Medications to Treat PTSD

Published on: 23 Nov 2021
veteran sitting alone looking down

Post-traumatic stress disorder (PTSD) affected an estimated 3.6% of adults in the United States in the last year. Although it’s often associated with combat veterans, children and adults can be diagnosed with PTSD as well.

PTSD is a mental health condition is a severe form of anxiety disorder that can last for months or years after someone witnesses or experiences trauma. Triggers can cause the trauma to resurface, resulting in extreme physical and/or emotional responses. Some common symptoms that can affect your everyday life include nightmares, flashbacks, anger, irritability, negative thoughts, sleep disturbance, or hyperarousal symptoms. Those with PTSD may even find themselves experiencing anxiety or depression in conjunction.

There are many treatment options for post-traumatic stress disorder, including PTSD medication and various therapy techniques. The most important thing to keep in mind when considering the right PTSD treatment medication or therapy is that since no two people have the same experience and treatment generally isn’t a one-size-fits-all plan. 

You might need to try different techniques before something works well for you and your symptoms. In the end, finding a mental health professional with experience in treating PTSD is likely going to be your best bet. Whether this means finding the best medication for PTSD or engaging in short-term trauma-focused CBT for PTSD, there are treatment options out there for you. 

Types of Medications Used to Treat PTSD

Sometimes medication for PTSD nightmares or other symptoms is prescribed. Typically, medication is used in conjunction with other treatment techniques like various forms of therapy. Most often, selective serotonin reuptake inhibitors (SSRIs) — antidepressants — are prescribed. They can help treat the depression symptoms that often present with PTSD. 

While just a couple of medications are approved by the Food and Drug Administration (FDA) to treat PTSD, many others are also prescribed “off-label.”  “Off-label is when medication is prescribed in a manner that is not specified by FDA’s packaging. A psychiatrist can set up a treatment plan utilizing a combination of medications to relieve these troubling PTSD symptoms. For instance, the prescription is used for a different condition or the dosage is different than what the FDA recommends.

SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs commonly known as antidepressants. They can be prescribed to treat major depressive disorder (MDD) and other psychological conditions like anxiety disorders and PTSD. 

SSRIs work in the brain by increasing serotonin levels — a chemical messenger or neurotransmitter that carries signals between nerve cells in the brain. SSRIs inhibit the reabsorption of serotonin, which is also called the “feel-good” neurotransmitter because it enhances and stabilizes happiness, mood, and sense of well-being. 

SSRIs to treat PTSD include:

  • Zoloft* (Sertraline)
  • Paxil* (Paroxetine)
  • Prozac (Fluoxetine)

*Only FDA-approved drugs to treat PTSD

Possible side effects of SSRIs to treat PTSD:

  • Anxiety
  • Insomnia
  • Nausea
  • Diarrhea
  • Sexual dysfunction

Anti-anxiety medications

Anti-anxiety medication may be prescribed for adults with PTSD if the anxiety prevents engagement in normal, daily activities. For example, if anxiety is so bad, attending work or school becomes problematic, an anti-anxiety medication might help.

Anti-anxiety medication can reduce symptoms of anxiety such as intense worry and fear or panic attacks. They can have a physical as well as a mental effect on anxiety. Anti-anxiety medication works by slowing down the nervous system, which helps you feel calm.  

Anti- Anxiety Medications to treat PTSD include:

  • Xanax (alprazolam)
  • Klonopin (clonazepam)
  • Valium (diazepam)
  • Ativan (lorazepam)

Possible side effects of anti-anxiety medications to treat PTSD:

  • Fatigue
  • Dizziness
  • Blurry vision
  • Loss of memory
  • Headaches
  • Confusion

Alpha-1 blockers

Alpha-1 blockers are a class of medication that can be part of PTSD treatment. They’re primarily known for the ability to help reduce the disruptive sleep and nightmares that are often associated with PTSD.

Alpha-1 blockers work by blocking alpha-1 receptors in the brain, helping you achieve better, deeper sleep. Alpha-1 blockers are generally only prescribed for people who experience PTSD nightmares. 

Popular Alpha-1 blockers to treat PTSD include:

  • Minipress (Prazosin) 
  • Doxazosin 

Possible side effects of Alpha-1 blockers to treat PTSD:

  • Being tired
  • Headache
  • Shortness of breath
  • Swelling of hands, feet, ankles, lower legs
  • Abnormal vision
  • Muscle pain or weakness
  • Joint pain or weakness
  • Runny nose

Mood stabilizers

Mood stabilizers can be prescribed to adults with PTSD who haven’t responded to antidepressants. They’re commonly used when primary symptoms of PTSD include agitation, anger, or irritability.

Mood stabilizers work to treat PTSD by balancing brain chemicals known to regulate emotions.

Mood stabilizers to treat PTSD include:

  • Topamax (Topiramate)
  • Lamictal (Lamotrigine) 

Possible side effects of mood stabilizers to treat PTSD:

  • Headache
  • Insomnia
  • Skin rash
  • Tiredness
  • Dizziness
  • Drowsiness

Medications Commonly Prescribed for PTSD

The PTSD medication list below can help you understand more about the types of medication available to treat PTSD, how they work, and any risks you should be aware of.

