Centrally acting anticholinergic drug trihexyphenidyl is highly effective in reducing nightmares associated with post-traumatic stress disorder.
Katsumasa Sogo, Masanobu Sogo, Yoshie Okawa
Brain and Behavior May 14, 2021 DOI: 10.1002/brb3.2147 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Open-label and single-blind trial Randomized Double-blind Case report Peer reviewed |
|---|---|
| Sample size | 34 |
| Population | Patients with refractory PTSD-related nightmares and flashbacks who had previously received psychiatric treatment for approximately 2-15 years without therapeutic benefit |
| Intervention | Trihexyphenidyl |
| Measures | Clinician-Administered PTSD Scale (CAPS), Impact of Event Scale-Revised (IES-R) |
| Topics | PTSD Dreaming |
| Keywords | Humans Trihexyphenidyl Cholinergic antagonists Pharmaceutical preparations Treatment outcome Single-blind method Dreams Stress disorders, post-traumatic Neurotransmitters Anticholinergic agents |
| Key findings | Trihexyphenidyl was associated with improvement to none or mild symptoms in most patients with refractory PTSD-related nightmares (88%) and flashbacks (79%), as measured by CAPS and IES-R. The authors state this is the first demonstration of TP's potential efficacy for these symptoms and call for double-blind, randomized controlled trials. |
Abstract
Introduction: Following a case study on scopolamine butyl bromide, an anticholinergic drug, we studied the effect of a central anticholinergic drug on post-traumatic stress disorder (PTSD)-related flashbacks and nightmares.
Methods: We administered trihexyphenidyl (TP) to 34 patients with refractory PTSD-related nightmares and flashbacks (open-label trial [n = 22]; single-blind trial [n = 12]), who had previously received psychiatric treatment for approximately 2-15 years, without therapeutic benefits. The effect of TP was determined using the Clinician-Administered PTSD Scale (CAPS) and the Impact of Event Scale-Revised (IES-R).
Results: Overall, most patients reported an improvement to none or mild on the CAPS for nightmares (88%) and flashbacks (79%).
Conclusion: This study is the first to demonstrate the potential efficacy of TP in the treatment of refractory PTSD-related nightmares and flashbacks. Further double-blind, randomized control trials are needed to explore the potential clinical benefits of TP in PTSD.
Comparable studies
Other randomized controlled trials on PTSD, most cited first.