Seed money from Seattle VA-affiliated foundation leads to PTSD breakthrough
November 9, 2009
The men would sleep only four or five hours a night. The bad dreams
came with devastating regularity.
The Vietnam veterans being seen by psychiatrist Murray Raskind, MD,
at the Puget Sound (Wash.) VA in the late 1990s needed a treatment for
their ongoing trauma nightmares. Nothing seemed to work. Many had
turned to alcohol over the years—anything to help them fall asleep.
Raskind had a theory: If he could make their brains less responsive to
norepinephrine, a hormone related to adrenaline, that would ease the
nightmares. Scouring the literature, he learned of a particular class of
hypertension drugs that worked by blocking norepinephrine. Only one,
prazosin, could cross the blood-brain barrier. That drug became his focus.
"I simply started using prazosin clinically with veterans who had
treatment-resistant PTSD trauma nightmares and sleep disruption,"
recalls Raskind. "It worked dramatically well, where nothing else had
been helpful."
Raskind knew the idea had promise. "We thought we had something
interesting, but we had to prove it in a well-controlled study."
Pilot funding would soon come from the Seattle Institute for Biomedical
and Clinical Research, one of the 82 nonprofits that foster VA research
nationwide.
Eileen Lennon, executive director of SIBCR, recalls: "We provided seed
money, unrestricted dollars. It was only a small amount until Dr. Raskind
was able to get outside funding." Says Raskind: "It was important in
getting the ball rolling. Based on the results of the placebo-controlled
pilot study, we were able to apply through SIBCR for larger grants and
to perform larger and more definitive trials."
Today, thanks to a series of studies supported by VA, the Department of
Defense, and the National Institute of Mental Health, prazosin is part of
clinical treatment guidelines for PTSD and traumatic brain injury. The
drug, an inexpensive generic, is still being studied, says Raskind, to arrive at a "sharper
definition of the range of symptoms that respond to it." Given in small doses throughout the
day, prazosin may also help daytime PTSD symptoms, notes Raskind.
Raskind points out that a current trial of prazosin in 200 active-duty troops with PTSD at
Walter Reed Army Medical Center and Madigan Army Medical Center is "the first placebocontrolled
trial of a medication for a mental health disorder ever done in the active-duty
military population."
He told the success story of his partnership with SIBCR at this year’s annual meeting of VA
nonprofits. SIBCR executive director Lennon was among those listening. "Everyone was
thrilled," she says. "It was an inspiring reminder of why we do what we do."
This article originally appeared in the Nov-Dec 2009 issue of VA Research Currents.