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Q. I am having insomnia and intense nightmares due to PTSD. Kindly help me.

Hi doctor,

I am suffering from extreme insomnia due to PTSD, which includes very intense nightmares. I also have depression. I need help and sleep. I am attaching my records. Kindly help me.

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Hello,

Welcome to icliniq.com.

The image that you have attached is significantly cropped out (attachments removed to protect the patient's identity), and I am unable to see any medicines that you are currently on. The drug most helpful for insomnia in PTSD (posttraumatic stress disorder) is Prazosin (Prazosin hydrochloride). Its dose needs to be up titrated gradually by your family physician while monitoring your blood pressure measurements. If you suffer from hypertension also, then it becomes the first choice as it is an antihypertensive as well.

Another drug that is proven to be most helpful is Trazodone (Trazodone hydrochloride). It can be started at 50 mg and titrated as per need. It is preferred if you cannot tolerate Prazosin due to some reason.

If these medications do not help much or you have tried them before, you can try Mirtazapine. It is an antidepressant along with significant sleep-promoting action.

I wish I could help you more, but since I don't have any information about your current or past medicines, it is difficult for me to make further comments.

Apart from medicines, relaxation techniques like mindfulness training and EMDR (eye movement desensitization and reprocessing) are also quite helpful if you can give them some time.

I hope this was helpful.


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