Please please explain the physiological basis for how, after 40 plus years of trying every concievable anti-anxiety med there is that this simple BP lowering med (which I understand isn't even a first line option) has immediately and almost completely eliminated my startle responses, fight/flight PTSD, chronic hypervigilence, etc in less than a week. And please tell me why more docs are not prescribing it. Someone needs to shout it from the roof tops--not just clinical trials in VA hospitals in Oregon--but I really want to know the medical details--how and why this is working so well. Thanks.
Why is Prazosin not being used more often for anxiety and PTSD?
Question posted by kiva49 on 19 Aug 2010
Last updated on 21 July 2018
8 Answers
campbell765
5 April 2018
I was just prescribed this for anxiety and PTSD my mg will be 3mg i hope this works but I am told it can make you dizzy so I hope it works. My doctor just prescribed it today by 9 days I will be up to 3mg. My doctor swears this works but to watch your blood pressure so it does not get too low and get up slowly just in case dizzy but no other bad side effects that I know of. This news you shared was very exciting. I will let you know how it works with me. It effects one of your brain chemicals
awareofthemoment
30 Dec 2017
My insurance company no longer covers Prazosin. Despite years of therapy and helpful EMDR training from one of the leading teachers of EMDR in our state, nothing seemed to stop the nightmares of being murdered all night long after a violent attack except for this one drug. All of the MN insurance companies have dropped covering this drug from their health plans (MN has its own form of "affordable health care". MN's plans range from $300-$525 per month but do not offer coverage of Prazosin this year ). The MN insurance plans also do not cover a common medication for asthma from their "formularies". These two prescriptions are $300 and $400 per month respectively ON TOP OF the monthly fee of $500 (if you want a PPO so you do not have to start again with a new HMO and brand new doctors).
This makes the cost of health care $1200 per month on the "affordable" health plan for a single mother of 3 who is making merely $42,000 per year. WHY IS PRAZOSIN suddenly not covered by any of the plans? It is the only thing that keeps the nightmares from happening all night long in various forms. There must be some reason Prazosin was covered in the past and suddenly this year every plan has excluded it from coverage. While I loved the time I took raising my kids and not working, it restricted my earning capacity so strongly that a graduate degree was not helpful... Stay in the workplace, women... count on yourself only!
Nwilsonnrf
7 Dec 2017
I agree. I was recently started on Prazosin (a week ago) for PTSD related nightmares. I was having nightmares at least four nights a week. Fighting in my sleep, crying screaming out and waking up feeling as if I were being suffocated. I take 2 mg at bedtime. Haven't had a nightmare this week but I've had wicked headaches the past two days. Wondering if it's a side effect of the meds. After seeing numerous sleep specialist and neurologist this seems to help. Wondering why it took so long to be prescribed. Has it cause headaches for anyone else?
Daronkennedy
28 Oct 2017
I am a 21 year old female. I have PTSD but not from combat which from what I’ve looked up are the only studies done on this.
My psychiatrist is a veteran which is why I feel like she prescribed me this. I’m on 1 mg and it doesn’t seem to be doing much. I’ve only been on it for three days... like ssri’s is there a waiting period until your body gets used to it and it begins working?
Inactive
4 Oct 2013
I researched it and have been taking it for a couple of days was not in combat but saw death in my family and was rearended at a redlight at 50mph Have to look at its side effects vs the antipsychotic seroquil
Already have better dreams and less startle response! I agree with kiva49
prescottsmith
18 Sep 2016
I was prescribed Seroquel first. I ended up with Neuroleptic Malignant Syndrome, a very serious illness. I did recover - some do not, but also ended up with chronic high blood pressure after a lifetime of low blood pressure. Prazosin helps with both the PTSD symptoms and the high blood pressure though as an alpha blocker it is not a first line choice for High Blood Pressure. It is working for me. I am scared of neurologists who prescribe too quickly with too little information.
Inactive
19 Nov 2016
Prazosin has helped me with PTSD nightmares and daytime symptoms when I take it in the morning. But I normally have low blood pressure so I'm very dizzy most of the time now. I've taken Seroquel in the past. I think it's a horrible medication. It caused such pain in my knees that I could barely walk, and I gained 25 pounds on it. I felt like I was starving all of the time. I've also tried Perphenazine which helped a lot but caused lumps under my skin on my face (not acne but more like cysts).
Choclablover
25 Aug 2012
I have been on several meds for nightmares related to PTSD.We recently changed to Prazozin. I've been on this one a while and my dr just increased the dosage to 2mg since i was still occasionally having nightmares. I feel it's helping .You do have to be careful since it drops your bloodpressure when u get up and down you can get dizzy.
I haven't had any major side effects with it.
Delila
27 Oct 2010
Hi, side effects for Prazosin are as follows;
Low blood pressure (hypotension) causing dizziness and fainting
A slow heart rate (bradycardia).
