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Symptoms such as nightmares and hypervigilance in ptsd are thought to be related to noradrenergic hyperactivity, suggesting the effectiveness of prazosin.
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Thiazide diuretics moderate prazosin is well-known to produce a first-dose phenomenon.
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Although the manufacturers state that a causal relationship to prazosin has not been established to date, the frequency of cataplectic attacks decreased when the drug was withdrawn and increased when it was resumed in at least 2 patients.
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in addition to its alpha-blocking activity, prazosin is an antagonist of the mt3 receptor which is not present in humans , with selectivity for this receptor over the mt1 and mt2 receptors.