disappearance or at least an important reduction of PTN. Conclusions PTN is a very common and distressing symptom in patients presenting PTSD. Nevertheless, there is no treatment with enough evidence for this pathology. On this account, it is fundamental to do more research in order to find and suitable treatment that can improve the quality of life of these patients. Disclosure No significant relationships.