Medication For Ptsd: What You Need To Know
Post-traumatic stress disorder is a condition that causes emotional and mental distress following a traumatic event or experience.
While PTSD is commonly thought to affect veterans, it can happen in any person who has experienced any level of terror, trauma, abuse, or other triggers.
In this article, I will explain more about PTSD, including symptoms, causes, diagnosis, and treatment options.
It may mention words or suggest ideas that may be triggering for people who are dealing with PTSD, so read with caution.
It is important to know that if you are dealing with symptoms of PTSD in your life, you are not alone and help is available.
While it can feel overwhelming to open up about something that caused trauma in your life, a medical provider will not necessarily make you relay specific details.
Healthcare providers will work with you to make you feel safe and cared for, while finding evidence-based and effective ways to find relief from your symptoms.
If you are experiencing severe PTSD symptoms and need immediate assistance, call the National Suicide Prevention Lifeline at 988, or dial 9-1-1.
Potential Side Effects Of Medication
Every medication has possible side effects, but these will vary between the antidepressant and the person taking the medication. Side effects should improve within a few days or weeks of treatment: always consult your doctor before you stop taking the medication.
The particular side effects of SSRIs can include the following:
- feeling nauseous and/or vomiting
- indigestion and stomach cramps, or loss of appetite
- sexual problems
- gastrointestinal bleeding
You should consult your doctor if you are experiencing side effects that bother you, have further questions about the usages of the medication, or if you feel you arent getting any results from it.
Its important to note, that while choosing your PTSD recovery path you need to address both the symptoms and the underlying condition. NICE guidance updated in 2018 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing and trauma focused cognitive behavioural therapy .
Please remember, these arent meant to be medical recommendations, but theyre tactics that have worked for others and might work for you, too. Be sure to work with a professional to find the best methods for you.
Dropout Side Effect And Adverse Effects
One common concern with trauma-focused treatment is dropout and rates of dropout appear to be similar across PE, CPT and trauma-focused CBT . A substantial minority of individuals drop out of PTSD treatment . Imel et al. conducted a meta-analysis of treatment dropout in PTSD treatment. The aggregate proportion of dropout across all active treatments was 18.28%, however, there was a large amount of variability across studies. The dropout rate varied between active interventions for PTSD across studies, but the differences were primarily driven by differences between studies. In addition, an increase in trauma focus did not predict an increase in the dropout rate. Imel et al. did find evidence across three relatively large trials that dropout is lower in present centered therapy compared to trauma specific treatments .
Unfortunately, few studies explicitly report on side effects and adverse effects of PTSD psychotherapy . The American Psychological Association guidelines recommends that research be conducted on side effects. When examining the results of large controlled trials there is no evidence that trauma-focused treatments are associated with a relative increase in adverse side effects . Clearly more research should examine and report on side effects and adverse effects of PTSD treatment.
Read Also: Is Autism Classed As A Learning Disability
What Are The Side Effects Of Ptsd Meds
Like all drugs, medications for PTSD can cause side effects. Common side effects of SSRIs may include agitation, shakiness, dry mouth, dizziness, bluSSRIs common side effects are red vision, indigestion, and loss of appetite.
Patients may need to try different SSRIs under the direction of a psychiatrist before they find the one that significantly reduces symptoms without causing intolerable side effects.
Clinician’s Guide To Medications For Ptsd
Matt Jeffreys, MD
The 2017 VA/DoD Clinical Practice Guideline for PTSD recommends trauma-focused psychotherapy as the first-line treatment for PTSD over pharmacotherapy . For patients who prefer pharmacotherapy or who do not have access to trauma-focused psychotherapy, medications remain a treatment option. PTSD also carries high levels of psychiatric comorbidities which may be treated with medications.
