The use of clonidine in the treatment of nightmares among patients with co-morbid PTSD and traumatic brain injury.

To describe the successful treatment of PTSD associated nightmares in two patients with PTSD. The report of the successful use of clonidine to treat PTSD associated nightmares among two Veterans following combat exposure. Clonidine, a centrally acting alpha-agonist agent used to treat hypertension, stimulates alpha-adrenoreceptors in the brain stem. This action results in reduced sympathetic outflow from the central nervous system. We hypothesize that this central mechanism of action is why clonidine may be more effective in treating nightmares among patients with PTSD when compared with other agents. Clonidine should be considered as an alternative in the treatment of nightmares among patients with PTSD.