PTSD Treatments and Medications

Post-traumatic stress disorder (PTSD) can be a difficult and challenging condition to deal with. It can last for a few months, multiple years, or for life. PTSD is associated with nightmares, heightened reactions, loss of self-control, and anxiety. If you or a loved one has PTSD, read on to learn what the condition is, what the treatment options are, and how to live with the disorder.

What is PTSD?

PTSD is a psychiatric disorder that develops in some people who have experienced a highly traumatic experience or shocking and scary event, such as a natural disaster, sexual assault, terrorist attack, war, or other violent situation. Common symptoms include irritability or agitation, severe anxiety, insomnia, vivid flashbacks, nightmares, and emotional detachment. There are a variety of effective treatments that can help with PTSD, including cognitive behavioral therapy (CBT), group therapy, and medications like selective serotonin reuptake inhibitors (SSRIs).

This mental health condition is fairly common in the U.S., with more than three million cases occurring every year. There are many treatments that exist to combat the disorder. And, there are still new treatments that are in the experimental phase that may alleviate symptoms, such as stellate ganglion block (SGB) and MDMA-assisted psychotherapy.

How is PTSD diagnosed?

PTSD is caused by a traumatic event or series of traumatic events. Those at risk for PTSD include people who have experienced war, natural disasters, assault, or other triggering events. The most common symptoms that generally lead to a diagnosis include increased irritability, nightmares or insomnia, emotional detachment, and severe anxiety. However, a medical diagnosis is generally required to rule out other diseases and conditions.

You may have PTSD if the symptoms you experience from a tragic event or exposure continue for more than a month and cause problems in your ability to function in day-to-day life. If you’re not sure whether you have PTSD, schedule an appointment with your primary healthcare provider or a mental health professional right away, as he or she can help diagnose the issue and provide further medical advice.

Here’s what you can expect at your appointment:

• Physical exam: Your healthcare provider will likely perform a physical exam to rule out any other diseases or conditions that could be causing your symptoms.

• Psychological evaluation: Your healthcare provider may perform a psychological evaluation and ask you questions about any traumatic events you’ve experienced in the past. He or she may take note of any signs and symptoms you’re displaying during the evaluation.

• Review of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria: Your healthcare provider may go through this list of criteria published by the American Psychiatric Association to help determine whether or not you have PTSD.

Questions the healthcare provider may ask you

During your appointment, your healthcare provider may ask the following questions to better inform the diagnosis of PTSD:

• Have you experienced a life-threatening event that has caused fear, helplessness, or horror?

• Do you have repeated memories of a stressful experience from your past?

• How do you feel when you’re reminded of said stressful event?

• Do you avoid activities or situations that remind you of a stressful event from the past?

• Have you been isolating yourself from others?

• Do you feel irritable or have outbursts?

• Do you have difficulty concentrating on daily tasks?

• Are you experiencing symptoms of depression or anxiety?

• Do you feel like you’re losing a sense of control?

• Have you been waking up in the middle of the night from nightmares?

Questions you should ask your healthcare provider

If you do have PTSD, it’s important to understand its causes and course of action over the short- and long-term. Here are some of the more important questions to ask your healthcare provider during your appointment:

• What exactly is post-traumatic stress disorder?

• How long does PTSD last?

• Do children react differently than adults to PTSD?

• How do I live with PTSD?

• What treatments are available?

• What is the best medication for me to take?

• What lifestyle changes can I make to help regulate symptoms of PTSD?

If you’re experiencing PTSD symptoms, your healthcare provider might refer you to a clinical psychologist, psychiatrist, psychotherapist, or other mental health professional to determine what treatment or treatment programs are best.

PTSD treatment options

After receiving your PTSD diagnosis, you’ll want to know all of your options when it comes to treating the disorder. The most popular treatment options include talk therapy, cognitive processing therapy, prolonged exposure therapy, eye movement desensitization and reprocessing (EMDR), stress inoculation training, and medications.

Talk therapy, also known as psychotherapy, is centered around the idea that talking about issues that are bothering you can help put them in perspective. Cognitive processing therapy and prolonged exposure therapy are two of the more common techniques used to help people recover from post-traumatic stress disorder. EMDR was originally designed to alleviate the distress associated with traumatic memories and stress inoculation training (SIT) is another form of cognitive therapy that is used to treat PTSD.

