Off-label use of doxazosin for the relief of nightmares in the context of Post-Traumatic Stress Disorder: a systematic review
DOI:
https://doi.org/10.11606/issn.1679-9836.v103i5e-226240Keywords:
Psychopharmacology, Doxasozin , Post-traumatic Stress Disorder, NightmaresAbstract
Introduction: The ICD-10 defines Post-Traumatic Stress Disorder (PTSD) as a prolonged and disproportionate response to traumatic events, characterized by re-experiencing the traumatic event, persistent avoidance and hyperarousal. In this context, studies on nightmares from traumatic events have gained notoriety and doxazosin, a selective alpha-1 adrenergic receptor antagonist, appears as a potential drug for treatment in this context. The objective of this systematic review is to elucidate the mechanisms of action, efficacy, potential side effects, predictors of treatment response, safety considerations associated with the use of doxazosin in the context of PTSD, identifying gaps in the literature. Material and Methods: This systematic review followed criteria from the Preferred Item Guidelines for Systematic Reviews and Meta-Analyses (PRISMA) and used the PICO strategy in formulating the guiding question. The Google Scholar, LILACS, PubMed and Science Direct databases were used for this review. The analysis was conducted with the descriptors according to the DECS/MESH platform (health descriptors): “Doxazosin”, “Post-Traumatic Stress Disorder” and “Nightmares”. Results: Of the articles reviewed, all presented positive results for the use of doxazosin in the treatment of PTSD-related nightmares, although many were not compared to placebo. Case reports demonstrate an improvement in nightmares, even in severe cases with comorbidities. Some studies have seen significant reductions in nightmares after treatment. Despite this, the use of doxazosin for this purpose is not yet recommended by the American Academy of Sleep Medicine, even though it is an alternative to Prazosin. The most commonly reported side effects were drowsiness and headache, but they were well tolerated. Conclusion: Although there are controversies, it is concluded that the use of doxazosin can be an alternative in the treatment of nightmares, in the context of PTSD. Finally, the need for more research on this topic is highlighted.
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Copyright (c) 2024 Gabriel de Oliveira Ribas, Sara Regina Corrêa Cunha, Amanda Vilela Nasser Calixto, Pedro Paulo Fagundes Miranda, Ana Luísa Boze, Fábio Yutani Koseki, Carolina Pola Candido
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