Case series: Continued remission of PTSD symptoms after discontinuation of prazosin

Front Psychiatry. 2023 Apr 21:14:1172754. doi: 10.3389/fpsyt.2023.1172754. eCollection 2023.

Abstract

Post-traumatic stress disorder is a debilitating chronic illness that affects 6 out of 100 adults after a severe trauma. The alpha-adrenergic antagonist prazosin, which is prescribed off-label for flashbacks and nightmares due to trauma, is often continued indefinitely due to reports of symptoms returning upon discontinuation. There is no standard guidance for a trial of discontinuation of prazosin due to intolerance or side effects. In this case series, three patients are started on prazosin leading to remission of trauma-related symptoms, and symptoms continue to remit after treatment for an average of about 2 years followed by discontinuation of the medication. There are many similarities in these case reports which serve to provide guidance as to when a trial of prazosin discontinuation may be warranted.

Keywords: flashbacks; nightmares; post-traumatic stress disorder; prazosin; psychopharmacology; trauma.

Publication types

  • Case Reports