A combo of therapy + medications may bring relief.
Not all veterans with post-traumatic stress disorder, or PTSD, need medications on their road to recovery. For some, psychotherapy alone may help them recover. When psychotherapy isn’t sufficient, there are many available medications to treat PTSD in veterans.
Selective Serotonin Reuptake Inhibitors
“The medications used to treat PTSD are selective serotonin reuptake inhibitors,” says Collin Reiff, MD, psychiatrist at NYU Langone Health. “They help treat PTSD because they’re really good at decreasing anxiety. They’re really good at decreasing hypervigilance or arousal.”
These medications—also known as SSRIs—work by increasing the availability of serotonin in the brain. Serotonin is a neurotransmitter that helps to regulate mood, sleep, appetite, and more. While SSRIs are often called antidepressants, they also help treat anxiety disorders, such as PTSD.
“They’re really good at decreasing panic attacks,” says Dr. Reiff. “They can enhance mood, they can improve sleep, [and] they can blunt the intensity of unwanted emotions.”
Other Medications That Can Help
SSRIs are the first-line medication to treat PTSD. However, other medications are available if someone does not find relief from SSRIs.
Alpha-2 Receptor Agonists
These medications dampen the activity of the sympathetic nervous system. Normally, this is the part of the body that causes faster heart rate, increased blood pressure, and sweating when you’re under stress. However, PTSD is related to a hyperactive sympathetic nervous system, leading to hyper-vigilance and panic attacks.
Selective Serotonin and Norepinephrine Reuptake Inhibitors
These are another category of antidepressants. “SNRIs are similar to SSRIs except they also increase the levels of norepinephrine in the brain, so it just adds another neurotransmitter to the equation,” says Dr. Reiff.
Researchers are currently testing the effectiveness of MDMA to treat PTSD for veterans. Currently, MDMA is classified as an illegal drug due to its psychedelic effects.
“What [MDMA] is really good at doing is deactivating the fear network. When that network is deactivated, it makes it easier, or so it seems so far, to talk about traumatic events, which individuals often avoid talking about,” says Dr. Reiff.
MDMA for the treatment of PTSD is currently in clinical trials. Research has been “promising,” says Dr. Reiff. If approved, MDMA may be rescheduled from schedule 1 (illegal) to schedule 2 or 3 (risky but allowed for medical use).
For more information about the treatment of PTSD in veterans, here are types of therapy that help treat PTSD.
Collin Reiff, MD, is an addiction psychiatrist at NYU Langone Health and a clinical assistant professor at NYU Grossman School of Medicine.
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Post-traumatic stress disorder is often treated
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with psychotherapy and/or medications.
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The medications used to treat PTSD
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are selective serotonin reuptake inhibitors.
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They help treat PTSD because they're really good
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at decreasing anxiety.
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They're really good at decreasing hypervigilance
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Again, that kind of relates to the anxiety component.
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They're really good at decreasing panic attacks.
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They can enhance mood.
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They can improve sleep.
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They can blunt the intensity of unwanted emotions.
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For some patients, these are a temporary bandaid.
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For some patients, the benefit is so great
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that they decide to take them for months
or maybe even years.
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Another medications that's used for PTSD
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is one that's alpha-2 agonist.
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That's just a fancy way of saying that it works
in the adrenergic system.
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What this medication does is it decreases
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the sympathetic response to perceived threats,
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which may be in the forms of memories
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or nightmares or flashbacks.
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That is a fight-or-flight response,
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really a flight response, to a perceived
threat or danger.
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There's some other medications that are used.
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The SNRIs: selective serotonin
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and norepinephrine reuptake inhibitors.
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There's some evidence that those are effective
for treating PTSD.
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SNRIs are similar to SSRIs
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except they also increase the levels of norepinephrine
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in the brain.
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So it just adds another neurotransmitter to the equation.
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Another compound that may be rescheduled
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in the near future from schedule 1,
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which means that it's currently illegal,
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to perhaps schedule 2 or schedule 3,
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What it's really good at doing is
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deactivating the fear network.
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When that network is deactivated,
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it makes it easier, or so it seems so far,
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to talk about traumatic events,
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which individuals often avoid talking about.
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MDMA is currently in phase of clinical trials
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for the treatment of post-traumatic stress disorder.
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So far, the research has been promising
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and we'll probably know within the next
two to three years
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if the medication is efficacious
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for the treatment of post-traumatic stress disorder.
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- Belkin MR, Schwartz TL. Alpha-2 receptor agonists for the treatment of posttraumatic stress disorder. Drugs Context. 2015;4:212286.
- Drug scheduling. United States Drug Enforcement Administration. (Accessed on August 19, 2020)
- Medications for PTSD. Washington, DC: U.S. Department of Veterans Affairs. (Accessed on August 19, 2020)
- What is MDMA? National Institute on Drug Abuse. (Accessed on August 19, 2020)