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Varenicline + prazosin is a combination therapy being investigated by Yale University for the treatment of heavy-drinking cigarette smokers. Varenicline is an FDA-approved smoking cessation aid that acts as a partial agonist at the alpha-4 beta-2 nicotinic acetylcholine receptor, reducing nicotine cravings and withdrawal symptoms. However, varenicline is frequently associated with sleep disturbances, including vivid dreams and insomnia. Prazosin, an alpha-1 adrenergic receptor antagonist traditionally used for hypertension and PTSD-related nightmares, is added to the regimen to mitigate these sleep-related side effects. Beyond improving sleep quality, the combination is being studied for its potential synergistic effects in reducing both nicotine dependence and heavy alcohol consumption in comorbid populations.
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