Also Check: Can Someone With Fibromyalgia Get Disability
Medications With Limited Or Minimal Proven Efficacy
Some medications are currently being prescribed for management of PTSD without supporting evidence from studies. Many small, open-label trials have shown promise for certain drug classes, whereas randomized, controlled trials have displayed conflicting results.13 These medications include benzodiazepines, mood stabilizers/anticonvulsants, and antipsychotics. These classes have shown poor effectiveness in managing PTSD, and their side-effect profiles and monitoring parameters outweigh their benefits.3,13
Benzodiazepines are commonly prescribed for PTSD without supporting evidence of improvements in core PTSD symptoms.3 They have been shown effective for quick symptomatic control of insomnia, anxiety/panic, and irritability, but they worsen PTSD by potentiating the acquisition of fear responses in military veterans and impede recovery from trauma.3,13,14 In a small study, eight veterans with combat-induced PTSD exhibited severe withdrawal reactions while taking a benzodiazepine.3 Withdrawal symptoms of benzodiazepines included anxiety, sleep disturbances, rage, hyperalertness, increased nightmares, and intrusive thoughts.3 Another problem associated with benzodiazepine use is the development of tolerance and dependence.
What Can I Expect
To receive medications for PTSD, you will need to meet with a provider who can prescribe these medications to you. Many different types of providers, including your family provider and even some nurses and physician assistants, can prescribe antidepressant medications for PTSD. You and your provider can work together to decide which antidepressant medication may be best for you.
In general, the 4 different SSRIs and SNRIs listed above appear to work equally well for PTSD. Once you fill your prescription, you will begin taking a pill at regular time each day. It may take a few weeks before you notice the effects of the medication. It is important to continue to take it even if you do not notice changes right away. You will meet with your provider every few months or so. Your provider will monitor your response to the medication and change your dose, if needed.
Video
Also Check: Social Security Office Abilene Tx
Selective Serotonin Reuptake Inhibitors
The neurotransmitter serotonin has a well-recognized role in the experience of mood and anxiety disorders. The activity of this neurotransmitter in both the peripheral and central nervous systems can be modulated by SSRIs.
The SSRIs sertraline and paroxetine are the only medications approved by the FDA for PTSD. While SSRIs are typically the first class of medications used in PTSD treatment , exceptions may occur for patients based upon their individual histories of side effects, response, comorbidities and personal preferences.
Examples of an exception would be:
- A patient with PTSD and co-occurring bipolar disorder where an antidepressant could cause mood instability that could be mitigated with a mood stabilizing medication before prescribing an SSRI.
- Intolerable sexual dysfunction or gastrointestinal side effects due to the effects of increased serotonin levels in the peripheral nervous system.
Each patient varies in their response and ability to tolerate a specific medication and dosage, so medications must be tailored to individual needs. Research indicates that maximum benefit from SSRI treatment depends upon adequate dosages and duration of treatment. Ensuring treatment adherence is key to successful pharmacotherapy for PTSD. Some typical dosage ranges for medications:
- Sertraline : 50 mg to 200 mg daily
- Paroxetine : 20 to 60 mg daily
- Fluoxetine : 20 mg to 60 mg daily
Veterans Affairs And Defense Department Guidelines Updated
The VA/DoD clinical practice guidelines originally recommended off-label risperidone, olanzapine, or quetiapine for the adjunctive treatment of patients with PTSD.1 However, in view of the disappointing results from the recent VA-sanctioned study of risperidone in PTSD,44 the guidelines have been revised to recommend against the use of risperidone as adjunctive therapy.52 The revised guidelines further state that there is insufficient evidence to recommend for or against the use of any other atypical antipsychotic as an adjunctive therapy for the treatment of PTSD.
Table 2 depicts the VA/DoDs current assessment of the drugs used to treat PTSD .52
Read Also: How Much Does Disability Pay For Bipolar
How Does It Work
PTSD may be related to changes in the brain that are linked to our ability to manage stress. People with PTSD appear to have different amounts of certain chemicals in the brain than people without PTSD. The 4 recommended SSRIs and SNRIs are believed to treat PTSD by putting these brain chemicals back in balance.
Video
Can Psilocybin Help Treat Ptsd
While therapy, antidepressants, and antipsychotics help many patients, these methods often fall short. Studies have suggested that antidepressants do not work well for people who have had multiple traumas over the course of years or chronic PTSD. A new study found that the antipsychotic risperidone worked no better than a placebo in alleviating typical PTSD symptoms in patients who had the disorder long-term or who continued to experience symptoms after being treated with antidepressants.
