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J Am Med Dir Assoc. 2013 Feb;14(2):130-1. doi: 10.1016/j.jamda.2012.10.007. Epub 2012 Nov 7.

Re-emergence of posttraumatic stress disorder nightmares with nursing home admission: treatment with prazosin.

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  • 1Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Abstract

Seniors with a history of emotional trauma decades earlier can experience a recurrence of posttraumatic stress disorder symptoms when transitioning to a nursing home. We present the case of an 86-year-old male Holocaust survivor admitted to a nursing home for physical therapy and rehabilitation 6 weeks after the death of his wife; the patient was expressing a persistent death wish. Despite the multiple risk factors for depression, his distress was specifically related to the reemergence of nightly posttraumatic nightmares. Over the course of 1 week of treatment with 1 mg prazosin at bedtime, his nightmares and his death wish completely resolved. He achieved his rehabilitation goals and was discharged to a community setting. This report highlights the importance of considering posttraumatic stress disorder in nursing home residents with a history of emotional trauma, and understanding how to address these symptoms pharmacologically and nonpharmacologically.

Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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