Medications for Anxiety & Trauma

MEDS FOR ANXIETY & TRAUMA DISORDERS (ATI-style but not boring) ✨

Think: GAD, panic disorder, OCD, PTSD, acute stress disorder, etc.

1⃣ SSRIs — FIRST-LINE BAD BITCHES

These are the “your brain is sad and stressed so let me pump serotonin back into your soul” meds.

  • Sertraline (Zoloft)

  • Paroxetine (Paxil)

  • Fluoxetine (Prozac)

  • Escitalopram (Lexapro)

  • Fluvoxamine

Takes 2–6 weeks
Watch for: sexual dysfunction, weight gain, serotonin syndrome (sweaty, agitated, tremors)

2⃣ SNRIs — THE STIMMIER COUSINS

Serotonin + norepinephrine = double whammy.

  • Venlafaxine (Effexor)

  • Duloxetine (Cymbalta)

Watch for: HTN, insomnia, sweating, nausea
NO MAOIs within 14 days.

3⃣ BENZODIAZEPINES — “STOP THE PANIC NOW” (Short-term ONLY)

These work fast but are addictive as hell so they’re NOT long-term.

  • Lorazepam (Ativan)

  • Alprazolam (Xanax)

  • Diazepam (Valium)

  • Clonazepam (Klonopin)

Big warnings:
🚫 Avoid alcohol
🚫 Risk for dependence
🚫 Sedation, respiratory depression
Used short-term only, not for PTSD long-term therapy.

4⃣ ATYPICAL ANXIOLYTIC — THE “SLOW BUT SAFE” ONE

Non-sedating, non-addictive. For chronic anxiety.

  • Buspirone (Buspar)

Onset: 2–6 weeks
Safe for long-term
NO grapefruit juice

5⃣ BETA BLOCKERS — FOR PHYSICAL SYMPTOMS

Stops the shaky hands, tachycardia, sweating.

  • Propranolol

  • Atenolol

Used for performance anxiety or situational anxiety.

6⃣ ANTI-EPILEPTICS FOR PTSD NIGHTMARES

  • Prazosin – helps nightmares & sleep

  • Carbamazepine / Valproate – mood stabilizing effects for aggression & impulsivity in PTSD (less common but ATI likes to sprinkle this in)

7⃣ OTHER PTSD SUPPORTS

  • SNRIs/SSRIs = first line for PTSD

  • Trazodone – often used to help them sleep

  • Hydroxyzine – antihistamine with anti-anxiety effects (non-addictive; “benzo-lite”)

8⃣ AVOID THESE IN PTSD

🚫 Benzos (can worsen dissociation + addiction risk)
🚫 Stimulants unless comorbid ADHD and carefully monitored