Treatment of PTSD

By Harold Cohen, Ph.D.

There are two primary types of treatment for posttraumatic stress disorder (PTSD) — psychotherapy and medications.

Psychotherapy for PTSD

Most people who experience post-traumatic stress disorder undergo some type of psychotherapy (most commonly either cognitive-behavioral therapy or group psychotherapy, or combination of the two). You can learn more about psychotherapy for PTSD now.

Psychotherapy techniques commonly prescribed include group psychotherapy, cognitive-behavioral therapy, EMDR and hypnotherapy.

Medications for PTSD

Medications are nearly always used in conjunction with psychotherapy for PTSD, because while medications may treat some of the symptoms commonly associated with the disorder, they will not relieve a person of the flashbacks or feelings associated with the original trauma. If one is receiving a medication from a general practitioner or their doctor, they should nearly always seek a psychotherapy referral in addition to the prescription.

Antidepressants

The most commonly prescribed class of medications for PTSD (and the one approved by the U.S. Food and Drug Administration) are the selective serotonin reuptake inhibitor (SSRI) antidepressants. These include drugs such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). Research shows that this group of medicines tends to decrease anxiety, depression, and panic associated with PTSD in many people. These types of antidepressants may also help reduce aggression, impulsivity, and suicidal thoughts that can occur in people with PTSD.

This class of antidepressants generally takes 6 to 8 weeks to work, so patience is needed when taking them. Many people don’t always respond to the first type of antidepressant tried, so another antidepressant may need to be tried if the first one is ineffective. A relapse of posttraumatic stress disorder is less likely if antidepressants are prescribed for at least a year. Antidepressants are particularly useful in patients who also suffer from depression (although they can be useful even in the absence of depression). They are also useful when there is a history of abuse of alcohol or other substances,

Other Medications

There are a variety of other medications often prescribed to try and help reduce the symptoms associated with PTSD. The most common alternative to antidepressants are the atypical antipsychotics. Atypical antipsychotics include medications such as risperidone (Risperdal), olanzapine (Zyprexa), and quetiapine (Seroquel). Antipsychotic medicines seem to be most useful in the treatment of PTSD in those who suffer from agitation, dissociation, hypervigilance, intense suspiciousness (paranoia), or brief breaks in being in touch with reality (brief psychotic reactions).

Other less directly effective but nevertheless potentially helpful medications for managing PTSD include mood stabilizers like lamotrigine (Lamictal), tiagabine (Gabitril), and divalproex sodium (Depakote). Medicines that help decrease the physical symptoms associated with PTSD include drugs such as clonidine (Catapres), guaneficine (Tenex), and propranolol.

Benzodiazepines (commonly referred to as minor tranquilizers, sleeping tablets, or anti-anxiety medications) are sometimes prescribed for certain symptoms of PTSD because they provide rapid relief of anxiety, but are also associated with dependence. In general, there is far more evidence for the use of antidepressants in PTSD than for the use of benzodiazepines. There is even a small amount of data indicating that although the benzodiazepines can provide immediate relief of symptoms, over the long haul they can exacerbate PTSD.

In general, medications should be prescribed for PTSD only by a psychiatrist. Specialists may prescribe two medications at the same time for people with PTSD who fail to respond to various single medications.

 

APA Reference
Cohen, H. (2006). Treatment of PTSD. Psych Central. Retrieved on October 20, 2014, from http://psychcentral.com/lib/an-overview-of-treatment-of-ptsd/000161
Scientifically Reviewed
    Last reviewed: By John M. Grohol, Psy.D. on 30 Jan 2013
    Published on PsychCentral.com. All rights reserved.