Sleep Disorders Treatment Minipress (Prazosin) for Stress Nightmares in PTSD By Brandon Peters, MD facebook twitter Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist. Learn about our editorial process Brandon Peters, MD Medically reviewed by Medically reviewed by Sanja Jelic, MD on July 23, 2020 Sanja Jelic, MD is board-certified in pulmonary disease, sleep medicine, critical care medicine, and internal medicine. She is an assistant professor and attending physician at Columbia University College of Physicians and Surgeons in New York, NY. Learn about our Medical Review Board Sanja Jelic, MD on July 23, 2020 Print Physicians prescribe prazosin, sold under the brand name of Minipress, to treat nightmares for post-traumatic stress disorder (PTSD). Oddly enough, this medication does not seem to be effective in patients with non-PTSD nightmares. Peter Glass / Getty Images How Common PTSD Is Historically, only veterans coming home from combat were diagnosed with PTSD. Now, clinicians recognize patients who experience other types of traumatic events can also suffer from this debilitating mental condition. About 8 percent of men and 20 percent of women who experience a traumatic event themselves or watch one happen as a non-participant get PTSD. Aside from the triggering event, you must also develop four general symptoms to receive a diagnosis: Re-experiencing the event even though it's over Avoiding reminders of the trauma, including people, places, and objects Negative changes in your mood and thoughts associated with the triggering event Chronic hyperarousal symptoms, which make you feel stressed and angry How Prazosin Works to Treat Nightmares Prazosin blocks norepinephrine, a stress hormone that affects your brain, at specialized chemical receptors called alpha-1 receptors. Receptors are the sites where cells transmit messages to each other. It is not clear how this specifically impacts sleep or dreams. Other Therapeutic Uses Clinical studies show prazosin might offer other therapeutic benefits to PTSD patients, but the results are mixed. Taking prazosin: Significantly reduced daytime PTSD symptoms when military personnel already taking it took it in the daytime too. Has a significant beneficial effect on alcohol cravings for participants who were alcohol dependent and trying to stop drinking. This is important when you consider the number of PTSD patients who turn to alcohol for comfort and end up with an alcohol use disorder. Who Should Not Use Prazosin There are only a few circumstances where you should not take prazosin or use with caution: If you have previously had adverse reactions to this or similar medications, don't take prazosin. If you've had cataract surgery, take prazosin with caution. Of course, your physician can help you determine whether these circumstances apply to your case. Common Side Effects Prazosin can cause side effects, including: Drowsiness, in 8 percent of patients Lack of energy, in 7 percent of patients Weakness, in 7 percent of patients Dizziness, in 10 percent of patients, and nausea in 5 percent of patients Palpitations (irregular heartbeats), in 5 percent of patients Headache, in 8 percent of patients Side effects of prazosin that occur in 1 to 4 percent of patients include: Vomiting Diarrhea and/or constipation Orthostatic hypotension (a form of low blood pressure triggered by standing up from a seated position too quickly) Depression Nasal congestion Fainting Safety Precautions As described above, certain people should use prazosin with caution or not at all. The safety of its use while pregnant or breastfeeding is not known, so use caution. It may be important to monitor your blood pressure with its use so that it does not become too low and cause fainting or falls. A Word From Verywell If you experience any difficulties, you should be in close contact with your primary healthcare provider. PTSD is a serious condition and it deserves treatment. Don't suffer in silence: reach out to get the help that you need to sleep more normally. If you suffer from depression and experience thoughts of suicide, reach out for help by calling the toll-free suicide prevention lifeline at 1-800-273-8255. Was this page helpful? Thanks for your feedback! Tossing and turning night over night can have a big impact on your quality of life. Our free guide can help you get the rest you need. Sign up for our newsletter and get it free. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Meredith LS, Eisenman DP, Green BL, Basurto-Dávila R, Cassells A, Tobin J. System factors affect the recognition and management of posttraumatic stress disorder by primary care clinicians. Med Care. 2009;47(6):686–694. doi:10.1097/MLR.0b013e318190db5d Iribarren J, Prolo P, Neagos N, Chiappelli F. Post-traumatic stress disorder: evidence-based research for the third millennium. Evid Based Complement Alternat Med. 2005;2(4):503–512. doi:10.1093/ecam/neh127 Bisson JI, Cosgrove S, Lewis C, Robert NP. Post-traumatic stress disorder. BMJ. 2015;351:h6161. doi:10.1136/bmj.h6161 Koola MM, Varghese SP, Fawcett JA. High-dose prazosin for the treatment of post-traumatic stress disorder. Ther Adv Psychopharmacol. 2014;4(1):43–47. doi:10.1177/2045125313500982 Prazosin. MedlinePlus [internet]. 2018. Suicide Prevention Lifeline Additional Reading "Prazosin." Epocrates Rx Pro. Version 16.3, 2016. Epocrates, Inc. San Mateo, California. Jeffrys, Matt, MD. U.S. Department of Veterans Affairs: Clinician's Guide to Medications for PTSD. Koola MM, Varghese SP, Fawcett JA. High-Dose Prazosin for the Treatment of Post-Traumatic Stress Disorder. Ther Adv Psychopharmacol. 2014;4(1):43-7. doi: 10.1177/2045125313500982.