85 percent of patients on prazosin for PTSD nightmares are stopped too low and given up on too soon. Two hosts walk a new PMHNP through why prazosin remains first-line in the 2024-2025 PTSD psychopharmacology algorithm update, the stepwise titration ladder from 1 milligram at bedtime up to the sex-specific target dose (about 7 mg for women, about 16 mg for men), and the three titration mistakes that turn an effective drug into an apparent failure: stopping at 4 mg, treating modest orthostasis as a hard stop, and layering a Z-drug on a subtherapeutic prazosin dose. You will leave with a concrete 6 to 8 week titration timeline, the orthostatic-check rhythm that keeps the climb safe, and the framing to tell a trauma patient up front: this is a multi-week project, not a same-week trial. Full post and references: https://psychnpfellowship.com/prazosin-pt ...