4 pharmacological treatments of PTSD
1. Anti-Depressants
Anti-depressants are one of the most commonly prescribed medications to treat PTSD. The main anti-depressant classes that can be used to treat PTSD include:
| Selective Serotonin Reuptake Inhibitors (SSRIs) | SSRIs tend to be the first prescription option for PTSD as they are safe, effective and well-tolerated. Examples: Sertraline, Paroxetine. |
| Serotonin Noradrenaline Reuptake Inhibitors (SNRIs) | SNRIs can be used to treat PTSD. Example: Venlafaxine. |
| Noradrenergic and Specific Serotonin Antidepressants (NaSSa) | NaSSa’s tends to be used in people who fail to respond to SSRIs and have significant sleep disturbance. Example: Mirtazapine. |
| Tri-Cyclic Antidepressants (TCAs) | TCAs tend to have more side effects and are dangerous if taken as an overdose. They tend to be used second-line after SSRIs and NaSSa’s. Example: Amitriptyline |
| Mono-Amine Oxidase Inhibitors (MAOIs) | MAOIs have certain diet restrictions such as the avoidance of Tyramine contained in foods including Bovril, Marmite, tofu, and game. MAOIs tend to be used after SSRIs, NaSSa and TCAs. Example: Phenelzine. |
2. Prazosin
Prazosin can be used to treat the nightmares associated with PTSD. It can be used alone or in combination with anti-depressant therapy. Prazosin is an alpha-blocker and can affect blood pressure. Therefore this medication is usually only prescribed by specialist mental health teams.
3. Anti-Psychotic Medication
In some cases of severe PTSD, an antipsychotic medication such as Risperidone may be considered. This is usually prescribed for individuals with highly distressing symptoms who have not responded to other pharmacological management strategies. Anti-psychotic medication is usually prescribed in combination with psychological therapies.
4. Benzodiazepines
The use of routine benzodiazepines after a traumatic event is not recommended to prevent PTSD.
References
NICE. (2018). Recommendations | Post-traumatic stress disorder | Guidance | NICE. Retrieved from https://www.nice.org.uk/guidance/ng116
Post-Traumatic Stress Disorder (PTSD) in the Global Context
Post-Traumatic Stress Disorder (PTSD) in the Global Context
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