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Prazosin for nightmares in serious illness
  1. Wil Santivasi,
  2. Erin Taylor,
  3. April Christensen and
  4. Jacob Strand
  1. Center for Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA
  1. Correspondence to Dr Wil Santivasi, Center for Palliative Medicine, Mayo Clinic, Rochester, MN 55905-0002, USA; santivasi.wil{at}


Nightmares can be a distressing symptom in patients living with serious illness. Prazosin, a selective alpha-1 adrenergic antagonist, has been suggested to treat nightmares, with most data supporting its use in post-traumatic stress disorder (PTSD). We present the case of a 60-year-old woman with metastatic breast cancer who experienced healthcare-associated nightmares following hospitalisation. She did not meet diagnostic criteria for PTSD. Atypical antipsychotics and benzodiazepines were ineffective in controlling her nightmares, resulting in referral to our outpatient palliative medicine clinic. Prazosin was initiated alongside interdisciplinary psychosocial support, resulting in rapid resolution of her nightmares. To our knowledge, this is the first case to report on use of prazosin to manage nightmares in the outpatient palliative medicine setting.

  • psychological care
  • quality of life
  • supportive care
  • symptoms and symptom management

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  • Contributors All authors provided clinical care to the patient. WS drafted the manuscript with support from ET, AC and JS. All authors critically revised the manuscript for intellectual content in preparation for submission. All authors approved the version to be submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.