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Medication for Trauma and Stressor-Related Disorders

Jamie Marich, Ph.D., LPCC-S, LICDC-CS, RMT, edited by C. E. Zupanick, Psy.D.

At one time or another, many trauma survivors may ask in desperation: Isn't there just a pill that I can take to wipe out these horrible memories? If you've asked that question, you are not alone. The fact remains, there is no "memory drug" that will make you simply forget about what happened. Even if one gets invented someday (some trials are in progress), wiping out traumatic memories may not eliminate the symptoms that show up in the body (e.g., sweats, muscle memory, pain related to the trauma). Thus, even though it seems a lot easier to just take a pill, recovering from PTSD and other trauma or stressor-related difficulties typically involves more comprehensive interventions. We've highlighted many of these interventions in this chapter.

With that caveat in mind, there are some drugs that may be helpful. In the United States, the Federal Drug Administration (FDA) is responsible for protecting the public health by assuring the safety, efficacy and security of human and veterinary drugs. The FDA regulates which drugs may come to market and for what purpose. However, the FDA does not regulate the practice of medicine. Therefore, drugs may be prescribed for a purpose that was not approved by the FDA. When this occurs it is called off-label prescribing. There are currently only two FDA-approved medications for use with PTSD. These are both antidepressant drugs: sertraline (Zoloft®) and paroxetine (Paxil®).

However, a great deal of off-label prescribing does occur. Drugs that were not intended to treat PTSD or other trauma-related disorders, are used to treat the symptoms of trauma (e.g., sleep disturbances). As we've discussed throughout this article, there is a great deal of overlap in psychiatric diagnoses. Before you agree to take a medication, be sure you have specifically mentioned to the provider your trauma background. Many symptoms of trauma and stressor-related disorders look like symptoms of other disorders; particularly bipolar disorder, ADHD, and psychotic disorders. Without properly considering your trauma background, your provider may prescribe medications that are not helpful, and may even make things worse.

If you or your therapist think it's a good idea to consider medication, you should ask about the prescribing provider's experience treating trauma and PTSD. You can also be your own advocate. For instance, if a provider recommends that you go on a lot of medications and this doesn't feel right to you, don't be silent. Ask questions. Speak up for yourself. If your provider gets annoyed at your questions, so what? In that case, it's probably wise to look for a different provider who will treat your questions and concerns with respect. If you think the provider has not adequately taken your trauma experiences into account, then it is your right and responsibility to obtain a second opinion.

 


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