Trial reportJournal of addiction medicine
A Randomized, Placebo-controlled, Clinical Trial of Prazosin for the Treatment of Alcohol Use Disorder.
Trial report in Journal of addiction medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- Yohimbine as a pharmacological probe for alcohol research: a systematic review of rodent and human studies.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2022Pooled it
- Alcohol withdrawal symptoms predict corticostriatal dysfunction that is reversed by prazosin treatment in alcohol use disorder.Addiction biology · 2022Trial
- Moderation of Prazosin's Efficacy by Alcohol Withdrawal Symptoms.The American journal of psychiatry · 2021Trial
- Effects of Prazosin on Provoked Alcohol Craving and Autonomic and Neuroendocrine Response to Stress in Alcohol Use Disorder.Alcoholism, clinical and experimental research · 2020Trial
- Brain activation and subjective anxiety during an anticipatory anxiety task is related to clinical outcome during prazosin treatment for alcohol use disorder.NeuroImage. Clinical · 2020Trial
- Alcohol Abstainer Status and Prazosin Treatment in Association with Changes in Posttraumatic Stress Disorder Symptoms in Veterans with Comorbid Alcohol Use Disorder and Posttraumatic Stress Disorder.Alcoholism, clinical and experimental research · 2019Trial
- Double-Blind Randomized Clinical Trial of Prazosin for Alcohol Use Disorder.The American journal of psychiatry · 2018Trial
- Spironolactone and clinical outcomes in patients with alcohol use disorder and comorbid hypertension: a target trial emulation study.Psychopharmacology · 2026Article
- Noradrenaline Modulates Central Amygdala GABA Transmission and Alcohol Drinking in Female Rats.Biological psychiatry · 2026Article
- Noradrenergic Mechanisms and Circuitry of Hyperkatifeia in Alcohol Use Disorder.Biological psychiatry · 2025Review
- Alcohol, flexible behavior, and the prefrontal cortex: Functional changes underlying impaired cognitive flexibility.Neuropharmacology · 2024Review
- Limited bedding and nesting increases ethanol drinking in female rats.Pharmacology, biochemistry, and behavior · 2024Article
- Effects of prazosin treatment on liver enzymes are moderated by alcohol withdrawal symptoms in individuals with alcohol use disorder.Alcohol, clinical & experimental research · 2024Article
- Chronic ethanol alters adrenergic receptor gene expression and produces cognitive deficits in male mice.Neurobiology of stress · 2023Article
- Chronic intermittent ethanol exposure disrupts stress-related tripartite communication to impact affect-related behavioral selection in male rats.Neurobiology of stress · 2023Article
- Utilizing precision medicine to treat alcohol use disorder: A commentary on the α1 receptor antagonist.Alcohol, clinical & experimental research · 2023Article
- Animal models of compulsion alcohol drinking: Why we love quinine-resistant intake and what we learned from it.Frontiers in psychiatry · 2023Review
- Sex differences in α-adrenergic receptor function contribute to impaired hypothalamic metaplasticity following chronic intermittent ethanol exposure.Alcoholism, clinical and experimental research · 2022Article
- Echocardiographic markers of early alcoholic cardiomyopathy: Six-month longitudinal study in heavy drinking patients.European journal of internal medicine · 2022Article
- The Amygdala Noradrenergic System Is Compromised With Alcohol Use Disorder.Biological psychiatry · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectivesThe noradrenergic system plays an important role in the pathophysiology of alcohol use disorder (AUD). Medications in this class may reduce drinking. Our aims were to investigate this in a unique sample of individuals with AUD.
methodsThirty-six individuals with AUD were randomized to treatment with prazosin, an alpha-1 noradrenergic antagonist, or placebo, for 6 weeks (target daily dose 16 mg). Hierarchical linear modeling was used to examine the effect of treatment group on rate of change in primary (drinks per week [DPW]) and several secondary outcome measures.
resultsPrazosin did not significantly affect rate of reduction in alcohol use in the intent to treat sample (n = 36) compared with placebo, but did significantly increase the rate of reduction in DPW in an optimal treatment exposure subgroup (beta = -0.3; P = 0.01; event rate ratio 0.74; confidence interval 0.59, 0.93; n = 27). Poor adherence and tolerability may have contributed to null effects. Diastolic blood pressure (DBP) moderated the effects of treatment group on rate of reduction in drinks per drinking day, supporting previous work in doxazosin, another alpha-1 antagonist. Specifically, prazosin was associated with greater rates of reduction in drinking compared with placebo in individuals with high but not low DBP.
conclusionsOur findings do not support the clinical utility of prazosin for all treatment-seeking AUD, but post hoc analyses indicate that it might have some efficacy in individuals who can tolerate it. Further work exploring the clinical utility of DBP as a treatment matching variable, and defining optimal values using sensitivity and specificity analyses, is warranted.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.