What do your dreams look like after prazosin?
May 10, 2012 7:04 PM   Subscribe

PTSD and nightmares. How does prazosin actually help you?

I'm newly labelled as having PTSD and the shrink gave me prazosin to help with the non stop nightmares I've been having lately. I understand that it blocks adrenaline but want to know how exactly it has affected your dreams if you are taking it.

I work out a lot of healing through my dreams (No snarky comments on that please. I've had a 12 year search to find the right type of therapy that allows me to actually talk about the trauma and, yes, it involves Jung and dream work). I don't want to suppress that harshly.

Also I'm worried that it will make the nightmares worse as, of course, that is the only first hand experiences that rise up on a Google search.

So if you've taken this for PTSD did you notice a complete lack of nightmares? All dreams? Do you still have nightmares but the flashback emotions are lessened? Did it help at all? Basically what do your dreams look like after taking prazosin and how long did it take to kick in if you found it helpful?

I'm supposed to work my way up to 4mg at night once I start if that matters any.
posted by kanata to Health & Fitness (10 answers total) 4 users marked this as a favorite
Hi kanata,
I have never taken this drug, so I am not qualified to answer your stated questions. I am only posting because so far you have no replies. I hope that changes. But I thought I would let you know I have recovered from some tough things myself, I have known people with PTSD and helped some of them cope, and I used to have terrible sleep problems, including nightmares so severe I was afraid to sleep. You are welcome to write me.

I will state briefly that a lot of drugs suppress dream function, like alcohol. Then when you come off them, you typically have worse nightmares for a time. There are nutritional things that can be done to help support a healthy chemical waking and sleeping cycle for the brain.

Best of luck.
posted by Michele in California at 10:24 PM on May 10, 2012

I looked up Prazosin (handy medical textbook), and it says that it is used to lower blood pressure (it's an alpha blocker). IANYD, L, or Pharm, but it does not seem to have any actual uses for PTSD, even off label uses. For what it's worth, I agree with the poster above. Sorry I couldn't be of more use.
posted by Sucht at 11:09 PM on May 10, 2012

Hi! Prazosin does have uses for PTSD, don't freak out. The VA recently discovered this because a bunch of vets they prescribed them to for blood pressure came back and said "Hey, thanks for fixing my nightmares." It is one

Prazosin does not make the nightmares worse. The initial dose they gave should also be small, if memory serves, and is mostly to make sure you can handle it without getting dizzy.

Low doses should not eliminate dreams, but may reduce the frequency of PTSD dreams or other scary dreams.
posted by corb at 4:46 AM on May 11, 2012

I know this is not specific to your medication, but is related. This talks about propranolol, a beta blocker. They are experimenting with the idea of having a patient take this drug, which decreases the stress response, and talk through their traumatic experience.

The theory is that if they can dissociate a physical stress response from the memory in a controlled setting, subsequent recall of the memory will no longer elicit the stress response. It's essentially breaking the connection between memory and panic.
posted by sarae at 5:11 AM on May 11, 2012 [1 favorite]

Sorry, I should have been more clear. I'm not suggesting you change your medication or anything, or suggesting this treatment will work for you.

Alpha and beta blockers are both used to lower blood pressure. I was thinking that the prazosin may be used to block the adrenaline (stress) response while you sleep (and have nightmares), working with the same idea as the propranolol trials. I am not a doctor, I don't know for sure that I am right, these are just my suspicions.
posted by sarae at 5:17 AM on May 11, 2012

Hi kanata,
I (finally) signed up for Metafilter just to post an answer to your question.

I have PTSD + violent, awful, distressing nightmares and was prescribed Prazosin right after a new study about its effectiveness for decreasing nightmares in people with combat-related PTSD was published - written by people working in the VA system. I will try to find out the specific study and post it if possible. But yes, it is definitely being prescribed for PTSD in a responsible fashion. Please don't have any anxiety on that account.

For me, the chronic insomnia and inability to fall asleep in anything under 2+ hours after going to bed (both understood by myself and my doctor as symptoms of PTSD) meant that I had to choose between taking Prazosin for the nightmares and continuing to take a different prescription that helped me get to sleep in something resembling a normal fashion.

(The difference in my life, functioning and mood when I started taking the sleep-aiding drug was phenomenal - a bigger difference than I had experienced taking anti-depressants. I surmise from that that being able to sleep well is an incredibly important need.)

So I chose to discontinue the Prazosin and go back to the earlier prescription. While taking Prazosin (which I did for 2 months and increased dosage once during that time) I did not have any nightmares, but I also was not sleeping well and did not recall any dreams, nightmare or otherwise, from that time.

None of this may be helpful for you - you may have a dissimilar presentation of PTSD symptoms than I do, so you may find different approaches to taking care of yourself helpful. I am sharing because it appears that use of Prazosin for PTSD is relatively new and info is scarce. I experienced no side effects at all.

If you decide to take Prazosin, I would be interested to hear your experience with it, especially as it impacts your dream work and therapy.
posted by Reference at 8:48 PM on May 11, 2012 [1 favorite]

I think this is most likely the study that my doctor was referring to when we discussed Prazosin for PTSD treatment. I am not able to access the full-text until Monday, alas.
posted by Reference at 8:57 PM on May 11, 2012

I take propranolol, Prazosin's cousin, but for a heart condition, not for PTSD (though I also have PTSD). It is the only thing that works for my heart condition. Since I've been on it, I have lost a lot of hyper-vigilance and have been having fewer flashbacks, so I'm quite pleased with that. Once, when I was in a very serious life or death situation since being on propranolol , my doctor had me take a "memory dampening" high dose of propranolol to help prevent me from getting PTSD from that encounter. The personality change away from being so jumpy and hyper-vigilant has been very subtle (the affect on my heart condition was, of course, immediately apparent). It has not affected my dreams or sleep at all.
posted by sweltering at 2:54 AM on May 12, 2012

Thanks sweltering and Reference. That gives me hope. I knew there were brief evidence for taking it for PTSD but was a little skeptical. I'm going to take it and hopefully it will help some. I am tired of the nightmares and always being on alert. I just need some decent sleep.
posted by kanata at 6:46 PM on May 12, 2012

To update anyone reading this, it has been 10 days since I started the Prazosin (I can't believe it has only been ten days!) and it has made an astounding difference in things. I'm averaging about 7-8 hours of solid sleep at night and even finding myself less ..um, i guess, paranoid about people following me in the woods when I go for a daily hike (which is something I was surprised it helped).

My worries that it would damage my dream work proved to be useless. If anything it has enhanced it as I'm able to have room in my sleep for other dreams. Which actually are turning out to be more vivid than ever and more fruitful. Even any nightmares involving the incident that break through are different. They seem to have a veil over them and don't feel like they are happening *now*! In fact, sometimes they turn out so that they have a different positive ending where I take action against the abusers and overcome them.

Anyway, I can drone on and on about how great this has been for my PTSD and how much regular consistent sleep has improved my mental health, especially after struggling with some sort of sleep problem for near 20 years.
posted by kanata at 8:24 AM on May 22, 2012 [2 favorites]

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