PTSD Medication: Types, Efficacy, and Side Effects

Post-traumatic stress disorder (PTSD) is a mental disorder that can occur after a person has experienced a traumatic event. It leads to symptoms that include intrusive memories, flashbacks, hypervigilance, anxiety, and nightmares. The condition is typically treated with certain PTSD medications and therapy.

Two medications are currently FDA-approved to treat PTSD: Zoloft (sertraline) and Paxil (paroxetine). However, other medications are also prescribed off-label to help relieve mood and anxiety symptoms.

Types of PTSD medications include:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Alpha-1 blockers
• Mood stabilizers

This article explores PTSD medications, how they work, the symptoms they can help, and potential side effects. It also discusses other treatments that can help people manage their condition.

SSRIs

SSRIs help relieve specific symptoms of PTSD by increasing serotonin levels in the brain. Serotonin is a chemical messenger that plays a role in mood and sleep.

PTSD can disrupt how chemical signals are sent throughout the brain and body. Increasing serotonin levels can potentially help symptoms that impact mood, anxiety, and sleep. 

SSRIs that are often prescribed to treat PTSD include:

• Zoloft (sertraline)
• Paxil (paroxetine)
• Prozac (fluoxetine)
  

Zoloft is one of the most commonly prescribed PTSD medications. Research has found that it is well-tolerated and effective, reducing symptoms in more than half of the people who take it. Studies have shown that Paxil can also be effective in reducing PTSD symptoms.

Side Effects of SSRIs

While SSRIs are safe and generally well-tolerated, they do have the potential to cause unwanted side effects. Some of the most common side effects associated with SSRI medications are:

• Decreased appetite
• Diarrhea
• Drowsiness
• Dry mouth 
• Insomnia
• Nausea
• Upset stomach
  
• Sexual side effects
  

SNRIs

As the name suggests, SNRIs inhibit the reuptake of the neurotransmitters serotonin and norepinephrine. Norepinephrine is a chemical that acts as a hormone and neurotransmitter, playing an essential role in the body's fight-or-flight stress response. By increasing levels of serotonin and norepinephrine in the brain, SNRIs help with mood and anxiety symptoms of PTSD. 

Side Effects of SNRIs

SNRIs can also lead to several different side effects. The most common of these include:

• Dry mouth
• Drowsiness
• Headache
• Problems sleeping
  
• Sexual problems
• Sweating

Compared to SSRIs, SNRIs tend to lead to more nausea, dry mouth, and insomnia. In some cases, they can also cause elevated blood pressure.

Anti-Anxiety Medications

Anti-anxiety medications are sometimes prescribed to help people manage symptoms of anxiety. These medications increase the amount of GABA that binds to the central nervous system (CNS) receptors.

GABA is an inhibitory receptor, so increasing its actions causes people to feel more relaxed, sedated, and sleepy.

These medications belong to a class of drugs known as benzodiazepines. They should be used with caution to treat anxiety associated with PTSD.

Side Effects of Anti-Anxiety Medications

Anti-anxiety medications can cause unwanted side effects such as:

• Blurred vision
• Confusion
• Dizziness
• Fatigue
• Headaches
• Memory problems

While they can help manage acute anxiety, they can also be habit-forming. They are classified as Schedule IV medications because they risk producing psychological and physical addiction. When taken for periods longer than two to four weeks, they can produce dependence and/or abuse.

Alpha-1 Blockers

Alpha-1 blockers are medications that act as alpha-adrenergic receptor agonists. They affect alpha receptors in the CNS, which helps inhibit the body's stress response. These medications are primarily prescribed to treat high blood pressure, prostate enlargement, and tumors.

The two alpha-1 blocker medications that are primarily prescribed for PTSD are:

• Cardura (doxazosin)
• Minipress (prazosin)

Side Effects of Alpha-1 Blockers

These medications can also produce side effects that include:

• Fatigue
• Headache
• Joint pain
• Muscle pain
• Runny nose
• Vision changes

Mood Stabilizers

Mood stabilizers may sometimes be prescribed for PTSD if other first-line treatments are ineffective or do not provide sufficient relief. These medications are typically utilized to treat bipolar disorder and work to regulate mood and balance emotions, which may help people better manage some symptoms of PTSD.

Mood stabilizing medications may include lithium and anticonvulsant medications such as Depakote (divalproex) or Lamictal (lamotrigine). 

Side Effects of Mood Stabilizers

Like other medications, mood stabilizers can lead to a range of side effects. Those that are most common include:

• Diarrhea
• Drowsiness
• Fatigue
• Headache
• Nausea
• Rapid heartbeat
• Weight gain

Other Ways to Manage PTSD

Medications can be an essential part of PTSD treatment, but they are often most effective when utilized as part of a comprehensive plan that include psychotherapy and social support. Other ways to manage PTSD include:

Cognitive-Behavioral Therapy (CBT)

CBT is the treatment strongly recommended by the American Psychological Association for PTSD. This approach to treatment focuses on helping people change unhelpful thoughts related to their trauma.

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a type of psychotherapy that uses bilateral eye movements to help people who have experienced trauma process difficult memories, emotions, and thoughts.

During this treatment, people focus on movements or sounds while thinking about the upsetting memory. While how and why it works are not entirely clear, evidence indicates that it can be an effective treatment that helps people process their trauma and heal.

Lifestyle Changes

In addition to PTSD medication and psychotherapy, lifestyle modifications can also support your well-being and trauma recovery.

Some helpful strategies:

• Join a PTSD support group: Talking to other trauma survivors can be a way to share your experiences, learn from others, and gain valuable emotional support.
• Connect with friends and family: Having social support can be critical for people with PTSD. Research indicates that people who have support as they receive treatment for their condition experience more significant improvements in their symptoms.
• Stay active: People who get regular exercise appear to cope better than those who don't. Exercise is linked to fewer PTSD symptoms, less depression, and better sleep.

Summary

Medication can be helpful in the treatment of PTSD, but it is often most effective when used along with trauma-focused talk therapy. The PTSD medications that are most frequently prescribed are Zoloft (sertraline), Paxil (paroxetine), Prozac (fluoxetine), and Effexor (venlafaxine). Zoloft and Paxil are FDA-approved for treating PTSD, but other medications are often prescribed off-label depending on an individual’s specific needs.