Today’s question is: How to treat sleep disturbances in patients with PTSD?  

Here is a summary of this episode:

• Prazosin is recommended as a first-line agent in sleep disturbances in PTSD with an average dose for men at 16 mg and for women, 7 mg titrated over 5 weeks.
• Trazodone can be used in patients with initial-sleep insomnia with PTSD at a starting dose of 50 mg.
• Avoid benzodiazepines due to its abuse potential. Also, its cognitive side effects may negatively affect psychotherapy effectiveness.
• Quetiapine should not be used first-line in the treatment of insomnia. It is associated with weight gain, which is not dose-related.

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