Prazosin Nightmares Treatment for PTSD, Side Effects, Interactions & More

By We Level Up NJ Treatment Center | Editor Yamilla Francese | Clinically Reviewed By Lauren Barry, LMFT, MCAP, QS, Director of Quality Assurance | Editorial Policy | Research Policy | Last Updated: January 3, 2023

Prazosin Uses & Guide

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. It has been shown, in several published studies, to significantly reduce nightmares and improve sleep in patients suffering from PTSD.

What is prazosin used to treat? Prazosin nightmares PTSD medication has shown effectiveness in treating Post-Traumatic Stress Disorder by improving sleep quality. Given the significant evidence for its utility in treating PTSD, in combination with the fact that many anxiety symptoms overlap with PTSD (e.g.insomnia, hyperarousal, and irritability), it is essential to evaluate its potential effectiveness in treating symptoms of other anxiety disorders and patient tolerability. [1]

Furthermore, prazosin is used alone or in combination with other medications to treat high blood pressure. This medication is in a class of medications called alpha-blockers. It works by relaxing the blood vessels so that blood can flow more quickly through the body.

Unfortunately, like other drugs, it may cause severe side effects, withdrawal, and substance abuse risks. Abuse of this drug is also a concern, as it has been a prescription drug on the market since 1988. Although it’s effective in treating symptoms associated with mental illness, many rehab centers are diving into its side effects and potential for abuse.

Some of the Prazosin off label uses include Post-traumatic stress disorder, nightmares, Raynaud’s phenomenon, pheochromocytoma, scorpion envenomation, and benign prostatic hypertrophy.

Common Questions Relating To Prazosin Hydrochloride Uses

Prazosin Overdose Death Statistics

The most significant adverse effect is the ‘first dose effect’ syncope with a sudden loss of consciousness (1%) with an initial dose of at least 2 mg. Hence, a patient should always be started at prazosin 1mg. Some of the common side effects of prazosin tablets are the following:

• Dizziness (10%)
• Headache (8%)
• Drowsiness (8%)
• Lack of energy (7%)
• Weakness (7%)
• Palpitations (5%)
• Nausea (5%)

In less than 1% of patients taking this medication, abdominal discomfort/pain, tachycardia, paresthesias, hallucinations, pruritus, incontinence, impotence, and priapism have been reported. [2]

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Prazosin Nightmares

Prazosin is recommended when PTSD-related nightmares and sleep problems are present because it has been shown to be both safe and effective in managing these distressing symptoms. It has been demonstrated in several peer-reviewed studies to significantly lessen nightmares and enhance sleep in PTSD patients.

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Prazosin Medication for Nightmares

In several published studies, this medication has been shown to significantly reduce nightmares and improve sleep in patients suffering from PTSD. [3] Nightmares are inherently distressing, prevent restorative sleep, and are associated with several psychiatric problems. Nightmares are highly dysphoric dreams involving intense negative emotions primarily present during late-night rapid eye movement (REM) sleep. About one in 20 of the general population experiences nightmares every week. In contrast, estimates of the prevalence of nightmares are far higher for psychiatric populations. [4]

Prazosin Used for Nightmares

Prazosin dose for nightmares is a lipid-soluble α1-adrenergic receptor antagonist that crosses the blood-brain barrier and decreases the sympathetic outflow in the brain. It has been approved by the US Food and Drug Administration for the treatment of hypertension. Still, it is seldom used today as an antihypertension medication because of the numerous other preferred antihypertension drugs available.

Dose of Prazosin for Nightmares

The highest reported prazosin dosage for PTSD is 16 mg daily. Furthermore, prazosin for PTSD dose 16 mg was well tolerated and beneficial for the pharmacologic treatment of alcohol dependence. A patient can start with the medication at 1 mg at bedtime for the first three days and then increase it to 2 mg at bedtime and rest for 4 days. The dose could be titrated to 16 mg if patients fail to respond and the adverse reactions are tolerable.

