PTSD Forum - Nightmares and PTSD

Okay, please bear with me as I write this VERY long response, but I am truly hoping that you will find it VERY helpful! Please, anyone who suffers from PTSD nightmares, don't "NOT" read it because it's long... there's a miracle drug in there....

Several years ago I began experiencing horrific nightmares following domestic abuse. I was pretty much getting about 3 hours of sleep a night (non-consecutive) and I would often wake up screaming and thrashing in bed. I could always recall these dreams VERY vividly. I would tell myself that it was just a dream and not real and be able to fall asleep again but within minutes I would be jerking awake after experiencing a "mutated" version of the same dream. I had to continually tell myself that these dreams were NOT real in order to fall back asleep, but they would always change somewhat and immediately reoccur. In one night, alone, I recorded over THIRTY nightmares spaced 3-5 minutes apart each!!!!

Needless to say, I received VERY little rest and remained VERY fatigued throughout the day - everyday. My doctor eventually put me on Ambien because my anxiety over the prospect that I MIGHT have a nightmare caused severe anxiolytic insomnia. Despite trying MANY different medications targeting both the insomnia (pretty much any and EVERY medication that caused drowsiness) AND the anxiety (I've tried probably 15 different types of anti-anxiety/anti-depressant medications), Ambien was the ONLY medication that allowed me to receive ANY rest - and that was because it just flat out knocked me out cold... when it worked.

Finally one day, I just couldn't take it anymore and I was extremely unhappy with the progress I was NOT making with my psychiatrists approach. He was trying every trick he knew and nothing was working! I decided to take matters into my own hands and do some googling where I ran across some publications and research indicating that an old blood-pressure medication had been found to offer significant relief to war veterans suffering PTSD related nightmares.

I brought printouts of the information to my psychiatrist and he researched the medication further and then prescribed it for me at the lowest available dosage. The medication is called Prazosin (Minipress). Not only did it stop my nightmares from the very first day, but after taking it for some time, I found that discontinuing the medication did not cause the nightmares to immediately return. Instead, when I didn't take it for a long period of time, I noticed a gradual shift in the undertones of my dreaming, over many weeks, so that, they slowly began to become more and more disturbing. At that time, I restarted my Prazosin regimen and, again, the nightmares immediately disappeared. Over the course of approximately 1.5 years I discontinued the medication 3 times to determine if my nightmares would continue. On my third attempt (after I had remarried) the nightmares did not return. Ultimately, I realized that the Prazosin was a very effective interim solution for me because, after remarrying and having a male present in my home at night, I no longer felt threatened by my abusive ex. I do not see any reason why a person could not take Prazosin long-term to relieve these nightmares and finally get some rest. However, based on my own experience, I believe that if they find the right "key" a person may be able to eliminate the nightmares on their own.

I believe that NOT experiencing the nightmares for such a very long time (when on the Prazosin) psychologically helped me to understand that I did not have to be a SLAVE to my subconscious. Experiencing peaceful, restful sleep while taking this medication tremendously increased my "sleep self confidence" so that I felt like I had MUCH more control over my dreams. I have NO DOUBT that this "sleep self confidence" has played a large role in my keeping my nightmares at bay, without medication, for almost 4 years now.

Check with your physician and see if s/he would be willing to prescribe the medication. Bringing in the supporting information I had found with documented MEDICAL sources is, I believe, what made my psychiatrist much more comfortable in prescribing it. He was able to easily validate the information I had found and readily found additional supporting research in several medical journals which he had access to online.

I would also VERY HIGHLY recommend a very low dose of Xanax to relieve any feelings of panic or extreme anxiety which might pop up for him at other times - particularly those where he is in the type of situation that triggers his traumatic memories and feelings. My doctor prescribes me .5 mg tablets with instruction to take 1/2 to 1 table 3 times daily. However, I find that this is completely unnecessary. I take 1 tablet when I find myself in a stressful situation that is generating feelings of anxiety or to which I am adversely reacting due to anxiety AND prior to any situation which I know, historically, will trigger these types of feelings. Taken ahead of time, Xanax works quite effectively to PREVENT these "panic" feelings. My prescription gives me 90 tablets for a 1 month supply, however, my 1 month supply lasts 6-8 months and my prescription always expires before I have a chance to use all of the refills. Using it in this way, I have had absolutely NO issues with dependency or tolerance and suffer NO ill effects from discontinuing the medication once the anxiety-causing situation has passed.

I VERY RARELY see him these days, but when I do, he never fails to thank me for telling him about this medication and it makes me feel on top of the world to hear my doctor say how many of his OTHER patients now sleep soundly because I took that initiative. It does not work for EVERY patient, but it does work for a great majority.