Prazosin, a drug used to treat high blood pressure, may also prevent post-traumatic headaches. The corresponding study was published in The Journal of Head and Face Pain.
Prazosin was approved by the FDA in 1976 to treat hypertension. It is also used off-label for various conditions, including trauma nightmares and sleep disruption in PTSD. Studies have found that the drug may also reduce post-traumatic headaches in veterans with combat-related mild traumatic brain injury, also known as concussion.
In the present study, researchers sought to see whether prazosin could prevent the occurrence of post-traumatic headaches. To do so, they recruited 48 active service members and veterans with headaches caused by concussion. The participants were split into two groups, either receiving a placebo or prazosin. Those taking prazosin took gradually increasing doses for five weeks before receiving a maximum dose at 12 weeks.
Ultimately, the researchers found that prazosin was well-tolerated and that participants taking the drug experienced fewer headaches. Whereas participants taking prazosin had an average of 18 headache days per month at the start of the trial, they had around six headache days per month by the end. To compare, those on the placebo reported around 12 headaches per month by the end of the trial. Participants in the prazosin group further reported at the end of the trial that headaches only had 'some impact' on their ability to function daily, while those on the placebo continued to report that their headaches had a 'severe impact'.
The researchers noted that a larger randomized controlled clinical trial is needed to confirm their results. They added that a dose-finding study would also be useful to understand whether lower doses of prazosin would deliver similar results.
"This study is the only clinical trial of an oral medication to demonstrate efficacy for post-traumatic headache. Because prazosin is widely used across VA and the Department of Defense to treat PTSD trauma nightmares and sleep disruption, many VA and DOD prescribers are familiar with prescribing this generically available, inexpensive medication," said senior author Dr. Murray Raskind, Professor at the Department of Psychiatry and Behavioral Sciences at the University of Washington, in a press release.
"Prazosin now offers an evidence-based approach to alleviate the suffering of Veterans and service members who have struggled for years with frequent post-traumatic headaches,” he added.