Management of trauma-related nightmares in PTSD: Can doxazosin serve as a pragmatic alternative to prazosin?

Doxazosin may represent a pragmatic pharmacological option for managing TRNs in PTSD, especially in the context of prazosin withdrawal. Its use should complement, rather than replace, first-line psychotherapeutic approaches and be integrated into a comprehensive, coordinated, and individualized treatment plan with careful monitoring of adverse effects. Larger, well-designed randomized controlled trials are needed to determine optimal dosing, treatment duration, and predictors of response.