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  1. To be considered for inclusion, studies had to test the efficacy of prazosin either alone or added to ongoing treatment in adults with PTSD, use validated tools to assess and monitor the disorders, allow comparisons on the basis of univariate analyses (i.e., p-values of t-tests and effect sizes) and list the identified adverse reactions.

  2. Clinicians are reluctant to increase the dose of prazosin due to side effect concerns. To date, the highest reported dose of prazosin used for PTSD is 16 mg daily. We illustrate two case reports using high-dose (up to 30 and 45 mg) prazosin for PTSD with comorbid treatment-resistant mood disorders.

  3. Background: Prazosin has been an accepted treatment for patients with post-traumatic stress disorder (PTSD) who experience sleep disturbances, including nightmares. Results of a recent large randomized control trial did not find benefit of prazosin vs placebo in improving such outcomes.

  4. Prazosin is lipophilic and crosses the blood-brain barrier to antagonize alpha-1 receptors in the central nervous system, potentially reducing autonomic arousal caused by PTSD.

  5. ral clinical studies demonstrated the relevant role of prazosin for treating PTSD symptoms. Prazosin is an af. dable and cost-efective pharmacologica. Key Words Prazosin alpha-adrenergic blocker, Posttraumatic stress disorder, Insomnia, Nightmares. INTRODUCTION.

  6. At least 10 clinical studies of prazosin in the treatment of PTSD, including open-label and randomized controlled trials, have been published. All of these studies support the efficacy of prazosin either for treating nightmares and improving sleep or for reducing the severity of PTSD.

  7. 1 Νοε 2022 · We continue to recommend prazosin as a first line agent in addressing nightmares and sleep disturbance related to PTSD. •. There is emerging evidence for clonidine as an alternative alpha-mediated medication for nightmares and sleep disturbance. •.