Because these drugs can also cause intolerable side effects, many patients are left to experience PTSD with no sign of relief. Many of these patients turn to substance abuse, develop anger management issues, or commit suicide. A study analyzing data from the National Comorbidity Survey showed that out of six anxiety diagnoses, PTSD was significantly associated with suicide attempts.
Stephen Ross, MD, a psychiatrist at NYU Langone, conducted a study on terminally ill cancer patients , and found that one-time treatment with psilocybin very quickly brought relief from distress that had lasted more than 6 months in 80 percent of study subjects.
Read Also: Lawyer For Social Security Disability Appeal
Class Discussion: Weighing Approval Of A New Miracle Drug
Teachers should read the following two paragraphs aloud before splitting the classroom into two groups:
A new pill has been made that helps people lose five pounds every time they take it. The weight loss community is going crazy about this new miracle drugbegging for the FDA to finally approve it so that people can lose weight instantly and feel more confident.
But there are drawbackstaking the drug increases the risk of many diseases, including heart disease. The drug also makes you age faster. Lastly, the drug takes away all appetite, so much so that it is difficult for a person taking the drug to get their daily nutrients from food.
Split the classroom into two groups. Half the class will act as lawyers arguing for the drugs approval, and the other half will serve as the FDA listening and responding with concerns. Whose arguments will be stronger?
This brief was written by Bella Ratner as part of the 2017 Summer Internship Program at NYU Langones Division of Medical Ethics.
What Meds Are Fda Approved For Ptsd
Selective serotonin reuptake inhibitors are indicated for the treatment of PTSD. They can effectively help relieve PTSD symptoms. SSRIs are the only medications for PTSD that have received FDA approval.
SSRIs are commonly used to treat major depressive disorders and generalized anxiety disorder in adults. The FDA has approved these medicines for PTSD treatment based on guidelines from the American Psychiatric Association. Examples of SSRIs used in PTSD patients include sertraline and paroxetine .
Read Also: Beaufort Sc Social Security Office
How To Get Ptsd Medication
Finding the right medication for PTSD treatment can take time and patience. You may find that the first medication you try isnt the most effective. Also, most people see a combination of PTSD medication and therapy work best together to improve symptoms.
As with any medication, reaching out to your doctor is the first thing you should do. If youre hoping to get information about a PTSD medication list or want to find any details about symptoms, options, side effects, or anything else relating to medication, talking to your doctor is important.
To find the right medication for PTSD, go through the following easy steps:
Types Of Medications Used To Treat Ptsd
Sometimes medication for PTSD nightmares or other symptoms is prescribed. Typically, medication is used in conjunction with other treatment techniques like various forms of therapy. Most often, selective serotonin reuptake inhibitors antidepressants are prescribed. They can help treat the depression symptoms that often present with PTSD.
While just a couple of medications are approved by the Food and Drug Administration to treat PTSD, many others are also prescribed off-label. Off-label is when medication is prescribed in a manner that is not specified by FDAs packaging. An in-person or online psychiatrist can set up a treatment plan utilizing a combination of medications to relieve these troubling PTSD symptoms. For instance, the prescription is used for a different condition or the dosage is different than what the FDA recommends.
Recommended Reading: Do You Accrue Vacation While On Short Term Disability Canada
Can Ptsd Be Prevented With Medication
Medication is rarely taken for the prevention of PTSD: It generally cant stop the development of post-traumatic stress disorder if you start taking it immediately after the traumatic event. The only medication that has been shown to reduce the risk of PTSD, in several studies, is hydrocortisone. This drug was mainly given to hospital patients immediately after major surgery or to hospital patients who had blood poisoning . PTSD was less common in these patients. It is thought that some people are more likely to develop post-traumatic stress disorder because their body doesnt produce enough cortisol in stressful situations. Hydrocortisone makes up for this.
When To See A Doctor
If you have experienced trauma and notice symptoms of PTSD in your life, talk with your healthcare provider.
It can be scary to bring up trauma, or it may even feel like you are not able to talk about it.
