Murray A. Raskind, MD, MRM Professor and Vice-Chair, Psychiatry and Behavioral Sciences University of Washington Director, VA Northwest Network (VISN 20) Mental Illness Research Education and Clinical Center (MIRECC) VA Puget Sound Health Care System Seattle, WA

Dr. Raskinds career first focused on brain noradrenergic abnormalities in aging and Alzheimers disease. This background served him well as his focus broadened to military PTSD after assuming directorship of the VA Puget Sound Health Care System Mental Health Service. Dr. Raskind's search for better treatments for military PTSD began with his clinical experience as medical advisor to the VA Puget Sound African American Veterans Stress Disorders Program beginning in 1995 (a role he continues to the present). The most common and distressing symptoms reported by these Vietnam combat Veterans with chronic PTSD are terrifying combat reenactment nightmares that awakened them sweating, anxious and unable to return to their severely disrupted sleep; and daytime irritability, hypervigilance and unpredictable anger outbursts that continued to destroy careers and families decades after these Veterans had returned from war. Dr. Raskind observed that these treatment resistant PTSD symptoms appeared to arise from a persistent and now maladaptive increased brain response to the "adrenaline-like" stress chemical, norepinephrine. Dr Raskind reasoned that a medication that normalized the brain norepinephrine response and was able to enter the brain easily would alleviate these Veterans' previously treatment resistant PTSD symptoms. Prazosin, an inexpensive norepinephrine "blocker" drug introduced to treat hypertension in 1973, was just such a medication and it worked! First with VISN 20 MIRECC support, and then with VA R&D Merit Review and DoD funding support, Dr. Raskind and his colleagues completed three positive randomized controlled trials of prazosin for PTSD in Vietnam Veterans at VA Puget Sound and in active duty soldiers at Joint Base Lewis McChord who have returned from Iraq and Afghanistan combat deployments (study performed by VA and Army personnel on site at JBLM). This active duty soldier MIRECC study is the first ever performed for any behavioral disorder in active duty combat experienced service members, and a pioneering example of VA/DoD collaboration. And, coming full circle to Alzheimers disease, he and his colleagues have demonstrated that increased noradrenergic activity contributed to agitation in dementia. In recognition of his contributions to noradrenergic system involvement in PTSD, alcohol abuse, and dementia, Dr. Raskind was selected as the 2011 Barnwell awardee, VA's highest honor for excellence in clinical research.

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