Alternatives to Prazosin for Nightmares

Doctors commonly prescribe it for high blood pressure but may prescribe it off-label to reduce PTSD nightmares. However, prazosin for nightmares side effects includes dizziness, weakness, heart palpitations, and nausea.  Other effective treatments for PTSD nightmares include CBT and IRT.

CBT or Cognitive Behavioral Therapy

CBT is a type of talk therapy that focuses on how people think and interpret events in their life. During a CBT session, a therapist will work with a patient to explore and develop methods to deal with specific challenges and behaviors. Studies show that CBT can be an effective treatment for helping manage PTSD symptoms, including sleep disturbances.

IRT or Imagery Rehearsal Therapy

IRT is a form of cognitive behavioral therapy (CBT). During IRT, a therapist will provide the individual with background information about sleep and nightmares. This can help a person manage their nightmares. The individual then works closely with their therapist to create nonfrightening endings for the nightmares they experience. They can write down these endings and rehearse them mentally.

IRT also helps a person learn how to monitor their nightmares to understand how effective the therapy is.

Side Effects of Prazosin for Nightmares

Some side effects of prazosin for nightmares dosage may occur that usually do not need medical attention. These side effects may disappear during treatment as your body adjusts to the medicine. Also, your healthcare professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them.

Side Effects & Symptoms

Posttraumatic stress disorder (PTSD) often follows a chronic course, and the disorder is resistant to treatment with antidepressants and cognitive-behavioral therapy in many patients. PTSD medication prazosin, an a1-adrenoceptor blocker, has shown some promise in treating chronic PTSD. [6]

Prazosin and PTSD have also been studied in younger and older adults with PTSD and patients with alcohol problems, in whom it was found to reduce cravings and stress responses. Prazosin HCL for PTSD offers some hope for treating resistant cases of PTSD in which recurrent nightmares are problematic, with a relatively rapid response within weeks. It is suggested that large-scale civilian trials of prazosin mental health uses be done, as well as studies concerning the use of prazosin classification in acute PTSD and as a potential preventive agent.

Prazosin for Insomnia

Thousands of people with post-traumatic stress disorder have taken prazosin for sleep dosage to ease the nightmares and disturbances that hunt their sleep. Numerous studies have shown the drug to be effective at controlling those episodes.

It can take up to 8 weeks to see the full benefits. When prazosin for sleep dose works well, you may notice a reduction of nightmares and improved sleep. You must continue taking prazosin dosage for sleep regularly, even if you are feeling well or there are no improvements in the first few weeks. Some conditions may become worse when the drug is abruptly stopped.

Prazosin Abuse

Many individuals with PTSD have turned to this medication as an alternative to other sleep aids and sedatives with a higher potential for abuse and addiction. However, misuse and abuse of this drug are possible and are characterized by using more than the dose prescribed.

Prazosin for anxiety dosage and PTSD medication users are just as much at risk of suffering from adverse side effects when misusing this medication as when using any other drug. Liver disease and different types of damage to the organs and workings of the body can result from misusing any medication. Always be cautious when taking any medications prescribed to you, and avoid taking ones that are not.

Prazosin High

Can prazosin make you high? No. If you take too much of this medication, you may experience a significant drop in blood pressure, with symptoms such as extreme dizziness. lightheadedness. fainting. This drug is not addictive and not a controlled substance.

Nonetheless, this drug may not be as life-threatening as other drugs of abuse like benzodiazepines, opioids, heroin, cocaine, and meth. However, this drug can still produce adverse side effects and withdrawal symptoms.

Prazosin Withdrawal Symptoms & Drug Detox

This type of medication is used for long-term treatment. It comes with serious risks if you don’t take it as prescribed. If you stop taking the drug and your blood pressure stays too high, it can put you at risk of severe health problems such as heart attack and stroke.

Do not stop taking this medication without first consulting your doctor. Some conditions may become worse when the drug is abruptly stopped. Your dose may need to be gradually decreased. Tell your doctor if your condition worsens (such as your routine blood pressure readings increase). Most patients experience a recurrence of insomnia and nightmares upon prazosin discontinuation.