A cough or wheezing, which means the airways that carry air to the lungs are narrowing (bronchospasm).
Thinking and acting more slowly.
Stuffy nose, headache, and swelling in the legs.
Prazosin may help reduce your nightmares, but it is not a cure for PTSD. Nightmares and anxiety may come back if you stop taking your medicine.
I guess this is why its use had been reduced?
Quetiapine is a similar drug/used for the same symptoms, and it appears the side effects aren't as serious? But i wouldn't guarantee that.
I hope this helps?
SonicScrewDriver
27 Dec 2014
Stuffy (stopped up/blocked off) nose.
This is what I've been struggling with since I started taking 6mgs of Prazosin.
If that stuffiness does not keep me awake because I'm trying to force air through my nostrils (like blowing and sucking air through a coffee stirrer), what then winds up happening if I manage to beat what I call “The Stuffen-ing” and actually doze off, once I've fallen asleep my brain tries to save us from dying of suffocation (via blocked nasal passages) by signaling my mouth to open... WIDE!
So that, what used to be a once-in-a-blue-moon thing, of me having nightmares where I'm trying so fiercely to talk to someone in my dreams (usually a family member, with whom I have a myriad of unresolved issues- Never felt that I was “heard” by this person) that I would wake up and realize that I was actually trying to SPEAK OUT LOUD in my sleep...
But that natural process of sleep paralysis, tries to prevent me from doing it, so that it just comes out as gasps and whispers...
This has been what sleep has been like, off and on, for a few months now, and I think the inflammation in my nostrils (brought on by the Prazosin) is the catalyst...
I'm going to alert my Doctor, the one who perscribed Prazosin, about my difficulties with an email. I'm sending her the same description of my symptoms/side-effects...
Savvo1
7 Feb 2015
Taking Prazosin at night caused me to get a stuffy nose before I went to bed.
Changing to taking it in the morning eliminated this side effect.
TheNurse07757
17 Aug 2016
I completely disagree with your last statement as well as pieces of the beginning. First of all, Seroquel is an Antipsychotic. It can treat schizophrenia, bipolar disorder, and depression. How besides a "calming effect" (more like drugged) is it comparable to Prazosin which is labeled as an antihypertensive? While I acknowledge that for nightmares/ PTSD is a use as well they just are not the same or comparable. The side effects COMPLETLY differ as well as dx, long term effects and drug interactions. I am also curious to know what does "cure PTSD"? There are things to help cope/ deal/ understand the disease and it's processes like group counseling, extensive 1:1 therapy and support from family and friends. There are many medications that can help relive sx to the disease but don't fool yourself that they can cure you.
Delila
19 Aug 2016
I don't see where anyone has mentioned a "cure" for PTSD, neither have the side effects of Quetiapine been likened to Prazosin? In fact the opposite was implied. Also, Quetiapine is used for more conditions than you have mentioned, & is not a lone depression cure. I was neglectful in saying it was a similar medication & should instead have focused on the similar conditions it can be used to treat
Inactive
19 Aug 2010
Good morning,
Post-Traumatic Stress Disorder (PTSD), your body may release too much adrenaline. Adrenaline is a hormone that can make you feel stressed and have nightmares.
Prazosin blocks some of the effects of adrenaline released in your body. This may help reduce the nightmares and sleep problems you have with PTSD.
By keeping you from having nightmares, prazosin may help you get better sleep. With better sleep, you can feel healthier and more alert. This may help lower your stress and help you feel more in control of your life.
Research shows that prazosin may help reduce nightmares, one of the symptoms of PTSD.1 More research is needed to confirm its effectiveness for treating PTSD.
Side effects include:
Low blood pressure (hypotension).
A slow heart rate (bradycardia).
A cough or wheezing, which means the airways that carry air to the lungs are narrowing (bronchospasm).
Thinking and acting more slowly.
Stuffy nose, headache, and swelling in the legs. These are rare side effects.
Since prazosin is more commonly used for high blood pressure, your doctor may want to look into its benefits vs. side effects for PTSD.
Prazosin may help reduce your nightmares, but it is not a cure for PTSD. Nightmares and anxiety may come back if you stop taking your medicine.
Prazosin lowers blood pressure (hypotension), which can make you feel dizzy. This usually stops when your body is used to prazosin. Be careful not to stand up too fast, especially if your dose has just been changed.
Erection drugs like Viagra also can lower your blood pressure. If you're taking erection drugs along with prazosin, your blood pressure may drop very fast. Tell your doctor if you're taking drugs for erection problems.
Prazosin can be taken safely with other PTSD medicines, such as antidepressants, but not with trazodone. Taking prazosin with trazodone can cause the rare side effect of priapism. This is an erection that doesn't go away, which can cause serious health problems.
