How To Choose An Effective PTSD Treatment

Medically reviewed by Paige Henry, LMSW, J.D.
Updated April 10, 2024by BetterHelp Editorial Team
Content warning: Please be advised, the below article might mention trauma-related topics that could be triggering to the reader. Please see our Get Help Now page for more immediate resources.
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Post-traumatic stress disorder (PTSD) affects millions of Americans with symptoms that adversely impact work, relationships, and daily life. PTSD can be complex and includes biological, psychological, and social components. The condition is often treated with talk therapy or medication. If you're looking to decide which type of PTSD treatment is most effective for you, there are a few options to consider.

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The effects of PTSD

The brain of a person with PTSD shows marked differences from a person without the condition. For example, brain imaging shows increased activity in the amygdala, the brain area controlling the fight or flight impulse when faced with danger. Brain imaging also shows changes in how the amygdala is integrated with the prefrontal cortex, the brain region responsible for rational thinking and judgment.

This altered brain structure partially explains the four symptom clusters that The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes as criteria for a PTSD diagnosis, including the following: 

  • Re-experiencing symptoms: Re-experiencing the traumatic event through nightmares, physical reactivity, distressing memories, and flashbacks 
  • Avoidance symptoms: Avoiding trauma-related stimuli, including external reminders, such as specific places, conversations, or objects, and internal reminders, such as thoughts and emotions
  • Cognitive symptoms: Unwanted thoughts or feelings, such as blaming oneself. The person might also demonstrate negative attitudes about the world or others 
  • Arousal symptoms: Changes in arousal levels, such as feeling on edge, irritability, increased anger, difficulty concentrating, hypervigilance, or easy startle  

Without treatment, some people’s symptoms may gradually lessen, while others may experience worsening symptoms or even physical medical problems, like hypertension.

Psychotherapeutic treatments for PTSD

Successful treatment for PTSD may depend on the individual. However, a few factors may influence the success of treatment.

According to the US Department of Veterans Affairs, the most effective first-line treatments for PTSD are cognitive-behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR). Other therapies for PTSD may include prolonged exposure therapy and cognitive processing therapy (CPT). 

In some instances, symptoms may be so severe they interfere with psychotherapy. Effective therapy often requires "talking through" or "remembering" traumatic memories, and this experience may be difficult or impossible for some people. In cases like these, medications might ease symptoms enough to reap the benefits of cognitive therapy.

However, consult your mental health and medical team before starting, changing, or stopping a medication. 


Questions to consider about PTSD medications

The decision to medicate or not can be complicated because there are various medications on the market, and each one has potential side effects to discuss with your doctor. In addition, starting a new medication can be scary, and you may be taking a risk to see whether the benefits outweigh any adverse effects.

The following questions can be considered as you contemplate which PTSD medication may be effective for you alongside your doctor's advice: 

  • Do you have other mental health problems besides PTSD, like panic disorder or major depressive disorder, that medication might treat? 
  • Are you prepared to handle potential side effects on the road to recovery?
  • Have you tried medication before, and what was your experience?
  • Do you have any health conditions that may contraindicate using some medications, such as hypertension or pregnancy?
  • Do you drink alcohol regularly or use any illicit recreational substances that might interact with medications?
  • Which PTSD symptoms are bothering you the most?
  • What is your goal for recovery?

Thinking about these questions before talking to your doctor can help you articulate your concerns about the type of medication that might be most helpful in your situation.

Types of PTSD medications

Note: Although the following sections discuss specific medications often used to treat PTSD symptoms, this article does not replace a doctor's or psychiatrist's medical advice. Do not take any medication without a prescription from a medical doctor, and consider asking for a second opinion from your doctor if you've made a decision based on the information below.

Doctors can prescribe various medications for PTSD symptoms. Many of these are the same that have proven effective in treating other mental health problems, such anxiety disorders and depression. Below are a few broad categories and specific medications that might be used, along with their pros and cons, to help you make a better decision alongside your doctor.

Selective serotonin reuptake inhibitors (SSRIs)

SSRIs are often the first line of defense in treating mood or anxiety disorders, including PTSD. This medication may work by altering serotonin transport in the brain, which plays a central role in mood control. Currently, the SSRIs sertraline and paroxetine are the only ones approved by the FDA for the treatment of PTSD. However, doctors can prescribe other medications off-label if the situation warrants it. This means that there’s insufficient evidence for the FDA to approve it for that purpose, but there is guideline development panel consensus that the medication is generally safe and effective for the condition.

