Thanks for providing additional articles for us to reference. I am glad that this article was brought up for journal club discussion (though sadly I was not able to make it to the in person session). What I really like about the articles chosen for us to discuss is how new they are. After graduation, I hope to continue to try to stay up to date on the most recent evidence, but it does pose potential risks. We as providers need to be able to look to the broader research in order to corroborate, and not take new evidence as the holy grail (as has been previously discussed). And, at the end of the day, as important as evidence based practice is, clinical expertise in individual settings also must play a role in what we decide to do. That is part of what our research classes and journal clubs teach us - the value of a critical eye in examining evidence. As has been brought up multiple times in this forum, other confounding research exists - enough to make us stop and think about what this more research means in the broader picture. Our job as NP's is to stay up to date, with the understanding that no single study can be taken to be an absolute.
On another note, I too work with veterans and have seen Prazosin change people's lives and also seen it have no effect, and it really seems to depend on a variety of factors that I don't know have yet been studied in depth. Regardless, I think it remains a very viable option, especially for veterans with PTSD and nightmares that are greatly impairing their sleep, while at the same time keeping in mind that there is the risk of it not being a solve.