Mainly it is not being prescribed because it is a drug meant to lower blood pressure by relaxing blood vessels and also due to side effects.
But it´s mechanism of action has proven to be effective on PTSD.
I aslo suffer from PTSD.
I hope I have been of help, take care.
prescottsmith
27 Oct 2010
What is a typical range of dosage for Prazosin when used for PTSD?
I am a 5'4" 140 lb. woman.
Thanks
Inactive
27 Oct 2010
Commonly this medication is for CPTSD (Combat Post Traumatic Stress Diosrder), you need to know this. But it can also be effective in the treatment of PTSD.
Prazosin can occasionally cause sudden fainting after the first dose and anytime that your dose is increased. To reduce your risk of fainting, the first dose prescribed by your Doctor will be the smallest dose available. And for this reason you must talk to your Doctor to start a safe treatment for you.
I can not tell you what dose you must take, as I am not a Doctor, every organism reacts in a different way to medications, therefore a dose that might be right for someone else may not be the adecuate one for you, we are all unique, but again I am not a DOCTOR nor pretend to be one. All this must be discussed with a proffesional, your Doctor.
Please make and appoinment with your DOCTOR and discuss this further, never self medicate.
All the best and take care.
prescottsmith
29 Oct 2010
Thanks, Actually it is helping with my PTSD sx. In addition I take it
for severe diaphoresis. It is that dosage that my doctor and I are
titrating regarding effectiveness - just wondered what dosage experiences
others were having. Again, thanks
Jocebeth
17 Sep 2016
I've had nightmares ever since I can remember way back to when I was like 4 or 5 yrs old I had the every night I ended up in my mother's bed until I was about 13 now, think for a minute n try and remember the scariest movie you have ever seen, now picture yourself in that movie, every, single, night... I don't have words to describe my feelings about my dreams, they've never been good ones... until I started taking prasozin. I am 37 now, I've been on it for about a year and guess what ? It works!!! I'm on 2mg in the morning and 3 my at nights I only wish a medication like this was around when I was growing up because of bad dreams I've never got r.e.m. I would wake up n feel like I never sleep but now my night mares are basically gone
Jocebeth
17 Sep 2016
I've had nightmares ever since I can remember way back to when I was like 4 or 5 yrs old I had the every night I ended up in my mother's bed until I was about 13 now, think for a minute n try and remember the scariest movie you have ever seen, now picture yourself in that movie, every, single, night... I don't have words to describe my feelings about my dreams, they've never been good ones... until I started taking prasozin. I am 37 now, I've been on it for about a year and guess what ? It works!!! I'm on 2mg in the morning and 3 my at nights I only wish a medication like this was around when I was growing up because of bad dreams I've never got r.e.m. I would wake up n feel like I never sleep but now my night mares are basically gone
Inertj
19 July 2017
Whoever The "anonymous" writer was who said that CPTSD was "combat" PTSD is absolutely INCORRECT!
C- PTSD is "complex" PTSD. Further it has nothing to do with combat whatsoever, it has to do with abuse by people who raised you or abuse that occurred with people you've been in a long term relationship with. Look it up, it's not that hard.
That "anonymous" person goes on to state emphatically to 'talk to your doctor' which is unhelpful - at the very least in this type of forum.
Please stop giving blatantly incorrect information.
Cheers
jjphoto1010
27 Nov 2017
C-PTSD is actually complex post-traumatic stress disorder, also known as complex trauma disorder. There is a combat PTSD, however it is known as combat PTSD.
I am being treated for C-PTSD and currently take Prazosin. It works very well at reducing my nightmares and I am very grateful!
campbell765
5 April 2018
My doctor just prescribed this for anxiety and PTSD or nightmares and help with sleeping. The dizzy part is what is unsure but I dont have high blood pressure 3mg is all I am prescribed at the moment curious to see how well it works my doctor spoke highly of it I know it cant cure PTSD but if it helps it is worth it. Thanks for your explanation. Which is what my doctor said it does. Will it help with better blood circulation? my hands and feet are always cold.
Trish99
14 May 2018
The “C” in C-PTSD stands for complex or chronic... not combat.
Itahbee0216
21 July 2018
I was on prazosin 1mg, and the first night i took it, was the last time i had a night terror. The second night, gone... i totally agree. This medication should be given to those with ptsd that do not fall in the catagory of any side effects.
Start #ScreamForProzosinForPTSD
Itahbee0216
21 July 2018
I am 5"4 130lbs, and they started me on 1mg. Worked like a charm.
Related topics
post traumatic stress disorder, anxiety, generalized anxiety disorder, prazosin, raynaud's syndrome
Further information
- Prazosin uses and safety info
- Prazosin prescribing info & package insert (for Health Professionals)
- Side effects of Prazosin (detailed)
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