Abstract
Prazosin is a generically available central nervous system (CNS) active alpha-1 adrenoreceptor antagonist that has been demonstrated effective in randomized controlled trials (RCTs) for posttraumatic stress disorder (PTSD) trauma nightmares, distressed awakenings, daytime hyperarousal symptoms, and global clinical function. The contribution of increased CNS noradrenergic activity to PTSD pathophysiology and the involvement of the postsynaptic alpha-1 adrenoreceptor in brain systems relevant to PTSD symptomatology provide neurobiologic rationale for prazosin as a PTSD pharmacotherapeutic. This article reviews the clinical observations that led to the development of prazosin therapy for PTSD in combat veterans and the subsequent RCTs that demonstrated prazosin efficacy.
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