Medications to Treat PTSD (Pharmacotherapy)

The use of medication in addition to psychotherapy has been shown to be beneficial in the treatment of PTSD and several types of psychopharmacological agents have been used to resolve PTSD symptoms, but little evidence has been documented to show their effectiveness. Treatment is symptom related.

Antidepressants & PTSD

Several types of antidepressants are used to treat PTSD:

  • Monoamine oxidase inhibitors (MAOIs)
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Selective norepinephrine reuptake inhibitors (SNRIs)
  • Tricyclic antidepressants (TCAs)

MAOIs & PTSD

MAOIs (e.g., phenelzine [Nardil]) have been shown to reduce depression, nightmares and night terrors, flashbacks, violent outbursts, and startle reactions.

Side effects that may occur with MOAIs include dizziness, drowsiness, and blurred vision.

SSRIs & PTSD

High-dose SSRI therapy (e.g., fluoxetine [Prozac]) may reduce depression, intrusive and avoidant symptoms, anger, explosive outbursts, hyperarousal symptoms, and numbing. In 1999, the FDA approved the use of sertraline (Zoloft) for treatment of PTSD.

Side effects that may occur with SSRIs include tardive dyskinesia, headache, gastrointestinal discomfort, weakness, loss of libido, and sexual dysfunction.

SNRIs & PTSD

High-dose nefazodone (Serzone) therapy may help control intrusive and hyperarousal symptoms.

Side effects that may occur with SNRIs include dry mouth, drowsiness, nausea, and dizziness.

TCAs & PTSD

Tricyclic antidepressants (e.g., clomipramine [Anafranil]; doxepin [Sinequan]) have been shown to reduce insomnia and dream disturbance, anxiety, guilt, flashbacks, and depression.

Side effects that may occur with TCAs include dry mouth, blurred vision, and rapid heart beat (tachycardia).

Antipsychotics & PTSD

Antipsychotics are used to treat intrusive and hyperarousal symptoms. These drugs have not been proven to relieve symptoms over the long term and have serious side effects.

Side effects that may occur with long-term use of antipsychotic medication include muscle tremors, rigidity, and spasms; and abnormal facial movements, such as lip smacking and tongue wagging.

Anxiolytics (Antianxiety Agents) & PTSD

Anxiolytics (e.g., buspirone [BuSpar]) have been shown to reduce anxiety, irritability, insomnia, and hypervigilance. No studies have been done demonstrate long-term effectiveness.

Benzodiazepines (e.g., diazepam [Valium]; chlordiazepoxide [Librium]) have a sedative effect and are used to reduce symptoms of acute stress and anxiety, such as panic attacks and phobias.

However, benzodiazepines carry a risk for substance dependence and usually are not recommended as treatment for PTSD, because patients with this disorder are often predisposed to developing substance abuse.

Mood Stabilizers & PTSD

Lithium has been shown to reduce intrusive symptoms and irritability.

Side effects that may occur with lithium include dry mouth, blurred vision, and rapid heart beat (tachycardia).

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 01 Feb 2001

Last Modified: 13 Feb 2015