Dual Diagnosis Treatment for PTSD & Drug Abuse

An integrated dual diagnosis approach will usually involve a combination of treatment modalities, including individual therapy, group therapy, family therapy, psycho-education, and pharmacotherapy. Psycho-education helps reduce the anxiety and distress associated with PTSD.

General physical signs of addiction include but are not limited to:

• Enlarged or small pupils
• Sudden weight loss or gain
• Bloodshot eyes
• Insomnia
• Unusual body odors
• Poor physical coordination
• Looking unkempt
• Slurred speech

Typical signs of an overdose may include but are not limited to:

• Drowsiness or trouble walking
• Agitation
• Aggression or violent behavior
• Difficulty breathing
• Nausea and vomiting
• Hallucinations
• Delusions
• Loss of consciousness

There are 4 types of PTSD symptoms, but they may not be precisely the same for everyone. Each person experiences symptoms in their way.

1. Reliving the event (also called re-experiencing symptoms). Memories of the traumatic event can come back at any time. They can feel genuine and scary. For example:
   • You may have nightmares.
   • You may feel like you are going through the event again. This is called a flashback.
   • You may see, hear, or smell something that causes you to relive the event. This is called a trigger. News reports, seeing an accident, or hearing fireworks are examples of triggers.
2. Avoiding things that remind you of the event. You may avoid situations or people that remind you of the trauma event. You may even avoid talking or thinking about the event. For example:
   • You may avoid crowds because they feel dangerous.
   • You may avoid driving if you were in a car accident or if your military convoy was bombed.
   • If you were in an earthquake, you might avoid watching movies about earthquakes.
   • You may keep very busy or avoid getting help, so you don’t have to think or talk about the event.
3. Having more negative thoughts and feelings than before the event. How you think about yourself and others may become more damaging because of the trauma. For example:
   • You may feel numb—unable to have positive or loving feelings toward other people—and lose interest in things you used to enjoy.
   • You may forget about parts of the traumatic event or not be able to talk about them.
   • You may think the world is dangerous and no one can be trusted.
   • You may feel guilt or shame about the event, wishing you had done more to keep it from happening.
4. Feeling on edge or keyed up (also called hyperarousal). You may be jittery or always alert and on the lookout for danger. You might suddenly become angry or irritable. For example:
   • You may have a hard time sleeping.
   • You may find it hard to concentrate.
   • You may be startled by a loud noise or surprise.
   • You might act unhealthy, like smoking, abusing drugs or alcohol, or driving aggressively.

People with PTSD are more prone to violent outbursts and panic attacks, which can be difficult for family and friends to witness. Feelings of guilt over these outbursts can drive those with PTSD to self-medicate with drugs and alcohol. Continued use of alcohol or other drugs in this way can lead to addiction.

We Level Up NJ’s thorough approach to rehabilitation supports several levels of care to ensure the best possible outcome for every client who enters our doors. From an intensive and more supportive atmosphere for those in the early days of recovery to a comfortable residential-style living dynamic upon completion of detox, we are here to help guide you down the safe and results-based path to your sobriety. Once detox is complete, a new doorway in dual diagnosis treatment opens up, referred to as a residential level of care to help the clients uncover the cause of drug abuse and receive PTSD therapies.

We Level Up NJ residential care program slowly and effectively introduces the individual into an atmosphere of therapeutic growth, marked by Master’s level therapists, clinicians, group counselors, psychiatrists, and a community of like-minded individuals with the same aim: to attain sobriety and live a great life.

Clients in residential therapy programs will live comfortably within the facility during this crucial and fragile time. This supportive environment is designed to give clients 24-hour care for sobriety, removing temptations for relapse and applying an air of recovery into every component of the treatment timeline.

We Level Up NJ finds that clients living in a supportive community, especially during their early recovery, can genuinely focus on what matters most: their recovery. Make this your opportunity to reclaim your life with a comfortable drug addiction treatment. Call today to speak with one of our treatment specialists.

Top Prazosin Medication Frequently Asked Questions