If your symptoms are affecting your quality of life, know that there is help and that your healthcare provider will work with you to find safe and effective ways to help you.
If you are too scared at the thought of having to discuss your traumatic experiences or that you will have to relive them, let your healthcare provider know.
You may be able to write down your thoughts instead of having to speak face to face.
Do not let the fear of being triggered prevent you from getting help.
Getting treatment as soon as possible helps stop symptoms from worsening.
If you ever experience thoughts of self-harm or suicidal thoughts, do not wait to reach out for help.
- Tell a loved one, friend, or spiritual leader.
- Contact your healthcare provider or mental health professional.
Don’t Miss: How To Disable Insta Account
How Long Does Post
The course of the illness varies from person to person. Some people may recover from symptoms within six months while others may experience symptoms for years. In order for someone to be diagnosed with PTSD, they must have symptoms for at least a month following the triggering event and last more than six months to meet full PTSD diagnostic criteria.
What Are Future Research Directions For Ptsd Pharmacotherapy
The pathophysiological mechanisms for PTSD in the brain are unknown, but there are several interesting neurotransmitters and pathways that could lead to new drug development for the treatment or the prevention of PTSD. There are competing hypotheses about the role of glucocorticoids following trauma and their effects on the brain. It might be possible to intervene at some level in the HPA axis or at the level of the glucocorticoid receptors in the brain to modulate the effects of stress and the development of PTSD. Some research suggests the potential ability of supplemental cortisol in reducing PTSD symptoms . Furthermore, in one small study, cortisol administered prior to PE demonstrated significantly better retention in treatment especially among those patients with increased sensitivity to glucocorticoids. The authors cite several actions of glucocorticoids including potentiating glutamate at NMDA receptors, decreased retrieval of fear memories and interactions with noradrenergic systems, as potential mechanisms of action on brain pathways affecting PTSD .
A recent study compared methylphenidate and the acetylcholinesterase inhibitor galantamine to placebo and found that methylphenidate, but not galantamine, improved cognitive complaints as well as PTSD symptom severity in patients with mild traumatic brain injury and/or PTSD. The authors propose larger randomized controlled trials to further evaluate improving cognition in those with PTSD and co-occurring mTBI .
Also Check: How Does Short Term Disability Work For Surgery
What Type Of Treatment Is This
SSRIs and SNRIs are types of antidepressant medication. Medications have 2 names: a brand name and a generic name . There are 4 SSRIs/SNRIs that are recommended for PTSD:
There are other types of antidepressant medications, but these four medications listed above are the ones that are most effective for PTSD.
Video
SSRI/SNRI: How do meds help?
Providers give an overview on why medications are used to treat PTSD.
Outcomes For Active Drug Vs Active Comparators
We also synthesised active-comparators studies separately to assess the differences between active drugs and active comparators . The analysis showed that sertraline relative to citalopram significantly reduces total severity of PTSD based on a clinician-assessed scale and avoidance symptoms . For symptoms of re-experiencing, the different drug classifications, including MAOI vs. TCAs , and specific drug branches, including phenelzine vs imipramine , had statistically significant differences.
Recommended Reading: How To Check On Disability Claim
What Are Some Of The Causes Of Ptsd
As mentioned, PTSD can often be caused by the traumatic experiences associated with military service however, other events can also lead to PTSD as well.
As it turns out, there are a multitude of reasons why someone might develop PTSD, many of which are not as obvious as being on the battlefield.
For example, the trauma of being in a car accident may be enough to cause PTSD symptoms, causing the individual to experience significant anxiety when confronted with things associated with the accident. They may avoid triggers such as the location where it occurred, or even resist the act of driving/riding in a car.
This type of event could be classified as a direct experience event because the person experienced the trauma of the car crash first-hand however, PTSD can also develop from indirect experiences as well.
An example of this dynamic might be a person who develops PTSD due to hearing several horrible stories of being trapped in an elevator in a high-rise building during a fire or earthquake. Indeed, the repeated exposure to these stories may be enough to elicit a stress response that develops into PTSD, despite the fact that the individual never had first-hand experience with the trauma.