Medication Management for PTSD
Each case of PTSD has unique biological, psychological and social determinants that require different treatment options. During the initial assessment, our psychologists will review all these factors to determine what medications are needed. Medications can work in conjunction with cognitive behavioral therapies (CBT) to relieve PTSD symptoms faster than just medication or CBT on its own.
The Role of Medication
PTSD medications are targeting four core symptoms:
- Intrusion- nightmares, unwanted thoughts of traumatic events, flashbacks
- Avoidance- avoiding triggers for traumatic memories, such as places, conversations and other reminders
- Negative alterations in cognitions and mood- self-blame for the trauma, negative beliefs about oneself and/or the world, persisting negative emotions, feelings of alienation and inability to feel positive emotions
- Alterations in arousal and reactivity- angry, reckless and/or self-destructive behavior, problems sleeping, concentration issues and hypervigilance
The medication prescribed to treat PTSD symptoms act broadly on neurotransmitters that affect the fear and anxiety parts of the brain. This include serotonin, norepinephrine, gamma-aminobutyric acid (GABA), the excitatory amino acid glutamate, dopamine and more. Medications do not entirely eliminate symptoms, but they will provide a reduction in symptoms to allow the patient to live a fuller life.
Medications that have proven to be effective in treating PTSD are similar to those used in treating depression and anxiety. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are typically prescribed for individuals suffering from PTSD to help manage symptoms. SSRIs can include sertraline (also known as Zoloft), paroxetine (Paxil) and fluoxetine (Prozac). SNRIs include venlafaxine (Effexor). Effects can typically be felt in four to six weeks.
Part of the challenge of medication and why medication management is important is determining the specific dose and timining of medication for each individual. There are no consistent relationships between height, age and clinical response to a medication. Trial often is the best determining factor to finding the most beneficial dosage. Typically, patients will start with a lower dose, increasing dosage in three to seven day intervals until clinical benefits are achieved.