{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:39:04Z","timestamp":1791380344447,"version":"4.3.3"},"reference-count":22,"publisher":"MedWorks Media","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychopharmacol Bull"],"abstract":"<jats:p>Objectives:\nOff-label use of prazosin for posttraumatic stress disorder-related sleep disturbances (PTSD-SD) is widespread in Veterans Health Administration (VA) settings, but clinical trials have had mixed results. Trial criteria may exclude significant sub-groups, and therefore a 2018 study may not provide the final evidence of prazosin efficacy for PTSD-SD. This study analyzed correlates of prazosin use in Vietnam era (VNE) and Operations Enduring Freedom\/Iraqi Freedom (OEF\/OIF) cohorts to illustrate patterns of usage in this heterogeneous population.\nMethod:\nData extracted on patients with PTSD-SD prescribed prazosin in 2015 described the proportion of days covered (PDC) \u2265 80% and daily dose \u2265 6 mg (therapeutic target dose) over the next 12 months.\nResults:\nBoth VNE (n = 41,365) and OEF\/OIF (n = 62,984) cohorts had high rates of comorbidity (N = 104,349; 46% hypertension, 22% alcohol use disorder, 14% drug use disorder). Adherence and dosing were low: 19% of veterans achieved PDC \u2265 80%; 7% achieved \u2265 6mg\/day (average 2.6 mg\/day). In covariate-adjusted models, VNE veterans had better adherence, VNE women had lower rates of therapeutic dosing, and minority race\/ethnicity was a strong risk factor for non-adherence. PDC correlated inversely with alcohol\/drug disorders.\nConclusion:\nPrazosin is prescribed for PTSD-SD to a diverse clinical population with multiple comorbidities and concurrent medications and is characterized by poor adherence and sub-optimal dosing. Future work should clarify the efficacy of prazosin for subgroups of veterans with PTSD-SD, notably women and racial\/ethnic minorities.<\/jats:p>","DOI":"10.64719\/pb.4605","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T11:23:34Z","timestamp":1761045814000},"page":"26-35","source":"Crossref","is-referenced-by-count":0,"title":["Demographic Variation in the Use of Prazosin for Treatment of Sleep Disturbance in Combat Veterans with PTSD"],"prefix":"10.64719","volume":"50","author":[{"given":"Miriam L.","family":"Rubin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurel A.","family":"Copeland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimee R.","family":"Kroll-Desrosiers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice G.","family":"Knittel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54175","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Nappi CM, Drummond SP, Hall JM. 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