Is there a role for prazosin in the treatment of post-traumatic stress disorder?

Background

Post-traumatic stress disorder (PTSD) is a common disorder with significant morbidity and associated comorbidities, including mood disorders and substance abuse, and is frequently misdiagnosed or under-diagnosed. Management of PTSD requires combined psychotherapy and pharmacotherapy, but some symptoms, particularly nightmares and sleep disturbance, are often resistant to treatment.

Objective

The aim of this article is to inform primary healthcare professionals of the prevalence and significance of PTSD, and to review the evidence that prazosin is a useful option for managing PTSD-associated nightmares and sleep disturbance.

Discussion

PTSD should be considered in patients with treatment-resistant mood disorders. A trauma history should be taken for these patients and in recognised groups of patients who have a high incidence of PTSD. The treatment of PTSD is challenging, frequently requiring specialist input from psychiatrists. Prazosin has been proven to be safe and effective in the management of nightmares and sleep disturbances associated with PTSD and is indicated where these distressing symptoms are present.