Study shows drug commonly prescribed to veterans could be making suicidal thoughts worse


    Photo: FOX 17 News

    NASHVILLE, Tenn. (WZTV) — A drug treating PTSD in our veterans could be killing them. Prazosin is a blood pressure medication commonly prescribed to treat PTSD nightmares, according to a WZTV news investigation. Only two drugs are approved by the FDA to treat PTSD, and Prazosin is not one of them.

    Retired Sgt. Allen Chapman said he takes 10 pills a day to treat depression, PTSD, and all the other side effects that come with working in a war zone overseas.

    “I’ve got so many medications, it takes a while to take them all in the morning,” Sgt. Chapman said.

    He served in the 230th Signal Company of the National Guard. He spent time in Afghanistan from 2011-2012.

    “When you get back, you’re used to all that high-speed stuff and then people here, people are just slow,” Sgt. Chapman said.

    It's one of the reasons readjusting is so hard, and why Sgt. Chapman went to the VA for help.

    “I was referred to a psychiatrist and we tried different medication, but it took a while to find the right balance, to find the right medication,” Sgt. Chapman said.

    One of those medications is Prazosin, a blood pressure medication that a VA doctor prescribed him to help with nightmares.

    “I didn’t wanna go to sleep. There are times I didn’t wanna lie down. I just didn’t want to go to sleep,” Sgt. Chapman said.

    Over time, he realized his nightmares weren't getting any better. In fact, he said they got worse.

    “I was killing people, and cutting up body parts, and chopping up their body, and it was always with a knife,” Sgt. Chapman said, describing his nightmares.

    Finally, Sgt. Chapman took himself off the medication, too afraid of the side effects.

    Dr. Vaughn McCall of Augusta University recently did a study on the drug. He found responses like Sgt. Chapman's aren't uncommon.

    "We found that not only did the Prazosin not seem to do much as an advantage to the suicidal ideation, it seemed to reduce the degree of improvement that we see in the nightmares and the general sleep disturbance," Dr. McCall said.

    He said patients who took a placebo saw more of an improvement.

    “It makes me pause and, at a minimum, I would hesitate giving Prazosin to a suicidal patient with PTSD,” Dr. McCall said.

    The VA declined an interview but sent FOX 17 News a statement saying, “Prazosin may not be as effective as we once thought and that it should no longer be routinely prescribed for PTSD nightmares, but that it could still benefit certain patients.”

    The VA responded to Dr. McCall's study by saying, "While it adds to evidence that Prazosin may not be effective for PTSD nightmares, it should not raise any significant safety concerns."

    However for Sgt. Chapman, the idea of increased suicidal thoughts certainly seems like a safely concern.

    LOSING A SON TO SUICIDE

    Sgt. John Toombs took a video of himself on an early November morning in 2016.

    “I went to the VA for help and they opened up a Pandora's box inside me and just kicked me out the door,” Toombs said in the video.

    The day before, he said the VA kicked him out of a residential drug treatment program for being late to take his medicine.

    “I came for help and they threw me out like a stray dog in the rain,” Toombs said in the video.

    Just moments after recording the video, he hung himself from a construction site on the Murfreesboro VA campus.

    Now his dad is speaking out about his son's struggle leading up to his death.

    “People don’t realize that it’s something you just don’t get over,” his dad, David Toombs said.

    David Toombs thinks about his son every moment of every day.

    “He was extremely smart, and a quick, dry, sense of humor, that would catch you off guard so fast and then he’d answer you so fast,” David said.

    Sgt. Toombs served as the man riding on the back of a convoy in Afghanistan, eyes peeled, looking for suicide bombers or anyone else who posed a threat to his team. His dad says, when he came back home, things were good for a couple years, but when he decided not to reenlist, it became harder and harder to recognize his son.

    “He just wasn’t the same person,” David said. “He said for him, the main thing was being helpless and hopeless. If he was in a position that felt helpless and hopeless that’s when it kicked in the worst.”

    His dad said getting kicked out of the drug rehab program was one of those helpless and hopeless times.

    At the time of his death, Sgt. Toombs had six medications in his system that listed suicidal thoughts as a side effect. It's something his father thinks is a rampant problem in the VA.

    “They’re over medicated and they’re dealing with an over complicated system and they just give up at some point,” David said.

    The VA declined an interview but sent FOX 17 News a statement saying, "Prescribers evaluate a veteran's response to medication at each encounter including the presence of any side effects.”

    However, Sgt. Allen Chapman, who served with Sgt. Toombs and lives with PTSD himself, says that hasn't been his experience.

    “I can go to the VA and request a certain medication and there’s no questions asked,” Sgt. Chapman said.

    He said his 10 different prescriptions are refilled without any discussion about how they're making him feel.

    “I’m in and out within 10 minutes and I’m like ‘You didn’t ask me anything!’” Sgt. Chapman said.

    According to their website, the Tennessee Valley Healthcare System says they process more than 5,000 prescriptions daily. David Toombs chalks it up as a quick fix when trying to keep up with the thousands of veterans walking through the VA doors.

    “It’s not a situation where they can just keep filling medication and fix, it sometimes gets worse,” David said.

    Now, he’ll keep fighting for a better outcome for the men and women who fight for our country.

    Here’s the full statement from the VA:

    “Doctors, nurse practitioners, and other medication prescribers at VA Tennessee Valley Healthcare System consider several factors when deciding if a medication is safe and effective for a specific Veteran. Prescribers evaluate a Veteran’s response to medications at each encounter including the presence of any side effects. Medications are discontinued if the risk of continuing treatment due to side effects is thought to outweigh the benefits. Clinical pharmacists with specialty training are available facility-wide to provide medication guidance based on the most current research and expert recommendations.

    The VA/DoD Clinical Practice Guideline for The Management of PTSD and Acute Stress Disorder was updated in 2017 to reflect the most recent literature which shows prazosin may not be as effective for PTSD nightmares as originally found in early studies. While it should no longer be routinely prescribed for PTSD nightmares, experience and research shows it may still be beneficial in certain patients. Results from the study published by McCall and colleagues in December 2018 adds to evidence that prazosin may be not be effective for PTSD nightmares but should not raise significant safety concerns. The study included Veterans with PTSD experiencing suicidal thoughts but there was no evidence that prazosin worsened this particular symptom. Larger studies would be needed to be more certain that prazosin could be responsible for worsening nightmares or insomnia.”- Chris Vadnais, U.S. Department of Veterans Affairs

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