Prazosin, a postsynaptic alpha-1 adrenoceptor blocker, lowers blood pressure by relaxing blood vessels. Prazosin has a minimal effect on cardiac function due to its alpha-1 receptor selectivity. The recommended starting dose in adults is 0.5 or 1 milligram (mg) taken two or three times a day.
In a small (n=15) (Krum et al. 1992), but high quality RCT, Prazosin twice daily was well tolerated and did not affect the baseline blood pressure; AD episodes were also less severe and shorter in duration over a 2 week period.
- There is level 1 evidence (from one RCT) (Krum et al. 1992), that Prazosin is superior to placebo in the prophylactic management of AD.
Prazosin can prophylactically reduce severity and duration of AD episodes in SCI.