Baseer Maroof, LCSW · Raleigh, NC · Adults 21+
Medication
What the guidelines say about medication for PTSD, in one place.
In short
- Sertraline, paroxetine and venlafaxine have the strongest evidence; only sertraline and paroxetine are FDA-approved for PTSD.
- VA/DoD recommends trauma-focused therapy over medication. APA lists these medications second line.
- Prazosin is suggested for trauma nightmares, not PTSD overall.
- Both guidelines advise against benzodiazepines.
The basicsWhat helpsHow it worksEvidenceCheck with a doctor
Lookup
Medication lookup
Tap a medication to see how each guideline rates it.
With your prescriber
Talk to your doctor
Starting, changing or stopping a medication is a decision to make with your prescriber. Bring this page if it helps.
Medication and therapy
Medication can be the right choice, especially if therapy isn’t available or you prefer it. APA found too little evidence to say whether SSRIs or psychotherapy is better head to head; the VA/DoD recommends trauma-focused therapy over medication. (APA 2025; VA/DoD 2023)
Fluoxetine
VA/DoD downgraded fluoxetine to insufficient evidence in 2023, while APA still lists it with sertraline, paroxetine and venlafaxine. (National Center for PTSD; APA 2025)
Sources
All sources, linked3 references⌄
- National Center for PTSD. Clinician’s Guide to Medications for PTSD. www.ptsd.va.gov/professional/treat/txessentials/clinician_guide_meds.asp
- Schnurr PP et al. (2024). The Management of Posttraumatic Stress Disorder and Acute Stress Disorder: synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline. Annals of Internal Medicine (2024). doi:10.7326/M23-2757. www.healthquality.va.gov/guidelines/MH/ptsd/PTSD-in-Annals-2024.pdf
- American Psychological Association (2025). Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. www.apa.org/ptsd-guideline
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