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PTSD: National Center for PTSD

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First, Do No Harm: Avoiding Prescribing Pitfalls


Rural Provider PTSD Toolkit

First, Do No Harm: Avoiding Prescribing Pitfalls
Iraq Veteran cap sitting next to prescription pill bottles
Individual, trauma-focused psychotherapy is the most effective treatment for PTSD, but medications can be helpful in some patients. For the best outcome, it is important to keep focused on treating the core symptoms of PTSD.

When medication use shifts from treatment of PTSD to the quick amelioration of anxiety, anger, sleep disturbance and nightmares, treatment is less likely to be effective and may result in harm. Clinicians must manage a confusing overlap of symptoms when treating patients with PTSD, insomnia, and chronic pain - and increasingly face difficult decisions about how to manage medications, especially in patients with active or past substance use disorders. It is important to pause before initiating any medication to consider all the ramifications.
Mindful Medication Prescribing
Figure 3: Mindful medication prescribing
Ask yourself... Is the drug indicated? Is there a safer alternative (drug or non-drug)? Is the benefit greater than the risk? How will the drug help with goals/outcomes? Could it make another condition worse? Is there a more important drug or behavioral treatment? How many psychoactive medications are prescribed? Are there interactions/contradictions in the regimen? Could a modifiable medication/substance, comorbidity, or social factor be causing the problem?

PTSD Information Voice Mail: (802) 296-6300
Also see: VA Mental Health