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The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special safety measures. Use each of these medications as recommended by your doctor or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Studies have shown that certain medications can help to ease symptoms of anxiety, depression, and insomnia in people with PTSD. More research is being done on drugs that target the biological changes of PTSD.

Selective Serotonin Reuptake Inhibitors (SSRIs)

  • Zoloft
  • Paroxetine
  • Fluoxetine

Beta-blockers

  • Propranolol

Common names include:

  • Sertraline
  • Paroxetine
  • Fluoxetine

SSRIs affect the concentration of serotonin, a neurotransmitter. This is a brain chemical that plays a role in depression and anxiety. SSRIs have been used to treat depression and anxiety. They are often considered the first-line medication to treat PTSD. Paroxetine and Sertraline have been approved by the FDA to treat PTSD. Improvement is usually seen in four to six weeks after beginning treatment.

Possible side effects include:

  • Nausea
  • Diarrhea
  • Insomnia
  • Sexual difficulties
  • Weight gain
  • Risk of severe mood and behavior changes, including suicidal thoughts in some patients (Young adults may be at a higher risk for this side effect.)

Common names include:

  • Propranolol
  • Prazosin

Alpha and beta-blockers are heart medications that treat blood pressure. They are sometimes used to treat symptoms of anxiety like sweating and trembling. Prazosin has also been effective for treating nightmares associated with PTSD. Possible side effects include:

  • Fatigue
  • Cold hands
  • Dizziness
  • Weakness
  • Low blood pressure

The following medications have shown some benefit for those with PTSD:

  • Venlafaxine (a selective norandrenergic reputake inhibitor)
  • Risperidone (an antipsychotic medication)

If medication is helpful, most people with acute PTSD (less than 3 months) will continue to take it for 6-12 months. People with chronic PTSD usually take medication from 12-24 months. They are slowly taken off medication. If symptoms return after medication is stopped, your doctor may recommend that you resume taking the medication for a longer period of time.

If you are taking medications, follow these general guidelines:

  • Take your medication as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Know what results and side effects to expect. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
  • Plan ahead for refills so you don’t run out.

Contact your doctor if:

  • You have any side effects that bother you
  • You feel that you are not getting results from your medications after the normal “waiting period”
  • You have further questions about usage or side effects

Call for emergency help if you have any thoughts of self-injury or suicide

References:

American Psychiatric Association: Guideline Watch (March 2009): Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder. Focus. 2009; 7.

Antidepressant use in children, adolescents, and adults. US Food and Drug Administration website. Available at: http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273. Updated August 12, 2010. Accessed November 25, 2012.

Ipser JC, Stein DJ. Evidence-based pharmacotherapy of post-traumatic stress disorder (PTSD). Int J Neuropsychopharmacol. 2012;15(6):825-840.

Post-traumatic stress disorder (PTSD). EBSCO DynaMed website. Available at https://dynamed.ebscohost.com/about/about-us. Updated October 5, 2012. Accessed November 25, 2012.

Moore DP, Jefferson JW. Handbook of Medical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier Mosby; 2004.

Stern, TA et al. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 1st ed. Philadelphia: Mosby Elsevier, 2008.

Treatment of anxiety disorders. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/anxiety-disorders/treatment-of-anxiety-disorders.shtml. Accessed November 25, 2012.

USP DI. 21st ed. Micromedex; 2001.

What medications are used to treat anxiety disorders? National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/publications/mental-health-medications/what-medications-are-used-to-treat-anxiety-disorders.shtml. Accessed November 25, 2012.

Raskind, MA et al. A trial of prazosin for combat trauma PTSD with nightmares in active-duty soldiers returned from Iraq and Afghanistan. Am J Psychiatry. 2013 Sep 1;170(9):1003-10.

2/18/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: Serretti A, Mandelli L. Antidepressants and body weight: a comprehensive review and meta-analysis. J Clin Psychiatry. 2010;71(10):1259-1272.

Last reviewed November 2012 by Rimas Lukas, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.