Not every client may experience success using SSRIs to treat PTSD. Some might experience side effects, which can be challenging. Side effects can include headaches, sexual dysfunction, and suicidal ideation. Doctors may also prescribe a similar type of medication called serotonin norepinephrine reuptake inhibitors (SNRIs), which benefits from combined serotonin reuptake inhabitation and norepinephrine reuptake inhibition. These can be more effective than SSRIs, but they tend to cause more side effects.


If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. Support is available 24/7.

Not everyone experiences these side effects, and adverse effects might be mild compared to the relief these medications offer. Studies have shown that 60% of clients find some relief from their symptoms by using them. However, only 20% to 30% achieve complete remission using medication alone. In addition, if you decide to take an SSRI, remember that it can take six to eight weeks for the medicine to begin working. 

Doctors commonly prescribe the following SSRIs for PTSD: 

  • Sertraline (Zoloft): This medicine may also be used for social anxiety disorder, panic disorder, and obsessive-compulsive disorder, which can co-occur with PTSD. 
  • Paroxetine (Paxil): Besides affecting serotonin reuptake, Paxil has the added benefit of a slight effect on norepinephrine and dopamine, which can also affect PTSD symptoms. In addition to PTSD, it has been approved for treating depression, panic disorder, obsessive-compulsive disorder, and social anxiety. 
  • Fluoxetine (Prozac): The use of Prozac for PTSD is off-label, and the results of its success as a treatment for this disorder are still inconclusive. However, fluoxetine may sometimes be prescribed when other medications are ineffective.
  • Venlafaxine (Effexor): This medicine does not fall strictly into the category of SSRI. Instead, it is an SNRI (serotonin-norepinephrine reuptake inhibitor). It works similarly to SSRIs. However, venlafaxine acts primarily by inhibiting the reuptake of norepinephrine in addition to serotonin. 
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Monoamine oxidase inhibitors (MAOIs)

MAOI medications work by blocking the removal of norepinephrine, serotonin, and dopamine from the brain. They are sometimes prescribed for anergic bipolar disorder, atypical depression, depression to is resistant to other medications, and PTSD. Although they can effectively treat PTSD and depressive disorders, they are not often the first line of defense due to safety issues and severe side effects. However, if SSRIs are not working and side effects like high blood pressure are closely monitored, MAOIs can be helpful for some people with PTSD.

The only MAOI that may be recommended for the treatment of PTSD is phenelzine. Some clients who take this medication experience reduced symptoms like avoidance, flashbacks, nightmares, and insomnia. However, they show a slight improvement in other areas. The medicine may cause hypertension and can interact dangerously with substances, so consult a doctor before using it. 

Beta blockers

Beta-blockers block norepinephrine at the brain synapses and block adrenaline from entering organs such as the muscles and the heart. They might help reduce hyperarousal and aggression. They can also improve symptoms of severe anxiety.

The beta blocker medication most used for PTSD is propranolol. Although not FDA-approved for this use, it has been found to help reduce explosive anger, exaggerated startling, intrusive flashbacks, and nightmares.

Counseling options 

Many medications offer support for clients experiencing PTSD or co-occurring mental illnesses. In some cases, a doctor might ask their client to try a prescription for a short time and then switch to another. In other cases, doctors prescribe more than one medication for PTSD and find they can complement each other.

There is no single answer for treating PTSD symptoms, and medications can help temporarily. However, remember that a compassionate and qualified therapist can be crucial in helping you overcome the physical, emotional, and social symptoms of PTSD. Often, medications are short-term, whereas therapy can have long-term impacts. A therapist can also help you determine if medications are reasonable options, although only a doctor or psychiatrist can prescribe them. 

If you're worried about attending therapy due to the cost, distance, or availability, you might also benefit from online counseling. Research shows that online therapy can be effective in treating PTSD. PTSD symptoms include anxiety symptoms that might be easier to manage when talking to a therapist through an online platform. In addition, online therapy has the benefit of being easy to reach from home or any other location with internet connectivity, which can make a significant difference for people with PTSD.

If you're interested in getting started, you can work with an online platform like BetterHelp, which has over 30,000 licensed therapists, counselors, and social workers specializing in various areas of mental health, including PTSD. 


PTSD is a mental illness caused by the experience of a traumatic event or multiple events. Various medications can help people gain control of their symptoms, although many have unpleasant and dangerous side effects. If you're considering medication, consult your primary care physician or psychiatrist for further guidance. If you're looking into a non-medical form of treatment for PTSD, consider talking to a therapist.
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