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Portsmouth Regional Hospital
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Medications for Post-traumatic Stress Disorder

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

Selective Serotonin Reuptake Inhibitors (SSRIs)

  • Sertraline
  • Paroxetine
  • Fluoxetine

Alpha and Beta-blockers

  • Propranolol
  • Prazosin
Selective Serotonin Reuptake Inhibitors (SSRIs)

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.)
Alpha and Beta-blockers

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
  • Lightheadedness
  • Weakness
  • Low blood pressure
Additional Classes of Medications

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

  • Venlafaxine (a selective norandrenergic reputake inhibitor)
  • Risperidone (an antipsychotic medication)
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 your child is taking medication, follow these general guidelines:

  • Give your child the medication as directed. Do not change the amount or schedule.
  • Use the measuring device that came with the medication. If you need to use a spoon, cup, or syringe, make sure it has the units that match your child’s prescription. For example, if the medication is given in milliliters (mL), the device should have mL on it.
  • Ask what side effects could occur. Report them to your child’s doctor.
  • Talk to your child’s doctor before stopping any prescription medication.
  • Plan ahead for refills if your child needs them.
  • Do not share your child’s prescription medication with anyone.
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 help if you have any thoughts of self-injury or suicide

Revision Information

  • 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 December 20, 2014.

  • Anxiety disorders. National Institute of Mental Health website. Available at: http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml. Accessed December 20, 2014.

  • 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: http://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml. Accessed December 20, 2014.

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

  • Posttraumatic stress disorder (PTSD). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 25, 2014. Accessed December 20, 2014.

  • 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.

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

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