Post-traumatic stress disorder (PTSD) can occur following a traumatic event. Nightmares are a common symptom of PTSD, which may cause a person to replay the traumatic event from their past. One possible medical treatment for PTSD nightmares is the drug prazosin.
NAMI also states that around 37% of those with PTSD have severe symptoms.
This article discusses PTSD nightmares and the drug prazosin. It outlines how prazosin works, its side effects, other PTSD medications, and other PTSD treatments.
PTSD is a disorder that can affect a person if they have
Long-term effects of PTSD include:
- difficulty sleeping
- refusal to discuss the event
- avoiding situations that remind the person of the event
- irritability and outbursts of anger
- feelings of guilt and blame
- feeling detached and estranged from others
People with PTSD may have intense nightmares that occur regularly. These nightmares may include replays of the traumatic event or events that caused the person to develop PTSD.
Find out more about PTSD.
Prazosin is a medication that comes in the form of an oral capsule. One brand name for the drug is Minipress. People can also purchase the generic version of the drug.
However, doctors also prescribe prazosin off-label to treat PTSD-associated nightmares. This means that the Food and Drug Administration (FDA) has not approved it for this purpose, but it may still help reduce PTSD nightmares.
Prazosin has an affect on alpha-1 receptors that are present on smooth muscle tissue, including the blood vessel walls and the brain. This results in the relaxation of these smooth muscles, leading to a decrease in blood pressure.
It is also able to cross the blood-brain barrier, which may help treat PTSD-associated nightmares.
Studies have shown that the medication can be an
However, the evidence is mixed. One
More research is needed to determine whether prazosin is an effective treatment for PTSD nightmares.
Prazosin has several potential side effects.
The most common of these affect between
More serious but less common side effects include hypotension, or low blood pressure. First-dose hypotension can be serious, so doctors recommend that a person takes their initial dose at night.
People may also develop orthostatic hypotension, which is a form of hypotension that occurs when a person stands up after sitting or lying down.
Other less common side effects, which affect between 1–4% of people, include:
There are also some very rare side effects. These affect less than 1% of people that take the drug and include:
If a person is taking other medications, they should always check with a doctor before taking prazosin. This is because it may interact with other medications.
One of the possible side effects of prazosin is low blood pressure. This may make a doctor less likely to prescribe prazosin to someone already taking medications that lower their blood pressure. This is to prevent their blood pressure from decreasing further.
There is no one medication that a person can use to treat all of their PTSD symptoms. Some medications can help with certain symptoms and may also increase the effectiveness of psychotherapy. However, they may not specifically treat PTSD nightmares.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are two types of antidepressant medications.
Below are four of the more common SSRIs and SNRIs that doctors may prescribe to treat PTSD:
However, the only FDA-approved antidepressants for PTSD are sertraline and paroxetine.
These medications work by balancing certain hormones and chemicals in the brain to reduce certain symptoms of PTSD.
There are several other nonmedical treatments that a person may wish to consider to help them manage their nightmares.
Imagery rehearsal therapy (IRT)
Imagery rehearsal therapy (IRT) is a possible treatment for PTSD nightmares. 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 their own 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 in order to understand how effective the therapy is.
Studies show that IRT is a
Cognitive behavioral therapy (CBT)
CBT is a type of talk therapy that focuses on the way 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 certain challenges and behaviors.
Studies show that CBT can be an effective treatment for helping manage PTSD symptoms, including sleep disturbances.
There are several other things that a person may wish to do to help manage their PTSD nightmares.
Some of the following measures may help a person reduce the frequency or intensity of PTSD nightmares:
- Talking: Regularly discussing the nightmares with a friend, family member, or therapist may help alleviate some of the anxiety associated with them. It may help a person process the emotions and memories that the nightmares bring up.
- Keeping a dream diary: Keeping track of dreams and writing them out on a page may help a person process them and achieve some distance from the nightmares.
- Relaxing before bed: Setting aside time to get comfortable and alleviate any stress may reduce the chances of having a bad dream. Taking a relaxing bath or meditating before bed may help.
- Avoiding screens before bed: Watching TV or scrolling on a mobile phone stimulates the brain, which may make it more difficult to unwind before bed.
One possible medication for PTSD nightmares is the drug prazosin. Doctors normally prescribe it for high blood pressure, but they may prescribe it off-label to reduce PTSD nightmares.
However, some side effects of prazosin include dizziness, headaches, drowsiness, weakness, heart palpitations, and nausea.
Other effective treatments for PTSD nightmares include CBT and IRT.
A person may also wish to discuss their nightmares with someone they trust, or keep a dream diary to help them cope.