Medications for Post-traumatic Stress Disorder

by Amy Scholten, MPH

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.

Prescription Medications

Antidepressants

  • Fluoxetine
  • Paroxetine
  • Sertraline
  • Venlafaxine
  • Nefazodone
  • Phenelzine
  • Imipramine

Benzodiazapines

  • Aprazolam
  • Clonazepam
  • Diazepam
  • Lorazepam

Alpha and Beta-blockers

  • Propranolol
  • Prazosin

Antidepressants

There are several types of antidepressant drugs that can be used to treat PTSD. It may take some time to find the right one that works for you. In most cases, it can take up to 6 weeks to get the full effect of the medication.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Common names include:

  • Fluoxetine
  • Paroxetine
  • Sertraline

SSRIs affect the concentration of a brain chemical called serotonin. Paroxetine and sertraline are FDA-approved for the treatment of PTSD. Although fluoxetine has not been approved specifically for PTSD, it has also been shown to be an effective treatment.

Possible side effects are listed here.

Selective Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

Common names include:

  • Venlafaxine

SNRIs affect the level of serotonin and norepinephrine in the brain.

Possible side effects are listed here.

Tricyclic Antidepressants

Common names include:

  • Imipramine

Imipramine works by increasing the activity of serotinin in the brain.

Possible side effects are listed here.

Atypical Antidepressants

Common names include:

  • Nefazodone

Nefazodone helps restore the balance of serotonin and norepinephrine. It may be prescribed if other antidepressants do not work.

Possible side effects are listed here.

Antidepressants have several side effects. They vary depending on the medication and affect people differently. The most common side effects include:

  • Dry mouth
  • Nausea
  • Constipation
  • Diarrhea
  • Headache
  • Drowsiness
  • Insomnia
  • High or low blood pressure
  • Lightheadedness
  • Sexual difficulties
  • Changes in appetite that can lead to weight gain or loss
  • Excessive sweating—venlafaxine
  • Blurry vision–nefazodone
  • Severe liver damage—nefazodone
  • 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.)

Benzodiazapines

Common names include:

  • Aprazolam
  • Clonazepam
  • Diazepam
  • Lorazepam

Benzodiazepines reduce symptoms of anxiety by enhancing the function of a brain chemical called gamma aminobutyric acid (GABA). These drugs produce a sedative effect. This is the only category of medications used for PTSD that can result in addiction. Because of this, benzodiazapines should be used cautiously and only for brief periods limited to 5 days.

Possible side effects include:

  • Drowsiness or lethargy
  • Confusion
  • Lightheadedness
  • Slow reaction time, impaired coordination
  • Memory changes

Alpha and Beta-blockers

Common names include:

  • Propranolol
  • Prazosin

Propranolol can help relieve some of the physical symptoms of anxiety such as tremor or heart palpitations. Prazosin has also been effective for treating nightmares associated with PTSD. Possible side effects include:

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

Note:

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.

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Do not share your prescription medication.
  • Medications can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medication, including over-the-counter products and supplements.
  • Plan ahead for refills as needed.

When to Contact Your Doctor

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 medical services if you have any thoughts of self-injury or suicide

References:

Antidepressant medication overview. EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated September 30, 2016. Accessed January 31, 2018.
Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Association; 2013.
Ipser JC, Stein DJ. Evidence-based pharmacotherapy of post-traumatic stress disorder (PTSD). Int J Neuropsychopharmacol. 2012;15(6):825-840.
Mental health medications. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml. Updated October 2016. Accessed February 1, 2018.
Posttraumatic stress disorder (PTSD). EBSCO DynaMed Plus website. Available at: http://www.dynamed... . Updated June 26, 2017. Accessed January 31, 2018.
Raskind, MA Peterson K, Williams T, 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;170(9):1003-1010.
2/18/2011 DynaMed Plus Systematic Literature Surveillance http://www.dynamed... : 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 2018 by EBSCO Medical Review Board Adrian Preda, MD
Last Updated: 2/1/2018

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