Medication for post-traumatic stress disorder

Photo of a traumatized woman being comforted

Although medication can’t replace psychological treatment, it can be a valuable addition in certain situations. But only a few medications have been proven to work. Because they may have side effects, it’s a good idea to carefully consider the pros and cons before deciding whether or not to use them.

Psychological support is the most important treatment for post-traumatic stress disorder (PTSD). Scientific guidelines advise people not to use medication alone or as the main treatment for PTSD. Medication is only considered in certain situations. The decision will depend on factors such as the type and severity of symptoms and whether the person has other illnesses such as depression, an anxiety disorder or an addiction.

Medication can be taken for the following purposes:

  • Temporary relief of severe symptoms such as insomnia or panic attacks
  • Long-term relief of PTSD symptoms

Antidepressants are the most commonly used medications in the treatment of PTSD. Sleeping pils and sedatives () aren’t suitable for the treatment of PTSD, because there’s a risk of becoming dependent on them and they hardly relieve the symptoms.

Before starting treatment with medication, it’s important to find out how effective it is and what side effects it may have. You should also talk to your doctor about what can be expected from the treatment, and then have regular appointments to discuss how well the medication is working and how to deal with any problems that arise. It is important for the doctors and psychologists who are treating you to share information about your treatment. Psychologists aren’t allowed to prescribe medication.

When are antidepressants an option?

Antidepressants are usually only considered for the treatment of PTSD if the person is feeling very depressed, anxious or irritable. They are also meant to help people fall asleep and stay asleep. Antidepressants can be used temporarily or for long-term treatment. Only two medications have been approved for the treatment of post-traumatic stress disorder in Germany: sertraline and paroxetine. Both of these drugs have been shown to relieve the symptoms in scientific studies. A number of other antidepressants (such as venflaxine) can be used too, but only “off label.” It often takes several weeks for antidepressants to have a noticeable effect.

In studies, the symptoms clearly improved within a few months in about

  • 35 out of 100 people who did not take antidepressants, and in about
  • 55 out of 100 people who did take antidepressants.

A lot of people who have PTSD are also able to manage without antidepressants. Because this medication can have side effects such as headaches, dizziness or nausea, it’s important to carefully consider whether you really need to take it.

What about sleeping pills and sedatives?

Sleeping pills and sedatives () are meant to reduce hyperarousal (e.g. feeling anxious, irritable and on edge) and improve sleep. But scientific guidelines now advise people who have PTSD not to use them. Hardly any studies have looked into their effectiveness. What’s more, you can become dependent on them within just a few weeks.

Can PTSD be prevented with medication?

Medication is rarely taken for the prevention of PTSD: It generally can’t stop the development of post-traumatic stress disorder when taken immediately after the traumatic event.

Amos T, Stein DJ, Ipser JC. Pharmacological interventions for preventing post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev 2014; (7): CD006239.

Deutschsprachige Gesellschaft für Psychotraumatologie (DeGPT). Posttraumatische Belastungsstörung (S3-Leitlinie, in Überarbeitung). AWMF-Registernr.: 155-001. 2019.

Frommberger U, Nyberg E, Angenendt J et al. Posttraumatische Belastungsstörungen. In: Berger M (Ed). Psychische Erkrankungen – Klinik und Therapie. München: Urban und Fischer; 2015.

Hetrick SE, Purcell R, Garner B et al. Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD). Cochrane Database Syst Rev 2010; (7): CD007316.

Hoskins M, Pearce J, Bethell A et al. Pharmacotherapy for post-traumatic stress disorder: systematic review and meta-analysis. Br J Psychiatry 2015; 206(2): 93-100.

Lee DJ, Schnitzlein CW, Wolf JP et al. Psychotherapy Versus Pharmacotherapy for Posttraumatic Stress Disorder: Systemic Review and Meta-Analyses to Determine First-Line Treatments. Depress Anxiety 2016; 33(9): 792-806.

Shalev A, Liberzon I, Marmar C. Post-Traumatic Stress Disorder. N Engl J Med 2017; 376(25): 2459-2469.

Sijbrandij M, Kleiboer A, Bisson JI et al. Pharmacological prevention of post-traumatic stress disorder and acute stress disorder: a systematic review and meta-analysis. Lancet Psychiatry 2015; 2(5): 413-421.

Williams T, Phillips NJ, Stein DJ et al. Pharmacotherapy for post traumatic stress disorder (PTSD). Cochrane Database Syst Rev 2022; (3): CD002795.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on January 31, 2023

Next planned update: 2026

Publisher:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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