Prazosin for treatment of post-traumatic stress disorder: a systematic review and meta-analysis

  title={Prazosin for treatment of post-traumatic stress disorder: a systematic review and meta-analysis},
  author={Christopher Reist and Elani Streja and Cynthia Crystal Tang and Bryan Shapiro and Jim Mintz and Michael Hollifield},
  journal={CNS Spectrums},
  pages={338 - 344}
Abstract 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. A meta-analysis that includes this most recent trial was conducted to examine the pooled effect of prazosin vs placebo on sleep disturbances and overall PTSD symptoms in patients with PTSD. Methods A… 

Trazodone Add-on in COVID-19-related Selective Serotonin Reuptake Inhibitor-resistant Post-traumatic Stress Disorder in Healthcare Workers: Two Case Reports

  • D. D. BerardisM. Fornaro M. Giannantonio
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    Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology
  • 2021
Two cases of HCWs directly involved in the treatment of COVID-19 patients who showed selective serotonin reuptake inhibitor-resistant PTSD, which was successfully treated with extended-release trazodone TRZ ContramidⓇ add-on are reported on.

Autonomic activity, posttraumatic and nontraumatic nightmares, and PTSD after trauma exposure.

A shared pathophysiology between PTSD and posttraumatic nightmares in the form of increased HR reactivity to startling tones could explain why PTSD is more strongly related to posttraumatic than nontraumatic nightmares, which could have important clinical implications.

β-adrenoceptor antagonists and nightmares: A pharmacoepidemiological-pharmacodynamic study.

In the large pharmacovigilance study, nightmares are more frequently reported for pindolol and metoprolol, and among β-adrenoceptor antagonists with high lipid solubility and high 5-HT1A receptor affinity, and in a pharmacoepidemiological-pharmacodynamic analysis.

Nightmare Disorder and Isolated Sleep Paralysis

  • A. StefaniB. Högl
  • Psychology, Medicine
    Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics
  • 2020
Nightmare disorder and recurrent isolated sleep paralysis are rapid eye movement (REM) parasomnias that cause significant distress to those who suffer from them. Nightmare disorder can cause insomnia

Pharmacological Management of Nightmares Associated with Posttraumatic Stress Disorder

A narrative review aimed to critically appraise proven as well as novel pharmacological agents used in the treatment of Post-traumatic nightmares, showing promising results.



Efficacy of Prazosin in Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis.

This study suggests that prazosin improves nightmares and overall PTSD symptoms including hyperarousal, sleep disturbances, total sleep time, and sleep quality.

Meta-analysis of the efficacy and safety of prazosin versus placebo for the treatment of nightmares and sleep disturbances in adults with posttraumatic stress disorder

PTSD-related nightmares, sleep disturbances, and overall illness severity showed a significant response to treatment with prazosin, with careful dose titration.

Trial of Prazosin for Post‐Traumatic Stress Disorder in Military Veterans

Prazosin did not alleviate distressing dreams or improve sleep quality in military veterans who had chronic PTSD, and there were no significant differences in these measures at 26 weeks of the trial.

Reduction of nightmares and other PTSD symptoms in combat veterans by prazosin: a placebo-controlled study.

These data support the efficacy of prazosin for nightmares, sleep disturbance, and other PTSD symptoms.

Evidence-based pharmacotherapy of post-traumatic stress disorder (PTSD).

  • J. IpserDan J Stein
  • Psychology, Medicine
    The international journal of neuropsychopharmacology
  • 2012
The largest body of evidence for short- and long-term efficacy of medication currently exists for SSRIs, with promising initial findings for the selective noradrenergic reuptake inhibitor venlafaxine and the atypical antipsychotic risperidone.

Randomized, double-blind comparison of sertraline and placebo for posttraumatic stress disorder in a Department of Veterans Affairs setting.

Sertraline was not demonstrated to be efficacious in the treatment of PTSD in the VA clinic settings studied, and gender, duration of illness, severity of injury, type of trauma, and history of alcohol/substance abuse were explored as potential moderators of outcome, but no consistent effects were uncovered.