Name BrandGenericDescription
ZoloftSertralineCan improve symptoms of PTSD, as well as general functioning and quality of life. Works by increasing serotonin in the brain. Insomnia can be a side effect.
MinipressPrazosinA high blood pressure medication that can be used off-label to treat post-traumatic stress disorder. Typically only prescribed to patients who have PTSD nightmares. Works by blocking the Alpha-1 receptor for norepinephrine.
PaxilParoxetineGood for those who have avoidance symptoms with PTSD. Can be helpful for a full range of PTSD symptoms. Works by increasing the mood-enhancing chemical serotonin.
Doxazosin Can help improve sleep while reducing nightmares often associated with PTSD. Works by blocking the alpha-1 receptors in the brain. 
TopamaxTopiramateA study by the US Department of Veterans Affairs showed a reduction in hyperarousal symptoms of PTSD. Needs further research.
LamictalLamotrigineMight be effective as a primary PTSD medication. Works to decrease core symptoms of avoidance and re-experiencing trauma.  

Talk to your psychiatrist or healthcare professional about the possible risks and benefits associated with the above medications before starting treatment.

How to Get PTSD Medication

Finding the right medication for PTSD treatment can take time and patience. You may find that the first medication you try isn’t the most effective. Also, most people see a combination of PTSD medication and therapy work best together to improve symptoms.

As with any medication, reaching out to your doctor is the first thing you should do. If you’re hoping to get information about a PTSD medication list or want to find any details about symptoms, options, side effects, or anything else relating to medication, talking to your doctor is important.  

To find the right medication for PTSD, go through the following easy steps:

  1. Get diagnosed
    After you’re diagnosed with PTSD, you can begin seriously considering your treatment — including medication — options.    
  2. Begin therapy or treatment
    PTSD treatment almost always requires a combination of therapy and medication. If you haven’t already, it may be time to think about starting therapy to help you cope with your symptoms.
  3. Consider your options for medication
    Learn the different PTSD treatment medication options. 
  4. Talk to a prescriber
    Your doctor can prescribe the right PTSD medication. 

Should You Treat PTSD with Medication? 

Whenever you seriously consider starting a new medication, being informed is the most important part of the process. Deciding to take medication is a personal, private decision that you’ll need to make for yourself. Enlist the help of doctors, friends, psychiatrists, therapists, and family, but ultimately, you need to be the one to make the decision. If you have questions or concerns, your doctor can be the first place you turn.

Questions to ask your doctor

  • Should I consider PTSD medication?
    Your doctor can discuss whether medication is something you may want to consider. Weighing the pros and cons of any medication is step one. Then, you’ll be better able to come to a decision that makes you feel good about your choice.   
  • What are the possible side effects of this medication?
    You want to know any potential side effects of medications you’re considering. This will not only help you determine if you really want to take it, but it’ll also help you monitor how you’re reacting after you start. Knowing what to look for means you can see potential red flags or dangerous side effects as soon as possible. 
  • What other treatments should I be considering for my PTSD?
    While medication can be one part of your treatment plan, the primary treatment for PTSD is actually psychotherapy. Combining these two techniques can help you identify and address your symptoms, learn coping skills, and treat additional symptoms and problems often related to PTSD. 
  • Should I consider treatment in conjunction with PTSD medication?

Focusing on additional treatments can help enhance your healing. Whether you’re looking for medication for PTSD nightmares or if you have problems with avoidance, the more emphasis you can put on an all-encompassing treatment plan, the better off your healing will ultimately be.

  • Are there any holistic or self-help techniques I can try?
    Many holistic and self-help techniques have shown efficacy in treating PTSD. Meditation, activity and exercise, a service dog, and learning to set boundaries are all things that many people have found helpful. Additionally, having a PTSD support network can be a critical component of your treatment plan. 
  • Should I consider therapy in addition to medication? 

Many forms of therapy have been found effective in treating and coping with PTSD. 

  • A type of cognitive-behavioral therapy (CBT) known as cognitive processing therapy is one technique that helps you overcome feelings of self-blame and any negative thoughts you might be experiencing because of PTSD. 
  • Exposure therapy is another seemingly effective treatment for PTSD. 
  • Group therapy is one more form of treatment that offers support from others who can relate to your trauma.
  • Are there any other conditions going on that could be contributing to PTSD?
    Substance abuse and major depressive disorder (MDD) are both possible for people with PTSD. Also, there’s an increased risk of agoraphobia, panic disorder, obsessive-compulsive disorder (OCD), and social phobia. This collective set of conditions is yet another reason why a full treatment plan, typically including therapy, will be so important in managing PTSD.

If you’re ready to seek out medication for treatment of your PTSD, get connected with a licensed prescriber today.

Sources:

1. NIMH » Post-Traumatic Stress Disorder (PTSD). Nimh.nih.gov. https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd.shtml. Published 2021. Accessed October 21, 2021.

2. Alexander W. Pharmacotherapy for Post-traumatic Stress Disorder In Combat Veterans: Focus on Antidepressants and Atypical Antipsychotic Agents. P T. 2012;37(1):32-38. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278188/

3. PTSD Facts & Treatment | Anxiety and Depression Association of America, ADAA. Adaa.org. https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd/treatment-facts. Published 2021. Accessed October 21, 2021.

4. Post Traumatic Stress Disorder (PTSD) Hyperarousal Symptoms Treated with Physiological Stress Management .” Post Traumatic Stress Disorder (PTSD) Hyperarousal Symptoms Treated With Physiological Stress Management – Full Text View – ClinicalTrials.gov, US Department of Veterans Affairs, https://clinicaltrials.gov/ct2/show/NCT00855816. Accessed October 21, 2021. 

5. CLINICAL PRACTICE GUIDELINE For The Treatment Of PTSD. American Psychological Association; 2017:11-17. https://www.apa.org/ptsd-guideline/ptsd.pdf. Accessed October 21, 2021.

5. Posttraumatic Stress Disorder | NAMI: National Alliance on Mental Illness. Nami.org. https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Posttraumatic-Stress-Disorder. Published 2017. Accessed October 21, 2021.

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