What are the main medicines for post traumatic stress disorder?
If you are prescribed a medicine, then there may be many reasons why that one has been chosen. These might include:
- side effects (which ones are important to you)
- local policies or agreements (such as what your GP surgery uses or agreements in your area)
- national policies (e.g. NICE, SIGN - see last question)
- familiarity (it may be better for prescribers to use medicines they are familiar with)
- relative costs for similar medicines (if two medicines are very similar, why waste money on the more expensive one?)
- personal preference (either yours or your prescriber)
- how bad your symptoms are
- any medicine you might have done well with in the past (as it's more likely to work again)
The main medicine treatment options are listed below. They are divided into "Main medicines" and "Others".
For convenience, the "Main medicines” are those medicines that are officially "approved" to treat the condition or symptoms (www.bnf.org/bnf/) and which are listed in the British National Formulary (BNF). To be listed in the BNF there needs to be good evidence that the medicine works and that the manufacturers have applied for a license (a long and costly exercise). "Others" are those medicines where there is some evidence that they help, but either not enough for a license or that no license has been applied for. These should usually only be used where other standard treatments have failed.
Main medicines
BNF Listed:
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Serotonin boosters (SSRIs) (such as sertraline up to 200mg a day, and paroxetine up to 50mg a day)
Others:
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Other serotonin boosters (SSRIs) may help (e.g. citalopram, escitalopram or fluoxetine)
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Amitriptyline (generally only prescribed by mental health specialists for PTSD)
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Phenelzine (generally only prescribed by mental health specialists for PTSD)
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Hypnotics (such as zaleplon, zolpidem, zopiclone or temazepam) - for short-term use where sleep is a major problem for an adult PTSD sufferer
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Antipsychotics (such as olanzapine), in addition to other medications in difficult-to-treat symptoms
It can be very difficult to decrease the symptoms of PTSD. Doses of SSRIs such as sertraline and paroxetine will generally need to be increased to the top end of the range for 6 to 12 months to get the full effect.
Updated 10.11