Authors: Check Jerome H, Neumann Brooke A, Check Diane L.
Rationale: A relative deficiency of dopamine in various tissues leading to increased tissue permeability allowing infiltration of irritants to cause inflammation with subsequent pain, or disrupt normal function of organs, may be the etiologic factor in a wide variety of medical conditions. Evidence to support this hypothesis has been shown by quick improvement of symptomatology after treatment with dopaminergic drugs especially dextroamphetamine sulfate, but also cabergoline, for both corporeal conditions and psychological ones.
Objective: To determine not only if treatment with dextroamphetamine may ameliorate backaches (which has been previously reported) but also improve chronic nightmare syndrome which has never been previously reported.
Findings: A total daily dosage of 18.8mg of dextroamphetamine sulfate was not only able to immediately completely relieve the backache, but while taking it he did not have one nightmare during three months of treatment. Previously he never had one week for 30 years without at least 1-3 nightmares.
Conclusion: Sometimes one case report provides more valid conclusions of the efficacy of a given drug than a randomized controlled study. The standard medication used for chronic nightmares is prazosin which may not be very effective in ameliorating chronic nightmares. The dramatic complete improvement of chronic nightmare syndrome, though it was only one patient, is sufficient for a treating physician to try dextroamphetamine therapy for prazosin failures or for patients who only had partial relief from prazosin and/or side effects, to try amphetamine therapy. Certainly, it would make sense to try dextroamphetamine for chronic nightmares if the patient also has other manifestations of the increased cellular permeability disorder.
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