13th Feb 2023
Medications, such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs), can be used in the treatment of post-traumatic stress disorder symptoms. Though PTSD medication is most effective when combined with psychological treatment, it can be used as a standalone treatment if therapy is not an option or has been ineffective.
PTSD is an anxiety disorder that develops after traumatic events like physical abuse or military combat. Unlike a typical stress reaction that wanes over time, PTSD can become a chronic and debilitating mental health condition.
In many cases, people with PTSD experience flashbacks, feel on edge and lash out in anger. They might blame themselves for the trauma they’ve experienced, have difficulty sleeping, and experience a diminished interest in activities that were once enjoyable.
However, PTSD has many more symptoms and is much more complex than a simple definition can describe. Further information can be found in our guide on PTSD.
While there are many different classes and types of PTSD medicines, only two have Food and Drug Administration (FDA) approval to treat PTSD: sertraline (Zoloft) and paroxetine (Paxil).
Yet, other unlicensed medications, like phenelzine (Nardil), nefazodone (Serzone), and imipramine (Tofranil), might be prescribed to treat some PTSD symptoms. These and other commonly prescribed medications for PTSD are outlined below.
SSRIs are the most effective class of PTSD medicines for most patients. PTSD medications like sertraline (Zoloft) and paroxetine (Paxil) help regulate serotonin in the brain, which helps regulate mood, sleep, and appetite.
Fluoxetine (Prozac) is another type of SSRI that might be prescribed if sertraline or paroxetine doesn’t have the desired effect. It isn’t approved by the FDA to treat PTSD but has shown value as an off-label treatment in clinical trials.
SSRIs come with some side effects of which to be aware. The most common side effects include agitation, indigestion, and loss of appetite. Dry mouth, blurred vision, and dizziness are also common.
More severe side effects include suicidal ideation, hyponatremia (a reduction in sodium levels), and serotonin syndrome, all of which can be life-threatening.
Like SSRIs, SNRIs are antidepressants and are commonly prescribed to treat PTSD symptoms. However, SNRIs like venlafaxine (Effexor) modulate serotonin and norepinephrine to treat core symptoms of PTSD. SNRIs provide a second-line treatment option for PTSD patients should one of the SSRIs listed above not work.
Venlafaxine has several common side effects, including dizziness, dry mouth, and reduced libido. More severe side effects include chest pain, nose bleeds, and anxiety attacks.
Another medication for PTSD is a class of drugs called SRIs. SRIs work by preventing the reuptake of norepinephrine and serotonin in the brain. These drugs, like nefazodone (Serzone), are atypical antidepressants and are not frequently prescribed.
SRIs can be used in conjunction with other medications, which is a benefit, but there are many side effects to consider as well. Common side effects include constipation, dry mouth, and insomnia. Dizziness, blurred vision, and agitation also commonly occur. Dangerous side effects (e.g., hepatotoxicity or liver damage) are also possible.
MAOIs operate on an enzyme in the brain responsible for breaking down dopamine, serotonin, and norepinephrine. By inhibiting that action, the number of neurotransmitters in the brain increases, thereby reducing symptoms of PTSD.
However, MAOIs are not as effective as SSRIs or SNRIs as PTSD treatment medication. Likewise, MAOIs like phenelzine (Nardil) have a long list of potential side effects and interactions, such as sleepiness, headache, and hypotension. Severe side effects may include seizures, liver dysfunction, and suicidal ideation.
TCAs like imipramine (Tofranil) are mood-enhancing drugs acting on chemicals that improve communication between brain cells. As a PTSD medication, it is not nearly as common as SSRIs or SNRIs, mainly because it has far more side effects.
Mild side effects include headache, nightmares, and drowsiness. Dizziness, nausea, and cramps are also common.
More severe side effects include:
In addition to medication for PTSD, patients can benefit from various therapies or self-help techniques. The American Psychological Association (APA) strongly recommends the treatment options below:
Additionally, the APA has conditionally recommended the following effective treatments:
Self-help strategies can be used with medication, therapy, or both to improve functionality and address PTSD symptoms. Common self-help strategies include:
Above all, seek professional help if you feel you might be a danger to yourself or others or feel that you can no longer manage your PTSD symptoms.