Prazosin for Prophylaxis of Chronic Post-Traumatic Headaches in OEF-OIF-OND Service Members and Veterans with Mild TBI
Abstract
Traumatic brain injury, particularly due to explosive blast, is very common among military Service members and Veterans who have served in Iraq and Afghanistan. By some estimates, 20% or more are affected. While traumatic brain injury, even if mild, is associated with a variety of consequences, the most common and potentially treatable is headaches. The headaches may start immediately or with a delay of days or weeks after the injury. For people who had a tendency to have headaches before the injury, their headaches can become worse afterward. Although most improve within a year, sometimes these headaches can increase in frequency and severity and progress to become very debilitating and difficult to treat with currently available medications. The objective of the proposed study is to formally evaluate the effectiveness of the medication prazosin for treating these headaches. Prazosin is a generic drug (trade name Minipress) originally marketed over 40 years ago as a treatment for high blood pressure. It has subsequently been found to be effective for treating combat-related post-traumatic stress disorder (PTSD) nightmares and disrupted sleep. In a preliminary study, prazosin has also been found to reduce headache intensity and frequency in Iraq and Afghanistan Veterans with traumatic brain injury and chronic headaches, and it also reduced headaches compared to placebo in active duty Iraq and Afghanistan Service members with PTSD, most of whom also had mild traumatic brain injury. The reported relief of headaches was substantial and is the motivation behind the proposed study. This study is designed to evaluate prazosin as a headache prophylaxis (preventive) agent. One significant benefit of prazosin is that having been on the market for many years, its safety has been demonstrated not only by initial testing, but by having been safely used by hundreds of thousands of patients. Over many years of clinical experience, prazosin has been found to have relatively few side effects. The most common side effect is a drop in blood pressure with standing; however, this can be avoided by starting with a low dose that is gradually increased. Because prazosin is a Food and Drug Administration-approved drug, the expected time needed for prazosin to become available as a treatment option is immediate upon completion of the study and publication of the results, unlike what it would be for the investigation of a new treatment agent. An additional benefit is that prazosin is not addictive or sedating like some of the other medications used to treat headaches, PTSD, and sleep problems. The likely contribution of this research is that if prazosin is found to be effective for preventing headaches related to traumatic brain injury, the care and quality of life of Service members and Veterans who are affected by this common and often difficult-to-treat condition will be greatly improved.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Aug 07, 2017
- Source ID
- W81XWH1520060
Entities
People
- Murray A. Raskind
Organizations
- Seattle Institute for Biomedical and Clinical Research
- United States Army