Conclusion
- Transcendental meditation is significantly not inferior to PE in the treatment of veterans with PTSD.
- The findings from this first comparative effectiveness trial comparing TM with an established psychotherapy for PTSD suggests the feasibility and efficacy of TM as an alternative therapy for veterans with PTSD.
- Because TM is self-administered after an initial expert training, it may offer an easy-to-implement approach that may be more accessible to veterans than other treatments.
5. Raskind MA, Peskind ER, Chow B, et al. Trial of prazosin for post-traumatic stress disorder in military veterans. N Engl J Med. 2018;378(6):507-517.
Several smaller randomized trials of prazosin involving a total of 283 active-duty service members, veterans, and civilian participants have shown efficacy of prazosin for PTSD-related nightmares, sleep disturbance, and overall clinical functioning. However, in a recent trial, Raskind et al5 failed to demonstrate such efficacy.
Study design
- Veterans with chronic PTSD nightmares were recruited from 13 VA medical centers to participate in a 26-week, double-blind, randomized controlled trial.
- A total of 304 participants were randomized to a prazosin treatment group (n = 152) or a placebo control group (n = 152).
- During the first 10 weeks, prazosin or placebo were administered in an escalating fashion up to a maximum dose.
- The CAPS, Pittsburgh Sleep Quality Index (PSQI), and Clinical Global Impressions of Change (CGIC) scores were measured at baseline, after 10 weeks, and after 26 weeks.
Outcomes
- Three primary outcomes measures were assessed: change in score from baseline to 10 weeks on CAPS item B2, the PSQI, and the CGIC.
- A secondary measure was change in score from baseline of the same measures at 26 weeks.
- There was no significant difference between the prazosin group and the placebo group in any of the primary or secondary measures.
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