Minipress (prazosin), a drug commonly used to treathigh blood pressureandurinary retention, has been shown in some studies to be safe and effective in managingnightmaresand sleep disturbances in people withpost-traumatic stress disorder (PTSD).
Minipress appears to block the responsiveness ofnorepinephrine, a chemical that triggers the body’s “fight or flight” response to real and perceived threats.By doing so, people with PTSD may enjoy fewer nightmares.
Minipress does not seem to have any effect in reducing nightmares in people without PTSD.
This article explains the causes of nightmares in people with PTSD and how Minipress can help. It also takes a look at the evidence supporting the claims and lists the possible risks and side effects of this off-label PTSD drug.
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How Common Is PTSD?
Historically, only veterans coming home from combat were diagnosed with PTSD. Now, clinicians recognize patients who experience other types of traumatic events can also suffer from this debilitating mental condition.
Women are more than twice as likely as men to develop PTSD after experiencing or witnessing a traumatic event.Aside from the triggering event, a diagnosis of PTSD requires symptoms in each of five categories:
How Prazosin Works to Treat Nightmares
Prazosin blocks responsiveness to norepinephrine, a stress hormone that affects your brain, at specialized chemical receptors called alpha-1 receptors. Receptors are the sites where cells transmit messages to each other.It is not clear how this specifically impactssleepor dreams.
Understanding Nightmare Disorder
Other Therapeutic Uses
Clinical studies show prazosin might offer other therapeutic benefits to PTSD patients, but the results are mixed. One study suggested that taking prazosin:
Who Should Not Use Prazosin
If you have previously had adverse reactions to this or similar medications, don’t take prazosin.
Prazosin isn’t usually prescribed to those over age 65.
People in the following groups should use prazosin with caution. Be sure to tell your healthcare provider if any of the following apply to you:
Common Side Effects
Prazosin can cause side effects. In clinical trials, these included:
Additional side effects of prazosin that occur in 1–4% of patients include:
Safety Precautions
As described above, certain people should use prazosin with caution or not at all. The safety of its use while pregnant or breastfeeding is not known, so these populations should use caution. It may also be important to monitor your blood pressure with prazosin use so that it does not become too low and cause fainting or falls.
A Word From Verywell
If you experience any difficulties, you should be in close contact with your primary healthcare provider. PTSD is a serious condition and it deserves treatment. Don’t suffer in silence: reach out to get the help that you need to sleep more normally. If you suffer from depression or experience thoughts of suicide, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor. If you or a loved one are in immediate danger, call911.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Koola MM, Varghese SP, Fawcett JA.High-dose prazosin for the treatment of post-traumatic stress disorder.Ther Adv Psychopharmacol. 2014;4(1):43–47. doi:10.1177/2045125313500982Brittanica.Norepinephrine.Stein MB, Rothbaum BO.175 Years of progress in PTSD therapeutics: learning from the past.Am J Psychiatry. 2018;175(6):508-516. doi:10.1176/appi.ajp.2017.17080955Diamond PR, Airdrie JN, Hiller R, et al.Change in prevalence of post-traumatic stress disorder in the two years following trauma: a meta-analytic study.European Journal of Psychotraumatology. 2022;13(1):2066456. doi:10.1080/20008198.2022.2066456U.S. Department of Veterans Affairs.PTSD: National Center for PTSD.Department of Veterans Affairs, National Center for PTSD.PTSD andDSM-5.Perez DM.Α1-adrenergic receptors in neurotransmission, synaptic plasticity, and cognition.Front Pharmacol. 2020;11:581098. doi:10.3389/fphar.2020.581098National Library of Medicine: MedlinePlus.Prazosin.National Library of Medicine: DailyMed.Minipress—prazosin hydrochloride capsule[drug label].
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Koola MM, Varghese SP, Fawcett JA.High-dose prazosin for the treatment of post-traumatic stress disorder.Ther Adv Psychopharmacol. 2014;4(1):43–47. doi:10.1177/2045125313500982Brittanica.Norepinephrine.Stein MB, Rothbaum BO.175 Years of progress in PTSD therapeutics: learning from the past.Am J Psychiatry. 2018;175(6):508-516. doi:10.1176/appi.ajp.2017.17080955Diamond PR, Airdrie JN, Hiller R, et al.Change in prevalence of post-traumatic stress disorder in the two years following trauma: a meta-analytic study.European Journal of Psychotraumatology. 2022;13(1):2066456. doi:10.1080/20008198.2022.2066456U.S. Department of Veterans Affairs.PTSD: National Center for PTSD.Department of Veterans Affairs, National Center for PTSD.PTSD andDSM-5.Perez DM.Α1-adrenergic receptors in neurotransmission, synaptic plasticity, and cognition.Front Pharmacol. 2020;11:581098. doi:10.3389/fphar.2020.581098National Library of Medicine: MedlinePlus.Prazosin.National Library of Medicine: DailyMed.Minipress—prazosin hydrochloride capsule[drug label].
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Koola MM, Varghese SP, Fawcett JA.High-dose prazosin for the treatment of post-traumatic stress disorder.Ther Adv Psychopharmacol. 2014;4(1):43–47. doi:10.1177/2045125313500982Brittanica.Norepinephrine.Stein MB, Rothbaum BO.175 Years of progress in PTSD therapeutics: learning from the past.Am J Psychiatry. 2018;175(6):508-516. doi:10.1176/appi.ajp.2017.17080955Diamond PR, Airdrie JN, Hiller R, et al.Change in prevalence of post-traumatic stress disorder in the two years following trauma: a meta-analytic study.European Journal of Psychotraumatology. 2022;13(1):2066456. doi:10.1080/20008198.2022.2066456U.S. Department of Veterans Affairs.PTSD: National Center for PTSD.Department of Veterans Affairs, National Center for PTSD.PTSD andDSM-5.Perez DM.Α1-adrenergic receptors in neurotransmission, synaptic plasticity, and cognition.Front Pharmacol. 2020;11:581098. doi:10.3389/fphar.2020.581098National Library of Medicine: MedlinePlus.Prazosin.National Library of Medicine: DailyMed.Minipress—prazosin hydrochloride capsule[drug label].
Koola MM, Varghese SP, Fawcett JA.High-dose prazosin for the treatment of post-traumatic stress disorder.Ther Adv Psychopharmacol. 2014;4(1):43–47. doi:10.1177/2045125313500982
Brittanica.Norepinephrine.
Stein MB, Rothbaum BO.175 Years of progress in PTSD therapeutics: learning from the past.Am J Psychiatry. 2018;175(6):508-516. doi:10.1176/appi.ajp.2017.17080955
Diamond PR, Airdrie JN, Hiller R, et al.Change in prevalence of post-traumatic stress disorder in the two years following trauma: a meta-analytic study.European Journal of Psychotraumatology. 2022;13(1):2066456. doi:10.1080/20008198.2022.2066456
U.S. Department of Veterans Affairs.PTSD: National Center for PTSD.
Department of Veterans Affairs, National Center for PTSD.PTSD andDSM-5.
Perez DM.Α1-adrenergic receptors in neurotransmission, synaptic plasticity, and cognition.Front Pharmacol. 2020;11:581098. doi:10.3389/fphar.2020.581098
National Library of Medicine: MedlinePlus.Prazosin.
National Library of Medicine: DailyMed.Minipress—prazosin hydrochloride capsule[drug label].
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