Medication |
Indication |
MOA |
Trial and Number of Participants |
Trial Dosagea |
Common AEs |
Prazosin |
NDPTSD,b ND |
α1- adrenergic antagonist |
Raskind (2018), RCT; N = 304 |
14.8 (6.1) mg/day |
Dizziness, drowsiness, weakness |
Ahmadpanah (2014), RCT; N = 100 |
15 mg/day |
Raskind (2013), RCT; N = 67 |
Men—AM: 4 mg (1.2), PM: 15.6 mg (6)Women—AM: 1.7 mg (0.5), PM: 7 mg (0.5) |
Germain (2012), RCT; N = 50 |
8.9 mg, range 1–15 mg/day |
Boynton (2009), retrospective chart review; N = 23 |
2.3 mg/day (1.4) |
Taylor (2008), crossover RCT; N = 13 |
3.1 mg/day (1.3) |
Raskind (2007), RCT; N = 34 |
13 mg/day (3) |
Daly (2005), case series; N = 28 |
1–6 mg/day |
Peskind (2003), open-label case series; N=9 |
2–4 mg/day |
Raskind (2003), double-blind crossover; N=10 |
9.5 mg/day (0.5) |
Atypical antipsychotic: aripiprazole |
PTSD |
Serotonin, dopamine, histamine, and α-adrenergic antagonist |
Lambert (2006), case series; N = 5 |
15–30 mg/day |
Headache, extrapyramidal reaction, drowsiness |
Atypical antipsychotic: olanzapine |
Jakovljevic (2003), case series; N = 5 |
10–20 mg/day |
Atypical antipsychotic: risperidone |
David (2006), open-label; N = 20 |
2.3 mg/day (0.6) |
Stanovic (2001), retrospective chart review; N = 10 |
0.5–2.0 mg/day |
Benzodiazepines: ND nitrazepam, triazolam |
ND |
Enhances effect of neurotransmitter γ-aminobutyric acid (GABA) at the GABAA receptor |
Ellingsen (1983), crossover RCT; N=40 |
One dose: 0.5 mg triazolam or 5 mg nitrazepam |
Drowsiness, headache, nervousness |
Clonidine |
PTSD |
α2-adrenergic receptor agonist |
Kinzie (1994), 2-wk pilot; N = 4 |
0.2 mg/day |
Rash, Rash, drowsiness |
Kinzie (1989), prospective pilot; N = 9 |
Clonidine 0.2 mg/day + imipramine up to 150 mg/day |
Cyproheptadine |
PTSD |
Serotonin antagonist, additional antihistaminicand anticholinergic effects |
Clark (1999), case series; N = 16 |
4–8 mg/day |
Drowsiness, incoordination, restlessness |
Gupta (1998), retrospective review; N = 9 |
4 days, 12 mg/day |
Brophy (1991), case series; N = 4 |
2–28 mg/day |
Gabapentin |
PTSD |
Unknown, but activity may be due to binding at α2δ subunit |
Hamner (2001), retrospective case series; N=30 |
1,377 mg/day (701) |
Dizziness, drowsiness, ataxia |
Nabilone |
PTSD |
Synthetic CB1 receptor agonist |
Jetly (2015), RCT; N = 10 |
1.95 mg/day (0.9) |
Drowsiness, dizziness, vertigo |
Fraser (2009), open-label; N = 47 |
0.2–4 mg/day |
Phenelzine |
PTSD |
MAO glutamate receptor inhibitor |
Lerer (1987), open-label, prospective trial; N = 25 |
30–90 mg/day |
Dizziness, constipation, orthostatic hypotension |
Hogben (1981), case series; N = 5 |
45–75 mg/day |
SSRI: fluvoxamine |
PTSD |
Enhances serotonergic activity |
Neylan (2001), open-label; N = 21 |
50 mg/day, then titrated to 100–250 mg/day |
Headache, insomnia, nausea |
De Boer (1992), prospective cohort trial; N = 24 |
Up to 300 mg/day |
Topiramate |
PTSD |
Unknown, but may be due to blockage of neuronal voltage dependent sodium channels; enhances GABAA activity, antagonizes glutamatereceptors, andinhibits carbonicanhydrase enzymes |
Alderman (2009), open-label pilot study; N = 29 |
200 mg/day |
Paresthesias, decreased serum bicarbonate, upper respiratory tract infection |
Tucker (2007), RCT; N = 40 |
150 mg/day |
Berlant (2004), case series; N = 33 |
12.5–25 mg/day, then titrated to clinical response |
Berlant (2002), case series; N = 35 |
12.5–500 mg/day |
Trazodone |
PTSD |
Serotonin, histamine, and alpha1- adrenergicantagonist |
Warner (2001), retrospective cohortstudy; N = 74 |
212 mg/day |
Drowsiness, hypertension, dizziness |
TCAs:amitriptyline, doxepin, imipramine |
PTSD |
Anticholinergic, antihistamine, inhibits serotonin-norepinephrinereceptors |
Boehnlein (1985), case series; N = 10 |
Imipramine 75–125 mg/day (n = 3); imipramine150 mg/day + phenelzine30 mg bid (n = 1); phenelzine 30 mg bid+ doxepin 50–100 mg/day + amitriptyline100 mg/day (n = 1); amitriptyline 100 mg/day+ doxepin 50–100 mg/day(n = 1); doxepin 50–100mg/day (n = 4) |
Anticholinergiceffects, orthostatichypotension, sedation |
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