Posttraumatic stress disorder-associated nightmares in adults and young people
Recurrent nightmares featuring a repeated story are commonly associated with posttraumatic stress disorder (PTSD). Treatment may include psychosocial interventions such as imagery rehearsal therapy or cognitive behavioural therapy.
Prazosin has been used to improve PTSD–associated nightmares and sleep disturbance, but evidence is conflicting. If prazosin is considered appropriate for PTSD–associated nightmares, a suitable regimen is:
prazosin 1 mg orally, at night for 2 days, then increase to 2 mg at night. Assess the patient’s response to therapy after 1 week to determine whether dose adjustment is needed. If it is, increase by 1 to 2 mg every week as tolerated. A dose between 3 and 15 mg at night is usually required. posttraumatic stress disorder–associated nightmares prazosin prazosin prazosin
Other drugs with limited evidence for PTSD–associated nightmares include clonidine, olanzapine, risperidone, aripiprazole, cyproheptadine, fluvoxamine, gabapentin, phenelzine, topiramate and tricyclic antidepressants. These drugs may be trialled by a psychiatrist.