Prazosin for the treatment of nightmares in hospitalized adult burn patients

Acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) can occur after a traumatic event; they are characterized by, among other symptoms, hypervigilance, dissociation, nightmares, and flashbacks. Prazosin, an alpha-1 receptor antagonist, has been shown to be effective in reducing nightmares related to ASD and PTSD. Burn patients are particularly susceptible to acute and post-traumatic stress symptoms, especially nightmares. The goal of this study is to examine the benefits of prazosin in treating nightmares, one of the common symptoms of ASD and PTSD, among a cohort of adult burn patients during their hospitalization. We performed a retrospective analysis of 45 hospitalized burn patients who met eligibility criteria admitted between August 2014 and January 2024 who received prazosin to treat trauma-related nightmares. Descriptive statistics were used to characterize response of nightmares to prazosin and adverse effects from prazosin. Twenty-three (51.1 %) patients had full remission of nightmares, 16 (35.6 %) had some improvement in nightmares, and 6 (13.3 %) patients had no improvement in nightmares. Prazosin was well tolerated and there were no clinically significant changes in blood pressure or heart rate. This study suggests that prazosin may be beneficial for the treatment of nightmares associated with burn trauma in the hospital setting.