Ketamine-Prazosin Combined Pharmacotherapy in Post-Traumatic Stress Disorder and Alcohol Use Disorder: Targeting Complementary Neurobiological Mechanisms.
Amanda Canada
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.
Comparable studies
Other theoretical and historical papers on ketamine for PTSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychoplastogens: A Promising Class of Plasticity-Promoting Neurotherapeutics. | 2018 | Theoretical or philosophical paper | |
| The Neurobiology and Pharmacotherapy of Posttraumatic Stress Disorder. | 2018 | Theoretical or philosophical paper |
Citations in the library
Cites 13
- Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms Pharmacological Reviews June 26, 2018
- A Randomized Controlled Trial of Repeated Ketamine Administration for Chronic Posttraumatic Stress Disorder. American Journal of Psychiatry January 5, 2021
- A Single Ketamine Infusion Combined With Motivational Enhancement Therapy for Alcohol Use Disorder: A Randomized Midazolam-Controlled Pilot Trial. American Journal of Psychiatry December 2, 2019
- Adjunctive Ketamine With Relapse Prevention–Based Psychological Therapy in the Treatment of Alcohol Use Disorder American Journal of Psychiatry January 11, 2022
- Long term structural and functional neural changes following a single infusion of Ketamine in PTSD Neuropsychopharmacology June 3, 2023
and 8 more in the library