The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, contact your doctor.

Studies have shown that medications help to ease symptoms of anxiety, depression, and insomnia in people with PTSD. More research is being conducted on drugs that target the biological changes associated with PTSD.

Prescription Medications

Selective Serotonin Reuptake Inhibitors (SSRIs)

  • Paroxetine (Paxil)
  • Zoloft (Sertraline)
  • Fluoxetine (Prozac)

FDA Public Health Advisory for Antidepressants

The FDA advises that people taking antidepressants should be closely observed. For some, the medications have been linked to worsening symptoms and suicidal thoughts. These adverse effects are most common in young adults. The effects tend to occur at the beginning of treatment or when there is an increase or decrease in the dose.

Although the warning is for all antidepressants, of most concern are the SSRI class such as:

For more information, please visit: http://www.fda.gov/cder/drug/antidepressants/

Atypical Antidepressants

  • Nefazodone (Serzone)
  • Venlafaxine (Effexor)

Tricyclic Antidepressants

  • Doxepin (Sinequan, Adapin)
  • Clomipramine (Anafranil)
  • Nortriptyline (Pamelor, Aventyl)
  • Amitriptyline (Elavil)
  • Imipramine (Tofranil, Janimine)
  • Maprotiline (Ludiomil)
  • Desipramine (Norpramin, Pertofrane)
  • Trimipramine (Surmontil)
  • Protriptyline (Vivactil)

Monoamine Oxidase Inhibitors

  • Selegiline (Eldepryl)
  • Isocarboxid (Marplan)
  • Phenelzine (Nardil)
  • Tranylcypromine (Parnate)

Selective Serotonin Reuptake Inhibitors (SSRIs)

*** see note above

Common names include:

SSRIs affect the concentration of serotonin, a neurotransmitter. This is a brain chemical that plays a role in depression and anxiety. SSRIs have been used effectively in the treatment of depression and anxiety and are often considered the first-line medication treatment in PTSD. Improvement is usually seen in four to six weeks after beginning treatment.

Possible side effects include:

Atypical Antidepressants

Common names include:

Atypical antidepressants also affect the concentration of the neurotransmitter serotonin and are often used as a second-line treatment for PTSD if SSRIs are not effective or well tolerated. Improvement is usually seen in 4-6 weeks after beginning treatment.

Possible side effects include:

  • Nausea
  • Nervousness
  • Diminished sex drive

Tricyclic Antidepressants

Common names include:

Tricyclic antidepressants regulate serotonin and/or noradrenaline in the brain. They are used in the treatment of PTSD for people who have had a good response to them in the past, or for those who do not respond to or tolerate SSRIs, nefazodone, or venlafaxine. Improvement is usually seen in 2-6 weeks after beginning treatment. Tricyclic antidepressants are not addictive.

Possible side effects include:

Monoamine Oxidase Inhibitors

Common names include:

Monoamine oxidase inhibitors (MAOIs) prevent the breakdown of serotonin and noradrenaline, and have been shown to be effective in treating PTSD. They are especially effective for people whose symptoms have not responded to other treatments. Improvement is usually seen in 2-6 weeks after beginning treatment. MAOIs are not addictive.

You should never take an MAOI and an SSRI at the same time. At minimum, a two- to five-week break is necessary if changing from one type of antidepressant to another. Ask your doctor about other prescription and nonprescription drugs that can interact with MAOIs. MAOIs can cause birth defects and should not be taken by pregnant women. When taking MAOIs, you should not eat food with a high tyramine content, such as cheese, dried meats and fish, red wine, vermouth, fava beans, and canned figs.

Possible side effects include:

  • Changes in blood pressure
  • Weight gain
  • Reduced sexual response
  • Insomnia

Note:

If medication is well tolerated, most people with acute PTSD (less than 3 months) will continue to take it for 6-12 months. People with chronic PTSD usually take medication from 12-24 months, and then are gradually tapered off. If symptoms return after medication is discontinued, your doctor may recommend that you resume taking the medication, and take it for a longer period.

Special Considerations

If you are taking medications, follow these general guidelines:

  • Take your medication as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Know what the results and side effects. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over-the-counter medication and herb or dietary supplements.
  • Plan ahead for refills so you don’t run out.

When to Contact Your Doctor

  • You have any side effects that are troublesome and persistent
  • You feel that you are not getting results from your medications after the normal “waiting period”
  • You have further questions about usage or side effects