A comprehensive search was performed using the databases EMBASE, Ovid MEDLINE, PubMed, Scopus, Web of The prazosin dose ranged from 1 to 16 mg/d
Your doctor will slowly increase your dose as needed
US Veterans PTSD guidelines state the target dose as being 6mg to 10mg/day, but studies suggest that veterans may require higher doses than civilians
8 ± 6
While nightmares are not by definition pathologic, those that are frequent or disabling and impair social, occupational, emotional, and physical wellbeing are considered a disorder
Results were mixed for the 4 RCTs: 3 reported significant improvement in the number of nightmares, and 1 found no reduction
We present a case in which low-dose prazosin was associated with nightmares and sleep disturbances in an elderly patient without previously diagnosed
This article examines the use of cyproheptadine, a serotonin antagonist, for reducing nightmares in patients with posttraumatic stress disorder
Prazosin is increasingly being used off-label to treat nightmares in patients with posttraumatic stress disorder
Results of a recent large randomized control trial did not find benefit of prazosin vs placebo in improving such outcomes
1 It has been postulated that posttraumatic stress disorder (PTSD)–related nightmares arise from fragmentation of rapid eye movement sleep
2 mg
Antidepressants, anxiolytics, anticonvulsants, antipsychotics, and other agents have been studied, with mixed results
Despite these clinical While clonidine is used clinically for the treatment of nightmares in posttraumatic stress disorder (PTSD), few case reports demonstrating this indication exist, and there have been few studies investigating clonidine's mechanism of action for controlling nightmare symptoms
The α 1-adrenergic antagonist prazosin has showed good effect against posttraumatic stress disorder-related nightmares in several randomized controlled trials
5: 9: Overall PTSD symptoms; nightmares Results: Forty-two patients were evaluated to determine symptom improvement after initiation of prazosin for PTSD nightmares in children and adolescents
James A
1,2 Because it has a half-life of only 2 to 3 hours and a duration of action of 6 to 10 hours, multiple daytime doses are required
Trial Regimen and Other Treatments
While prazosin was the most frequently prescribed nightmare medication (106) of all the agents employed for PTSD nightmares at the VAMC, its success rate (49%) was lower at a dose range of 1
Furthermore, in adults, prazosin has been found to be efficacious and generally well tolerated at dose ranges of 10 to 15 mg at night in the treatment of PTSD-associated sleep disturbances (trouble falling/staying asleep, nightmares)
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