What is your approach to using prazosin to treat day-time symptoms in PTSD?

I will only use prazosin during the day if the patient is using it for sleep disturbance/nightmares. If they are not using prazosin, then I prefer guanfacine during the day.

If using prazosin, I start at 0.5 mg in the morning and then BID. I will titrate up based on reaction and side effects.

• Prazosin does not have evidence to treat symptoms other than nightmares from PTSD.
• Typically, it works very well for trauma-related nightmares and general nightmares that disrupt sleep.
• Since I treat teens/children, I hardly use AM dosage of prazosin; however, in adults, lower dosages have been use...