Faculty mentor/PI email address
richardsonc2@ihn.org; forsbemm@rowan.edu
Keywords
Post-traumatic stress disorder (PTSD), Alpha-1 adrenergic antagonists, Prazosin, Doxazosin, Flashbacks, Nightmares, Remission, Central nervous system, Case report, Psychiatric illness
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Introduction
Research has indicated that potentially 90% of older adults have undergone at least one potentially traumatic event in their lifetime. Post-traumatic stress disorder (PTSD) is a psychiatric illness that follows a traumatic life event where the person is exposed to death, threatened death, actual or threatened serious injury, or actual/threatened sexual violence. This event triggers symptoms including flashbacks, recurrent nightmares, hypervigilance, dissociative reactions, and physiologic reactions to traumatic cues. Some recent reports in PTSD treatment have indicated the potential for the use of centrally-acting alpha-1 antagonists, such as prazosin and doxazosin, as effective treatments for PTSD-associated flashbacks and nightmares.
Methods
This case report focuses on a 74-year-old female with a past psychiatric history of PTSD following domestic violence, major depressive disorder, and unspecified anxiety disorder. The patient’s history and data were reviewed utilizing documentation from her primary treating psychiatrist to evaluate her PTSD symptoms and response to alpha-1 antagonists.
Results
The patient was first treated with prazosin 1 mg daily in April 2020, with rapid and complete resolution of daytime flashbacks. The dosing of prazosin 1 mg was changed to bedtime in January 2021, with subsequent resolution of nightmares. She was later switched to doxazosin 1 mg at bedtime due to its longer half-life to maintain the resolution of symptoms. The patient did not experience adverse effects.
Conclusion
This case demonstrates the potential for the use of alpha-1 adrenergic antagonists in the treatment of PTSD-associated flashbacks and nightmares. Further research is needed to determine the role of doxazosin.
Disciplines
Chemicals and Drugs | Medicine and Health Sciences | Mental Disorders
Included in
When Flashbacks Don’t Return: Lasting PTSD Remission After Utilization of Alpha-1 Adrenergic Antagonists
Introduction
Research has indicated that potentially 90% of older adults have undergone at least one potentially traumatic event in their lifetime. Post-traumatic stress disorder (PTSD) is a psychiatric illness that follows a traumatic life event where the person is exposed to death, threatened death, actual or threatened serious injury, or actual/threatened sexual violence. This event triggers symptoms including flashbacks, recurrent nightmares, hypervigilance, dissociative reactions, and physiologic reactions to traumatic cues. Some recent reports in PTSD treatment have indicated the potential for the use of centrally-acting alpha-1 antagonists, such as prazosin and doxazosin, as effective treatments for PTSD-associated flashbacks and nightmares.
Methods
This case report focuses on a 74-year-old female with a past psychiatric history of PTSD following domestic violence, major depressive disorder, and unspecified anxiety disorder. The patient’s history and data were reviewed utilizing documentation from her primary treating psychiatrist to evaluate her PTSD symptoms and response to alpha-1 antagonists.
Results
The patient was first treated with prazosin 1 mg daily in April 2020, with rapid and complete resolution of daytime flashbacks. The dosing of prazosin 1 mg was changed to bedtime in January 2021, with subsequent resolution of nightmares. She was later switched to doxazosin 1 mg at bedtime due to its longer half-life to maintain the resolution of symptoms. The patient did not experience adverse effects.
Conclusion
This case demonstrates the potential for the use of alpha-1 adrenergic antagonists in the treatment of PTSD-associated flashbacks and nightmares. Further research is needed to determine the role of doxazosin.