A medication that has shown promising results for PTSD nightmares is prazosin. The results of one meta-analysis demonstrated that prazosin is a safe, effective treatment for PTSD nightmares.
Typically, patients with PTSD develop recurrent nightmares and hyperarousal that in turn lead to insomnia. Therapies such as phenelzine, nefazodone, trazodone, mirtazapine, and prazosin have been utilized in the treatment of PTSD-related sleep disturbances.
The following may be used for the treatment of nightmare disorder: nitrazepam, prazosin, and triazolam.
When someone experiences nightmares from PTSD, they can seem very real to them. They might feel like they are back in a situation that is not safe, the traumatic experience that caused the disruption in the first place. Symptoms can keep them awake or unable to fall asleep for long periods of time.
Although further studies are necessary, the research undertaken until now shows that melatonin modulates fear conditioning and fear extinction and consequently melatonin may serve as an agent for the treatment of PTSD.
One possible medication for PTSD nightmares is the drug prazosin. Doctors normally prescribe it for high blood pressure, but they may prescribe it off-label to reduce PTSD nightmares. However, some side effects of prazosin include dizziness, headaches, drowsiness, weakness, heart palpitations, and nausea.
Psychotherapy. Cognitive Behavior Therapy (CBT): CBT is a type of psychotherapy that has consistently been found to be the most effective treatment of PTSD both in the short term and the long term.
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The SSRIs sertraline and paroxetine are the only medications approved by the FDA for PTSD.
If someone has PTSD, it may cause changes in their thinking and mood. They may suffer from recurrent, intrusive memories. Upsetting dreams, flashbacks, negative thoughts, and hopelessness are also common. Experiencing PTSD triggers may cause the symptoms to become worse or reoccur frequently.
Chronic feelings of guilt, shame and self-blame. Feelings of emptiness. Difficulty forming and maintaining close relationships. Feeling as through no one understands you or what you've been through.
Imagery rehearsal therapy has four basic steps that can be taught in one day, experts say. First, people are asked to write down every detail of their nightmare. Next, each person rewrites the nightmare with a positive arch, making sure that it ends with a pleasant or empowering solution or resolution.
After experiencing a traumatic event, nightmares are even more common. Nightmares may be an intense expression of the body working through traumatic experiences, so intense that the nightmare causes the sleeper to wake up. Nightmares may also represent a breakdown in the body's ability to process trauma.
After a trauma, people may talk more in their sleep. Talking during sleep can affect bed partners. Feeling "on alert." People with PTSD may feel the need to be on guard, to protect themselves from danger. It is difficult to have restful sleep when you feel the need to be always alert or are startled easily by noise.
For veterans, an example of a PTSD nightmare usually involves the replaying of traumatic events they witnessed or took part in. Similar to civilians who suffer from PTSD, their nightmares could be a replay of the traumatic event, such as physical abuse or violence.
Changes in the brain
One part of the brain responsible for memory and emotions is known as the hippocampus. In people with PTSD, the hippocampus appears smaller in size. It's thought that changes in this part of the brain may be related to fear and anxiety, memory problems and flashbacks.
Nightmares are primarily a REM sleep phenomenon, but they may also occur during NREM sleep in patients with PTSD (12). These dysphoric dreams often depict themes, images, and emotions that can be related to traumatic events. Nightmares may trigger short or prolonged awakenings from sleep.