Question: In adults with posttraumatic stress disorder, how effective is prazosin adjunct to psychotherapy (particularly eye movement desensitisation reprocessing), compared to any pharmacological and psychological combination, in reducing trauma related nightmares?


No definite clinical implications can be made from the available evidence. Neither of the papers included in this BEST summary specifically evaluated prazosin as an adjunct to psychotherapy. One systematic review reported that, based on a small evidence base, prozosin can reduce the severity and frequency of nightmares associated with post-traumatic stress disorder. Positive results were also reported in a recent randomised control trial which compared prazosin with placebo. The authors have consistently suggested that more studies are needed to replicate these findings in other settings and patient populations. The authors of the randomised controlled trial also suggested that studies combining prazosin with effective psychotherapies are needed to evaluate if even larger improvements can be made.

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