title: Prazosin for treating sleep disturbances in adults with posttraumatic stress disorder: a systematic review and meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  Posttraumatic stress disorder (PTSD) is a disorder with significant sleep morbidity and limited treatment options. Prazosin may constitute a novel management approach and has been tested recently in a number of trials. We conducted a meta-analysis to examine the effectiveness of prazosin for nightmares and other sleep disturbances in adults with PTSD.
  
  
  METHODS
  A systematic review of databases for randomized, double-blind, placebo-controlled trials of adults diagnosed with PTSD and reporting sleep disturbances that were treated with prazosin was conducted in January 2015. No limitations were placed on language or year of publication.
  
  
  RESULTS
  Six randomized controlled trials of prazosin for sleep disturbances in patients with PTSD were included (sample n=240). We found that prazosin was statistically significantly more effective than placebo in improving sleep quality [g=0.987, 95% confidence interval (CI): 0.324-1.651] and in reducing overall PTSD symptoms (g=0.699, 95% CI: 0.139-1.260) and sleep disturbances in particular (g=0.799, 95% CI: 0.391-1.234).
  
  
  CONCLUSIONS
  Prazosin showed medium-to-large and statistically significant effects on PTSD symptoms in general and sleep disturbances in particular. While promising, results should be interpreted with caution given the limited total number of participants and the limitations induced by the majority of participants being male and noncivilian.
authors.affiliation: Queen's University Department of Psychiatry, Providence Care, Mental Health Services, 752 King Street West, Postal Bag 603, Kingston, ON, K7L 7X3, Canada. Electronic address: d.khachatryan@queensu.ca.
authors.forename: Davit
authors.initials: D
authors.lastname: Khachatryan
authors.affiliation: Queen's University Department of Psychiatry, Providence Care, Mental Health Services, 752 King Street West, Postal Bag 603, Kingston, ON, K7L 7X3, Canada. Electronic address: Dianne.groll@queensu.ca.
authors.forename: Dianne
authors.initials: D
authors.lastname: Groll
authors.affiliation: University of Concordia, Department of Psychology Richard J. Renaud Science Complex, 7141 Sherbrooke W. Electronic address: linda.booij@concordia.ca.
authors.forename: Linda
authors.initials: L
authors.lastname: Booij
authors.affiliation: University of British Columbia, Department of Psychiatry Detwiller Pavilion, 2255 Wesbrook Mall, Vancouver, BC, Canada, V6T 2A1. Electronic address: sepehryaa@alumni.ubc.ca.
authors.forename: Amir A
authors.initials: AA
authors.lastname: Sepehry
authors.affiliation: University of British Columbia, Department of Psychiatry Detwiller Pavilion, 2255 Wesbrook Mall, Vancouver, BC, Canada, V6T 2A1. Electronic address: christian.schutz@ubc.ca.
authors.forename: Christian G
authors.initials: CG
authors.lastname: Schütz
mesh_terms: D058668:Adrenergic alpha-1 Receptor Antagonists / Q000494:pharmacology*; D000328:Adult; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D011224:Prazosin / Q000494:pharmacology*; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data*; D012893:Sleep Wake Disorders / Q000188:drug therapy* / Q000209:etiology; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000188:drug therapy*
chemical_list: D058668:Adrenergic alpha-1 Receptor Antagonists; D011224:Prazosin
keywords: Meta-analysis; Nightmares; PTSD; Prazosin; Sleep disturbance