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In six controlled, short-term trials, the alpha-1 adrenoceptor antagonist prazosin modestly reduced adrenergically driven overarousal and nightmares and improved sleep in about 280 mostly military veterans with post-traumatic stress disorder (PTSD). Now, in a 26-week, multisite, double-blind, Veterans Affairs clinical trial, researchers have randomized 304 military veterans with combat-related nightmares and a score of ≥50 (of 136 points) on the Clinician-Administered PTSD Scale to increasing doses of prazosin (mean maintenance dose, 14.8 mg) or to placebo.
Enrollees did not have substance dependence, active suicidal ideation, or psychosocial instability. They also had not undergone cognitive-behavioral therapy recently; 78% were taking anti…