There’s no cure for PTSD—it’s treated symptomatically. However, you can treat your symptoms and prevent them from getting out of hand with a combination of the treatments listed above and approved medications prescribed by your healthcare provider.

PTSD medications

Your healthcare provider may prescribe one or more medications in the following drug classes to help manage PTSD symptoms. Talk to your healthcare provider about which prescription medications are safe for you and remember to always use over-the-counter medicines as directed.

Antidepressants

Antidepressants are medications used to treat depression, anxiety, chronic pain, addiction, and other anxiety disorders. Doctors don’t know exactly how they work but they seem to reduce the intensity of one’s feeling so they are not as overwhelming. Some popular brands are Prozac, Lexapro, Zoloft, and Wellbutrin. Antidepressants can improve your mood, enhance sleep, and increase your appetite and concentration. Common side effects include weight gain, dizziness, headaches, and sexual dysfunction.

Antipsychotics

Antipsychotic medication works by altering certain chemicals in the brain, like dopamine and serotonin. Popular antipsychotics are Abilify, Zyprexa, and Risperdal. These medications are effective in reducing delusions, hallucinations, anxiety, and agitation. Some side effects include stiffness, weight gain, constipation, and drowsiness.

Beta blockers

Beta blockers, also known as beta-adrenergic blocking agents, work by blocking the effects of epinephrine (adrenaline) in your body and reducing your blood pressure. They cause your heart to beat more slowly and with less force, lowering your overall blood pressure. Inderal LA, Zebeta, and Tenormin are common brand names. Beta blockers can improve blood flow and reduce your risk of a heart attack, but they’re known to cause dizziness, fatigue, headache, constipation, reduced libido, and erectile dysfunction.

Benzodiazepines

These medications work by increasing the effects of a brain chemical called gamma-aminobutyric acid (GABA) and act as a sedative, slowing down the body’s functions. Xanax, Klonopin, Valium, and Ativan are some of the more popular benzodiazepines. This type of medicine can help people sleep, reduce anxiety, and relax muscles but are highly addictive and should be used sparingly with the utmost caution. These are not intended for long-term use.

Short-term use of benzodiazepines is generally safe and effective. However, long-term use can lead to dependence on the drug and substance abuse. Side effects may include drowsiness, confusion, trembling, vision problems, and feelings of depression and rebound anxiety.

Monoamine oxidase inhibitors (MAOIs)

Similar to antidepressants, MAOIs work by affecting changes in the brain chemistry that are thought to play a role in depression. Specifically, MAOIs inhibit the activity of one or both monoamine oxidase enzymes: monoamine oxidase A and monoamine oxidase B. Popular brand names include Marplan, Nardil, and Emsam.

When taking MAOIs, people may experience improved mood and less frequent panic attacks. Some of the most common side effects include dry mouth, nausea, drowsiness, insomnia, and headaches. Use of this medication comes with a host of dietary and medication restrictions that when combined can be fatal. Patients are advised to wear a medic alert tag if they are on this medication.

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs work by increasing serotonin levels in the brain and blocking the reabsorption of serotonin into neurons. Some popular brand names are Zoloft, Paxil, Prozac, Lexapro, and Celexa. Paxil and Zoloft are approved by the Food and Drug Administration (FDA) for PTSD treatment. SSRIs are known to help those with anxiety, obsessive-compulsive disorder (OCD), and PTSD. Some side effects include nausea, insomnia, dizziness, sexual dysfunction including decreased libido, erectile dysfunction, and delayed or inability to orgasm for both men and women.

Serotonin-norepinephrine reuptake inhibitors (SNRIs)

SNRIs are a class of antidepressants that can treat anxiety disorders, such as PTSD, OCD, and attention deficit hyperactivity disorder. They work by blocking the reabsorption of serotonin and norepinephrine back into the nerve cells that released them—this increases the levels of active neurotransmitters in the brain.

Common brand names include Cymbalta, Fetzima, Ultram, and Strattera. If you take SNRIs to treat PTSD, you may experience improved mood, fewer panic attacks, and fewer feelings of anxiety. Some side effects include excessive sweating, headaches, dry mouth, and hypertension.

What is the best medication for PTSD?

The best medication for PTSD depends on patients’ symptoms, medical conditions, medical history, and medications they may already be taking that could interact with PTSD medication as well as response to treatment. Talk to your healthcare provider about which medication is safe for you.

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