Medication for PTSD: what you need to know

Medication can play a valuable role in treating post-traumatic stress disorder (PTSD). Although trauma-focused psychotherapy or EMDR (eye movement desensitisation and reprocessing) is often the primary approach, medication can reduce distressing symptoms and make it easier to engage in therapy and manage daily life. 

Purpose of medication in PTSD treatment

Medication is often an important part of PTSD treatment but it’s rarely the only approach used. It tends to be part of a broader recovery toolkit that usually also involves therapy, social support and self-care. 

Creating your treatment plan for PTSD should be collaborative and tailored to your needs. Therefore, taking medication should also be a shared decision between you and your healthcare provider, based on your preferences, medical history and what feels right for you. 

Typically, medication is prescribed:

• To reduce symptoms of PTSD such as hyperarousal, flashbacks and nightmares, depressed mood, anxiety or sleep disturbances
• When the symptoms make it difficult to engage effectively in therapy and function in daily life and relationships
• When PTSD symptoms are severe or long-lasting 
• As an alternative treatment if a person is unable or unwilling to start therapy 
• When there are co-occurring mental health conditions, such as depression or suicidal thoughts 
• As a supportive measure while waiting for therapy, especially when access is delayed – this is a common approach and not a sign that therapy has been ruled out 

What works for one person may not work for another – medication can be effective for some, while others prefer to manage their symptoms through therapy alone. The most important thing is that you feel informed and supported in whatever path you choose. 

Benefits of medication 

Treatment is a process, and while medication isn’t a cure for PTSD, it can be one step towards relief and recovery. In many cases, medication can offer enough relief to help you engage in therapy as it can significantly reduce distressing symptoms. 

It can also help ease specific symptom clusters, including:

• Hyperarousal: medication can reduce the feeling of being constantly on edge (being jumpy, overly alert or easily startled). It helps to calm the nervous system and make everyday life feel more manageable
• Re-experiencing the trauma: when people feel like they are transported back to the scene of the trauma, and experience flashbacks and nightmares. Medications help reduce these symptoms 
• Sleep problems: it’s common to struggle to fall asleep, stay asleep, or experience vivid nightmares. Some medication can improve sleep quality, reduce nightmares and support more restful sleep
• Low mood and anxiety: antidepressants can lift depressed mood and help ease persistent anxiety, which are common in PTSD
• Panic attacks, irritability and poor concentration: medication can help reduce panic symptoms and irritability, improve emotional regulation and help you to think more clearly 
• Co-occurring conditions: many people with PTSD also experience other mental health issues, such as depression and anxiety disorders. The right medication can provide broader support and address these overlapping symptoms

Commonly prescribed medications

Below is an overview of some of the most commonly prescribed medications for PTSD, how they work and why they might be chosen. The aim of medication is to reduce symptoms and allow people to function better and engage in therapy - not to ‘erase’ trauma.

Remember that not every medication is right for everyone, and treatment decisions are based on symptoms, other health conditions and personal preferences.

Duration of treatment

When it comes to medication for PTSD, there’s no ‘one-size-fits-all’ timeline. How long you need to take medication depends on several factors, including:

• The severity and duration of symptoms
• Whether your PTSD is acute or chronic
• The presence of other mental health conditions, like depression or anxiety 
• How well you respond to treatment 

Things to keep in mind about PTSD medication

• It’s not forever – but it can be long-term: most people gradually reduce or stop medication once they’re feeling better – recovery is possible, and medication isn’t usually meant to be taken forever. However, some people may choose to stay on the medication when it continues to support their wellbeing or helps with other health conditions
• Don’t stop medication suddenly: if and when you come off medication, it’s important that this is done gradually and under medical supervision – stopping suddenly can lead to withdrawal symptoms or the return of distressing feelings
• It’s a collaborative process: you’ll work closely with your GP or specialist to decide whether to continue or adjust medication, how long to stay on it and when to stop. These choices are based on your goals, progress and personal circumstances

Side effects and withdrawal symptoms 

Like most medication, medication for PTSD can cause side effects. For most people, these are mild and temporary –  subsiding after a few weeks, once the body has adjusted. 

Not everyone experiences side effects. For many people who do, the benefits of medication (improved sleep, reduced anxiety and stabilised mood) far outweigh the drawbacks. If there are side effects, these can generally be managed in collaboration with your healthcare provider.

Common side effects

• Nausea 
• Headaches
• Sleep disturbances 
• Increased anxiety or restlessness at first
• Sweating or dizziness
• Sexual side effects, such as reduced libido or difficulty reaching orgasm 
• Emotional blunting – a reduced ability to feel emotions, often described as feeling numb, flat or disconnected 

Rarer or more serious side effects 

• Mood changes, such as agitation or low mood
• Suicidal thoughts, especially in the early stages
• Severe allergic reactions 
• Hyponatremia (low sodium levels) in older adults