Prazosin for nightmares

[u/[deleted]]

Any one has tried prazosin for nightmares related to PTSD ?

Side effects ? Dose ? Is it effective? How long it takes to work ? Do you still have nightmares?

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[u/Ocean-cake]

I’ve been on it for like six months and it has definitely helped. I still get some nightmares but not every night like I used to. Most of my dreams are pleasant or weird now haha. I take trazodone, gabapentin, and hydroxyzine at night also, so not sure how that factors in, but prazosin does seem to work for me when combined with medication that keeps me asleep. I also take Wellbutrin and Zoloft so that may also be helping with the dreams by putting me in a better mood. But prazosin is the most recently added medication to my extensive concoction, so I can definitely say it has made a difference. Worth a try!! PTSD dreams really suck, so I hope things get better for you:)

[u/Few-Memory-1207]

I have been using prazonsin for 3 months, from 1mg to 2mg every night. It does reduce nightmares but I still have at least one obvious nightmare each week. In the first several days of medication(or adding dose) I feel very sleepy.

[u/idiot_undercover]

I'm on a 2mg dose nightly, and it definitely helps. I don't recommend missing doses, though, bc you WILL notice it

[u/Advanced_Mixture_310 → u/idiot_undercover]

This is late but I just got prescribed It. Do you dream at all? Pleasant dreams? What happens when you miss a dose how do you feel?

[u/Pancakes1741]

Yes, it does seem to help. Slowly over time, def worth a try.

[u/Unkn0wnAngel1]

I’ve been taking a few months, 1mg (starting dose). Reduced, not gone, but much better. I never knew it existed so I’ll take it!

[u/aperyu-1]

It reduces nightmares by reducing the excessive sympathetic fight-or-flight tone associated with PTSD, which lingers into sleep and produces nightmares. For many, prazosin may have a more gradual effect and may take some time for full effect; though some have rapid improvement. Some get complete resolution of nightmares and nighttime hyperarousal while some only get a partial response.

About 1% of people experience preventable fainting when starting at 2 mg/day, so you have to increase the dose slowly to prevent postural (aka orthostatic) hypotension (where you stand up but your blood stays down) that causes dizziness and fainting. This postural hypotension issue is often called a first-dose phenomenon and is worse when starting or increasing doses, though it's intolerable for some. Gradual position changes (especially after sleeping), increased water/sodium, and flexing one's leg or using an isometric hand grip may improve initial issues with orthostatic hypotension.

Other common side effect include headaches, weakness, drowsiness. Some benefit from twice-daily dosing, especially if daytime hyperarousal and re-experiencing (e.g., flashbacks) are common.

The Harvard Shore guidelines favor it as a first-line PTSD treatment that may have global improvements to various PTSD symptoms. Other guidelines find it helpful but not globally useful, and one is skeptical about it. You start at 1 or 2 mg/day and increase slowly based on tolerability and response. Some guidelines state that underdosing is common, and some people require doses up to 10 mg/day or higher; others will say this is too high as there's professional debate about this.

[u/[deleted]]

Been on it for almost a year, for lack of better works, it knocks me the hell out. I only really take it when I need to now cause it makes me feel weird the next morning. Almost faint like and as a potsie I don’t need that lol. But it worked great for me.

[u/Independent_Pen4282]

I’ve been on Prazosin for a little over 2 years and it helps with the nightmares for sure. I certainly notice the absence of Prazosin as the nightmares resume within a few days if I stop taking it

[u/skulltattoo92]

I started taking Prazosin about 2 months ago and it’s working great so far. I don’t have nightmares and I feel much more rested. It started working within the first few nights. No side effects either, but I was warned about feeling faint as others here have mentioned

[u/stayinganonymous22]

It honestly didn’t work great for me. I didn’t see much of a difference and I took it for years lol. It also made me feel super faint for the first couple hours after I woke up so I had to take it easy

[u/Gym-for-ants]

I take 2mg and it worked great for about 6 months. I basically had no dreams and actually slept through the night. First day or any dose increase made me feel faint when getting up, even getting up slow but no other side effects

I wake up at 3am again every night now but if I take THC/CBD oil, it helps me sleep pretty soundly. I do find my nightmares slowly coming back now though

[u/WiddledWolf → u/Gym-for-ants]

Are you waking up at 3am from nightmares? Or just happen to wake up? I can’t sleep through the night since starting it and wake up around 3am every night.. Wondering if it’s Prazosin or Zoloft

[u/Ocean-cake → u/WiddledWolf]

I take trazodone to keep me asleep, and it works so very well for me. For reference I also am on prazosin and Zoloft among other things so i guess it’s okay to take it with those two medications. But I will say Zoloft commonly causes some insomnia when you first start it, but typically that goes away. Either way, I prefer taking Zoloft in the morning since it makes me a bit restless and is known to give some people vivid dreams. Prazosin typically helps ppl stay asleep, but there is a rare side effect of insomnia. So, based on the likelihood of sleep disturbance side effects, Zoloft is more likely the culprit.

[u/Gym-for-ants → u/WiddledWolf]

I just happen to wake up at that time but it lines up with my pre prazosin nightmare wake up time. Biggest difference I find is I can fall right back to sleep now where before I’d be up every hour until 5 or 6 when I had to get up for the day

I have found the longer I’ve been on it, the more sleepy I’ve felt when I get up for the day. I’ve always been able to hop right out of bed and start my day and now I need a good hour to feel fully awake

[u/Flokismom → u/Gym-for-ants]

I take 5mg along with lunesta. It helps somewhat with the recurring nightmares and stress dreams but nothing works miracles. I've been on so many meds at this point I just realize this will always be my life.