Blood pressure drug relieves nightmares of war

The war followed Gillian Boice home from Iraq and into her dreams.

The thrashing would begin minutes after the Army officer fell asleep. She sometimes screamed out battle orders. She often woke the next morning already exhausted.

Relief came in the form of a decades-old blood pressure drug. Puget Sound-area military health specialists have turned it into a leading treatment for nightmares, after experimenting with it as a long shot.

“Prazosin has changed so, so much in my life,” said Boice, a retired military police lieutenant colonel living in Olympia. “I couldn’t sleep before, and it’s given me my nights back.”

Thousands of veterans who fought in conflicts ranging from Vietnam to Iraq and Afghanistan are taking prazosin for trauma-related nightmares. Its nighttime use started at the Seattle VA hospital and has spread across the country.

Today, the prazosin initiative is one of Madigan Army Medical Center’s most visible campaigns on Fort Lewis. Signs in company headquarters buildings and banners attached to fences outside – many with the slogan “Got Nightmares?” – can be found all over post.

Hospital officials have delivered briefings to most units at Fort Lewis. They say acknowledging having problems with nightmares can be less stigmatizing for soldiers than talking about post-traumatic stress disorder.

Dr. Murray Raskind, the director of the VA’s Northwest Mental Illness Research, Education and Clinical Center, first experimented with using the drug to treat nightmare-stricken Vietnam veterans.

Other treatments required sedatives, which could become addictive and often sidelined service members from future deployments. But this drug doesn’t appear to have any major side effects, officials said.

Service members now deployed in combat zones are taking prazosin, also sold by the trade names Minipress, Vasoflex and Hypovase.

It’s a cheap fix for a problem that has spiked in veterans since the start of the wars in Iraq and Afghanistan. Because it was introduced in 1973 and can be produced generically, it costs pennies per dose.

Three trials of the drug’s effect on nightmares have been positive, and the Puget Sound VA and Madigan Army Medical Center are in the midst of larger studies that aim to establish the use of prazosin as standard practice to fight nightmares.