Neural Mechanisms of Change During the Treatment of Alcohol Use Disorders With Prazosin

Inclusion Criteria:

1. Males and females age 18-65 meeting DSM-IV criteria for alcohol dependence in the past
year;

2. seeking but not currently receiving treatment;

3. able to provide voluntary informed consent;

4. have at least 4 drinking days in the past 30 days

5. english-speaking

6. have a primary care physician or psychiatrist willing to continue prazosin if the
patient tolerates it well and is finding it beneficial.

Exclusion Criteria:

1. severe neurological (e.g., head injury/stroke) conditions, Meniere's disease,
narcolepsy, benign positional vertigo, heart disease or unstable angina, history of
dysrhythmia/syncope, SBP<110, SBP>160, DBP>110, HR<55, HR>110, irregular heart rhythm,
chronic renal or hepatic failure, pancreatitis or insulin-dependent diabetes, or other
medical problems requiring immediate attention;

2. schizophrenia, schizoaffective disorder, PTSD, Bipolar I disorder, suicidal thoughts
within the last month;

3. current dependence on another drug of abuse (except nicotine);

4. contraindications to MRI (e.g., pacemaker);

5. active legal problems with the potential to result in incarceration;

6. pregnancy or lactation, or child bearing age and not on birth control;

7. currently receiving treatment for alcohol dependence;

8. current use of psychoactive medications including SSRI's and other antidepressants,
anti-craving medications, anxiolytics including benzodiazepines, antipsychotics, mood
stabilizers or anticonvulsants;

9. history of seizures or DT's during alcohol withdrawal.