{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T08:10:47Z","timestamp":1778227847202,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Australas Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To provide a clinical update on the treatment of night-time symptoms of posttraumatic stress disorder (PTSD) with prazosin, which is a centrally acting alpha-1 adrenergic receptor antagonist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a narrative review of the relevant literature and Clinical Practice Guidelines pertaining to treatment of trauma-related nightmares and insomnia with prazosin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There is a high degree of heterogeneity among the limited clinical trials to date. However, the most recent systematic review and meta-analysis supports the use of prazosin for suitable patients with PTSD-related nightmares and insomnia. Prazosin is generally well tolerated but patients may experience first-dose hypotension, orthostatic hypotension, or syncope among other side effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although the evidence is very mixed, prazosin may be considered for a targeted time-limited trial in patients whose PTSD is dominated by nightmares and insomnia, who are unresponsive to first-line treatment with trauma-focused psychotherapy and\/or evidence-based pharmacotherapies such as antidepressants, and after excluding treatable conditions like obstructive sleep apnoea. The trial should ensure that an adequate dose is used for an adequate duration (if tolerated) with monitoring of blood pressure and any emergent side effects as well as sleep-targeted benefits.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10398562261448412","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T04:08:19Z","timestamp":1778040499000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical update on the use of prazosin for night-time symptoms of PTSD"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5002-9918","authenticated-orcid":false,"given":"Paul A.","family":"Maguire","sequence":"first","affiliation":[{"name":"The Australian National University School of Medicine and Psychology"},{"name":"Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6931-2913","authenticated-orcid":false,"given":"Tarun","family":"Bastiampillai","sequence":"additional","affiliation":[{"name":"Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA)"},{"name":"Flinders University"},{"name":"Monash University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9264-5310","authenticated-orcid":false,"given":"Stephen","family":"Allison","sequence":"additional","affiliation":[{"name":"Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA)"},{"name":"Flinders University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona","family":"Wilkes","sequence":"additional","affiliation":[{"name":"The Australian National University School of Medicine and Psychology"},{"name":"Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3351-6911","authenticated-orcid":false,"given":"Jeffrey C. L.","family":"Looi","sequence":"additional","affiliation":[{"name":"Consortium of Australian-Academic Psychiatrists for Independent Policy and Research Analysis (CAPIPRA)"},{"name":"The Australian National University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-023-04716-w"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2019.20476"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.04.007"},{"key":"e_1_3_5_5_2","volume-title":"Statistics ABo. National study of mental health and wellbeing","year":"2022","unstructured":"Statistics ABo. National study of mental health and wellbeing. ABS 2022."},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/comp.2000.16568"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-015-0587-8"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11020415"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.27883"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.7178"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2015.10.007"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2019.06.010"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2025.111253"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1507598"},{"key":"e_1_3_5_15_2","unstructured":"American Psychological Association. APA clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. https:\/\/www.apa.org\/about\/policy\/guideline-ptsd-in-adults.pdf (2025 accessed 30 September 2025)."},{"key":"e_1_3_5_16_2","volume-title":"Australian guidelines for the treatment of acute stress disorder, posttraumatic stress disorder, and complex PTSD","author":"Lethbridge R","year":"2020","unstructured":"Lethbridge R, Australia P. Australian guidelines for the treatment of acute stress disorder, posttraumatic stress disorder, and complex PTSD, 2020."},{"key":"e_1_3_5_17_2","unstructured":"Therapeutic Guidelines. Melbourne: therapeutic guidelines limited. https:\/\/www.tg.org.au (2025 accessed 30 September 2025)."},{"key":"e_1_3_5_18_2","volume-title":"The maudsley prescribing guidelines in psychiatry","author":"Taylor DM","year":"2025","unstructured":"Taylor DM, Barnes TR, Young AH. The maudsley prescribing guidelines in psychiatry. John Wiley & Sons, 2025."},{"key":"e_1_3_5_19_2","unstructured":"Guideline NG116 N. Post-traumatic stress disorder. https:\/\/opis-cdn.tinkoffjournal.ru\/mercury\/emdr-pdf-01.pdf (2018 accessed 30 September 2025)."},{"key":"e_1_3_5_20_2","unstructured":"US Department of Veterans Affairs and Department of Defense. VA\/DoD clinical practice guideline for management of posttraumatic stress disorder and acute stress disorder. https:\/\/www.healthquality.va._gov\/guidelines\/MH\/ptsd\/VA-DoD-CPG-PTSD-FullCPGAug242023.pdf (2023 accessed 30 September 2025)."},{"key":"e_1_3_5_21_2","volume-title":"Prazosin for PTSD-related nightmares (Guidelines)","author":"TAM (Treatments and Medicines) NHS Highland","year":"2025","unstructured":"TAM (Treatments and Medicines) NHS Highland. Prazosin for PTSD-related nightmares (Guidelines), 2025. https:\/\/rightdecisions.scot.nhs.uk\/tam-treatments-and-medicines-nhs-highland\/adult-therapeutic-guidelines\/mental-health\/prazosin-for-ptsd-related-nightmares-guidelines\/ (accessed 30 September 2025)."},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/jcpt.13274"}],"container-title":["Australasian Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10398562261448412","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10398562261448412","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10398562261448412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T07:18:39Z","timestamp":1778224719000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10398562261448412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,5]]},"references-count":21,"alternative-id":["10.1177\/10398562261448412"],"URL":"https:\/\/doi.org\/10.1177\/10398562261448412","relation":{},"ISSN":["1039-8562","1440-1665"],"issn-type":[{"value":"1039-8562","type":"print"},{"value":"1440-1665","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,5]]},"article-number":"10398562261448412"}}