Ketamine-Prazosin Combined Pharmacotherapy in Post-Traumatic Stress Disorder and Alcohol Use Disorder: Targeting Complementary Neurobiological Mechanisms.
The Nursing clinics of North America March 1, 2026 DOI: 10.1016/j.cnur.2025.09.004 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Population | Not specified |
| Interventions | Ketamine Prazosin |
| Topics | Addiction Ketamine Esketamine PTSD |
| Keywords | Combination pharmacotherapy Neurobiological mechanisms Nurse practitioners Posttraumatic stress disorder Prazosin |
| Key points | Proposes that combining ketamine and prazosin may improve PTSD and AUD outcomes through complementary mechanisms, though untested in trials. |
Abstract
Posttraumatic Stress Disorder (PTSD) and Alcohol Use Disorder (AUD) often co-occur, worsening outcomes, relapse rates, and treatment response. Ketamine produces rapid and sustained PTSD symptom reduction and reduces AUD relapse. Prazosin effectively treats PTSD-related nightmares and may reduce alcohol consumption in individuals with heightened autonomic reactivity. The dual complementary mechanisms, modulation of glutamatergic neurotransmission and attenuation of noradrenergic hyperactivity, provide a compelling rationale for combination pharmacotherapy. Potential benefits include improved stabilization, readiness for trauma-focused therapy, and broader symptom control. Although untested in clinical trials, this approach warrants nurse practitioner-led research to evaluate safety, efficacy, and integration into multidisciplinary care.