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Re: Prazosin for PTSD/nightmares anyone? » zonked

Posted by SLS on April 11, 2014, at 0:28:25

In reply to Prazosin for PTSD/nightmares anyone?, posted by zonked on April 10, 2014, at 23:39:02

Hi Zonked.

I am currently taking prazosin 30 mg/day for bipolar depression, possibly attributed, at least partially, to "developmental PTSD". With the exception of reduced libido, I experience no side effects. It feels like a very clean antidepressant. I've done some research on this drug, and I am convinced that:

1. Prazosin given at night treats nightmares and disrupted sleep due to PTSD.

2. Prazosin treats the daytime depression and anxiety associated with PTSD if dosed high enough 3 times a day.

3. The dosages of prazosin used in the treatment of PTSD have historically been too low. Some doctors are going to 40 mg/day.

If you are going to try prazosin, I recommend that you start with a single 1 mg dose at bedtime to avoid the initial dizziness and vertigo that usually occurs. You can then go to 3 mg at night for a few days before considering daytime dosing.

I'll try to answer any questions you may have.


- Scott


----------------------------------------------------


Ther Adv Psychopharmacol. 2014 Feb;4(1):43-47.
High-dose prazosin for the treatment of post-traumatic stress disorder.
Koola MM1, Varghese SP2, Fawcett JA3.
Author information
Abstract

Patients with post-traumatic stress disorder (PTSD) are frequently symptomatic despite being on medications currently approved by the US Food and Drug Administration for PTSD. There is evidence to support the notion that prazosin is effective for PTSD nightmares. However, PTSD-related nightmares often do not resolve completely on a low dose of prazosin. The capacity of prazosin to treat daytime symptoms of PTSD which are distressing to patients has not been well studied. 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. We report that high-dose prazosin was safe, tolerable and effective for PTSD in adults. To our knowledge, this is the first case series to highlight the importance of using high-dose prazosin for the treatment of PTSD. In patients with partial response to currently available medications for PTSD, greater utilization of high-dose prazosin for the management of PTSD may lead to better outcomes.
KEYWORDS:

High dose prazosin, comorbid depression, post-traumatic stress disorder


- Scott


Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw

 

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