Prazosin in the Treatment of PTSD

@article{Green2014PrazosinIT,
  title={Prazosin in the Treatment of PTSD},
  author={Ben Green},
  journal={Journal of Psychiatric Practice},
  year={2014},
  volume={20},
  pages={253–259}
}
  • B. Green
  • Published 1 July 2014
  • Psychology, Medicine
  • Journal of Psychiatric Practice
Posttraumatic stress disorder (PTSD) often follows a chronic course, and the disorder is resistant to treatment with antidepressants and cognitive-behavioral therapy in a proportion of patients. Prazosin, an a1-adrenoceptor blocker, has shown some promise in treating chronic PTSD. A review of this literature was conducted via a search of MEDLINE and SUMMON, using keywords such as PTSD, prazosin, treatment, and resistance. At least 10 clinical studies of prazosin in the treatment of PTSD… 
Using Prazosin to Treat Posttraumatic Stress Disorder and Associations: A Systematic Review
TLDR
Several clinical studies demonstrated the relevant role of prazosin for treating PTSD symptoms, and it is shown that this drug is an affordable and cost-effective pharmacological option compared to other drugs used to treat PTSD.
Treatment Resistance in Post-traumatic Stress Disorder
  • A. McFarlane
  • Psychology
    Treatment Resistance in Psychiatry
  • 2018
TLDR
It is argued that a staging model of PTSD will lead to more systematic research into the treatment of PTSD and assist in strategies to develop treatment resistance such as a personalised medicine approach.
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
TLDR
PTSD-related nightmares, sleep disturbances, and overall illness severity showed a significant response to treatment with prazosin, with careful dose titration.
Treatments for Post-traumatic Stress Disorder: Pharmaceutical and Electrophysiologic Considerations
TLDR
While the evidence for combined psychotherapy and either pharmacological or physiological treatments is only now emerging, some of these modalities appear promising.
The preclinical profile of brexpiprazole: what is its clinical relevance for the treatment of psychiatric disorders?
TLDR
Brexpiprazole is a serotonin–dopamine activity modulator in clinical development for schizophrenia, adjunctive treatment of major depressive disorder, agitation in Alzheimer’s disease and post-traumatic stress disorder and has shown robust antipsychotic, antidepressant-like and anxiolytic activities in animal models.
Sleep Disturbances and Nightmares in a Patient Treated with Prazosin.
  • S. Kosari, M. Naunton
  • Medicine, Psychology
    Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
  • 2016
TLDR
A case in which low-dose prazosin was associated with nightmares and sleep disturbances in an elderly patient without previously diagnosed mental illness or coexisting environmental risk factors for nightmares is presented.
Recent Advancements in Treating Sleep Disorders in Co-Occurring PTSD
TLDR
Targeted treatment of sleep disorders in the context of PTSD offers a unique and underutilized opportunity to advance clinical care and research.
Treatment of sleep disturbances in refugees suffering from post-traumatic stress disorder
TLDR
It is indicated that sleep disturbances are a prominent part of the PTSD symptom structure in refugees but that research on treatment of sleep disturbances is limited.
The Neurochemical Effects of Prazosin Treatment on Fear Circuitry in a Rat Traumatic Stress Model
TLDR
It is demonstrated that prazosin might alleviate defensive behaviors and traumatic stress symptoms when given during the traumatic cue presentation in the stressed rats, however prazoin administration resulted in higher anxiety levels in non stressed rats when the neutral cue was presented.
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References

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TLDR
Preliminary support for the use of prazosin in targeting reduction of trauma-related nightmares and promoting improvement of global clinical status within an international sample of severely traumatized refugee patients is provided.
Prazosin Versus Quetiapine for Nighttime Posttraumatic Stress Disorder Symptoms in Veterans: An Assessment of Long-Term Comparative Effectiveness and Safety
TLDR
Prazosin should be used first-line for treating nighttime PTSD symptoms in a veteran population because of similar rate of short-term effectiveness, superior long- term effectiveness, and lower incidence of events leading to discontinuation, compared with quetiapine.
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TLDR
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TLDR
Nine older men with chronic PTSD secondary to military or Holocaust trauma were prescribed the lipophilic alpha-1 adrenergic antagonist prazosin for treatment-resistant trauma-related nightmares and it substantially reduced nightmares and moderately or markedly reduced overall PTSD severity.
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TLDR
The course of PTSD in a sample of primary care patients is chronic and Cox regression analyses indicated that baseline clinical variables did not have a significant relationship with probability of PTSD recovery, but time-varying models showed that the course of psychosocial impairment was a significant predictor of the likelihood of recovery from PTSD.
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TLDR
Treatment in the hands of counselors with minimal cognitive- behavioral therapy (CBT) experience was as efficacious as that of CBT experts and treatment gains were maintained at follow-up, although a minority of patients received additional treatment.
Post-traumatic stress disorder: new directions in pharmacotherapy
SUMMARY As many as 10% of the population experience post-traumatic stress disorder (PTSD) at some time in their lives. It often runs a severe, chronic and treatment-resistant course. This article
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