There are two primary types of treatment for posttraumatic stress disorder (PTSD) — psychotherapy and medications. PTSD treatment is readily available to those suffering from the symptoms of this condition — things like flashbacks, anxiety, and nightmares. The kinds of PTSD treatments available will depend on whether you’re a veteran or non-veteran, whether you have insurance or pay for it out of pocket, or rely on public healthcare options.
Psychotherapy for PTSD
Most people who experience PTSD undergo some type of psychotherapy (most commonly either individual therapy or group psychotherapy, or a combination of the two). The most common and effective types of psychotherapy used to treat PTSD include exposure therapies (such as trauma-focused cognitive behavioral therapy or cognitive processing therapy) and reprocessing therapy (known as EMDR for eye movement desensitization and reprocessing). These are all evidence-based treatments that are supported by a multitude of research studies demonstrating their effectiveness in the treatment of PTSD.
Most psychotherapy approaches to help a person with this condition are time-limited and can be successfully completed by most people with mild to medium severity within a year. Some people will take less time, and more severe forms of PTSD can often take longer to treat. Some treatment approaches recommend both once-weekly individual and group therapy, while other approaches focus on just individual therapy.
Learn more: Psychotherapy for PTSD
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.
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,
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.
National Institute for Health and Care Excellence. (2018). Post-traumatic stress disorder: management retrieved from https://www.nice.org.uk/guidance/cg26/chapter/1-Guidance#the-treatment-of-ptsd
National Center for PTSD. (2018). Treatment of PTSD. U.S. Dept. of Veterans Affairs retrieved from https://www.ptsd.va.gov/public/treatment/therapy-med/index.asp
National Center for PTSD. (2018). Medications for PTSD. U.S. Dept. of Veterans Affairs retrieved from https://www.ptsd.va.gov/public/treatment/therapy-med/medications-for-ptsd.asp