Multiple studies have found that prazosin reduces nightmares and sleep disturbances among patients with PTSD,191-195 and there has been more recent evidence that prazosin may have broader therapeutic effects in this disorder, reducing daytime symptoms and the overall burden of PTSD symptoms.191,196

Bottom line: Fatigue is the most common neuropsychiatrie side effect associated with “-adrenergic antagonists; Inhibitors,research,lifescience,medical other neuropsychiatrie side effects are infrequent. Prazosin appears to improve sleep-related symptoms of PTSD and may reduce the overall burden of symptoms in this disorder. Vasodilators Hydralazine Hydralazine, a systemic vasodilator, the use of which is usually reserved for patients with severe hypertension, occasionally has neuropsychiatrie side effects. Fatigue

Inhibitors,research,lifescience,medical or asthenia occur slightly more often with hydralazine than with placebo, although this effect is not prominent. Hydralazine has been associated on rare occasions with the direct onset of depression,197 mild anxiety,198 psychosis,199 and delirium (due to withdrawal of hydralazine that has led to acute hypertension in a patient receiving hydralazine for afterload reduction).200 Furthermore, hydralazine does not appear to adversely affect cognition (with longer-term use) in the elderly.201 Inhibitors,research,lifescience,medical One neuropsychiatrie consequence of hydralazine use is systemic lupus erythematosus; in fact, hydralazine is perhaps the most common cause of drug-induced lupus.202 Inhibitors,research,lifescience,medical However, drug-induced lupus affects the CNS less commonly than does idiopathic lupus, and though mood symptoms and fatigue may occur with hydralazineinduced lupus, more serious neuropsychiatrie reactions have not been clearly described.203 Nitrates (nitroglycerin, Isosorbide dinitrate, and nitroprusside) Nitrates, most commonly used to treat angina, have minimal neuropsychiatrie side effects. The rapid reduction in blood pressure caused by these agents can theoretically lead to an acute confusional Inhibitors,research,lifescience,medical state, and, indeed, nitroprusside-induced delirium has occurred in at least one patient.204 A single case report has also selleckchem described hallucinations and suicidal ideation in a patient taking isosorbide old dinitrate,205 but mood symptoms or psychotic symptoms

have not otherwise been associated with nitrate medications. Bottom line: Vasodilators are generally associated with low rates of neuropsychiatrie consequences. Hydralazine is a leading cause of drug-induced lupus, but this syndrome affects the central nervous system much less commonly than the idiopathic form of the disorder. Antiplatelet and anticoagulant agents Aspirin (salicylic acid) has few neuropsychiatrie consequences. It has not been consistently associated with mood symptoms, fatigue, sedation, anxiety, psychosis, or delirium when used at therapeutic doses. However, salicylate intoxication can lead to psychosis and delirium, possibly as a result of acidosis.206-208 Therapeutically, aspirin may have beneficial effects in patients with dementia.