Dear Abby (no relation to the advice columnist),
I loved hearing your supervising psychiatrist's thoughts on prazosin. I just spoke to my preceptor about a patient who has been on prazosin for a couple of years, who is very difficult to work with (seems to have a personality disorder in the making) though a diagnosis of PTSD for her is dubious. I suspect prazosin was prescribed for her for the very reasons your psychiatrist mentioned.
My own personal bias is that trauma is best addressed through psychotherapeutic modalities, many of which we learned about in our trauma class this quarter. Somatic psychotherapies in particular (Somatic Experiencing, Sensorimotor Psychotherapy) and yoga are particularly promising in targeting unconscious processes and sympathetic arousal; however because the data on these modalities is limited we have not been exposed to them with the exception of EMDR. Now, I may be exhibiting the biases of overconfidence and premature closure on this; I suppose my future forays into training in somatic psychotherapy will tell. Nevertheless, pharmacotherapy has its place in healing from trauma, but must be used judiciously of course and its need and effectiveness evaluated on an ongoing basis.