Clonidine Use for the Treatment of Nightmares in Posttraumatic Stress Disorder

Introduction. While clonidine is used clinically for the treatment of nightmares in posttraumatic stress disorder (PTSD), few case reports demonstrating this indication exist, and there have been few studies investigating clonidine’s mechanism of action for controlling nightmare symptoms. Case Repor...

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Main Authors: Jill S. Bange, Kelly E. Melvin
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Psychiatry
Online Access:http://dx.doi.org/10.1155/2022/5251406
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author Jill S. Bange
Kelly E. Melvin
author_facet Jill S. Bange
Kelly E. Melvin
author_sort Jill S. Bange
collection DOAJ
description Introduction. While clonidine is used clinically for the treatment of nightmares in posttraumatic stress disorder (PTSD), few case reports demonstrating this indication exist, and there have been few studies investigating clonidine’s mechanism of action for controlling nightmare symptoms. Case Report. In order to further characterize clonidine’s role in treating nightmare symptoms in PTSD, we offer this case report describing one United States veteran who presented to an inpatient psychiatric unit after a suicide attempt. At that time, she described a remote history of PTSD symptoms, including nightmares, flashbacks, hyperarousal, and avoidance behaviors which had been well controlled on sertraline and clonidine. Upon her admission, her home sertraline and alprazolam were continued but her home clonidine was not continued. On day two of her hospital stay, she stated that her nightmares had returned. Her home clonidine was restarted on day two. On day three and thereafter, the patient no longer complained of nightmares. Conclusion. Our patient’s nightmare symptoms had been controlled for years after beginning clonidine as an outpatient, but off clonidine, she had a return of her nightmare symptoms. Her nightmares again resolved once clonidine was resumed. Given this pattern in the patient’s response to clonidine, this case may serve as additional evidence in the literature that clonidine has a role in treating nightmares in PTSD. Current proposed mechanisms of action for clonidine’s ability to control nightmare symptoms in PTSD include that clonidine may alter the proportions of REM and non-REM sleep in a dose-dependent manner or that clonidine may play a role in memory consolidation. Further formal medication trials are the ideal future direction for establishing this role for clonidine.
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spelling doaj-art-278bf57f76234ab08ae7d36969cd81312025-02-03T06:11:19ZengWileyCase Reports in Psychiatry2090-68382022-01-01202210.1155/2022/5251406Clonidine Use for the Treatment of Nightmares in Posttraumatic Stress DisorderJill S. Bange0Kelly E. Melvin1Department of Psychiatry and Behavioral HealthDepartment of Psychiatry and Behavioral HealthIntroduction. While clonidine is used clinically for the treatment of nightmares in posttraumatic stress disorder (PTSD), few case reports demonstrating this indication exist, and there have been few studies investigating clonidine’s mechanism of action for controlling nightmare symptoms. Case Report. In order to further characterize clonidine’s role in treating nightmare symptoms in PTSD, we offer this case report describing one United States veteran who presented to an inpatient psychiatric unit after a suicide attempt. At that time, she described a remote history of PTSD symptoms, including nightmares, flashbacks, hyperarousal, and avoidance behaviors which had been well controlled on sertraline and clonidine. Upon her admission, her home sertraline and alprazolam were continued but her home clonidine was not continued. On day two of her hospital stay, she stated that her nightmares had returned. Her home clonidine was restarted on day two. On day three and thereafter, the patient no longer complained of nightmares. Conclusion. Our patient’s nightmare symptoms had been controlled for years after beginning clonidine as an outpatient, but off clonidine, she had a return of her nightmare symptoms. Her nightmares again resolved once clonidine was resumed. Given this pattern in the patient’s response to clonidine, this case may serve as additional evidence in the literature that clonidine has a role in treating nightmares in PTSD. Current proposed mechanisms of action for clonidine’s ability to control nightmare symptoms in PTSD include that clonidine may alter the proportions of REM and non-REM sleep in a dose-dependent manner or that clonidine may play a role in memory consolidation. Further formal medication trials are the ideal future direction for establishing this role for clonidine.http://dx.doi.org/10.1155/2022/5251406
spellingShingle Jill S. Bange
Kelly E. Melvin
Clonidine Use for the Treatment of Nightmares in Posttraumatic Stress Disorder
Case Reports in Psychiatry
title Clonidine Use for the Treatment of Nightmares in Posttraumatic Stress Disorder
title_full Clonidine Use for the Treatment of Nightmares in Posttraumatic Stress Disorder
title_fullStr Clonidine Use for the Treatment of Nightmares in Posttraumatic Stress Disorder
title_full_unstemmed Clonidine Use for the Treatment of Nightmares in Posttraumatic Stress Disorder
title_short Clonidine Use for the Treatment of Nightmares in Posttraumatic Stress Disorder
title_sort clonidine use for the treatment of nightmares in posttraumatic stress disorder
url http://dx.doi.org/10.1155/2022/5251406
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