Taking Medication During EMDR or Trauma Therapy

What is known about medicine and trauma therapy together

The honest answer is that the evidence is limited. The VA/DoD guideline says: "There is insufficient evidence to recommend for or against the combination or augmentation of psychotherapy (see Recommendation 8 and Recommendation 9) or medications (see Recommendation 15) with any psychotherapy or medication for the treatment of PTSD." That is a Neither for nor against rating, with separate statements for antipsychotics and MDMA.

It also notes that evidence is inconclusive on whether combining effective medications or psychotherapies enhances outcomes. The trials it describes looked mainly at Prolonged Exposure with paroxetine or sertraline, so they say little about any particular person's EMDR. NIMH simply notes that providers may prescribe SSRIs and other medications along with psychotherapy.

This means we cannot tell you that a medicine will help or harm your therapy. It does mean that many combinations are a judgment call for you and the people treating you, and the steps below can make that easier.

The one group the guideline flags

The guideline recommends against benzodiazepines for PTSD (Strong against), and it links them with decreased effectiveness of recommended PTSD treatments. The National Center for PTSD says they can make talk therapy less effective. If you take one, this is worth raising with both clinicians. Do not stop it suddenly, because the label warns of withdrawal reactions that can be life-threatening. Your prescriber can talk you through what is safe.

What to tell each clinician

NIMH advises telling a provider about all your medications, including over-the-counter drugs, herbal remedies, vitamins and supplements. Be specific about when symptoms began and how often they occur.

• Tell your therapist: what you take, any recent change, and side effects that could affect a session, such as sleepiness or dizziness.
• Tell your prescriber: which therapy you are in, how sessions are going, and whether symptoms feel different for a while.
• Tell both: if your sleep, mood or safety changes, or if you notice new or worse thoughts of self-harm.
• Ask both: whether anything about a medicine should be planned around your therapy, and who you should call with questions between visits.

How coordination can work

Coordination simply means two people treating you can share what is useful, with your agreement. NIMH says discussions with a provider are private and cannot be shared without your expressed permission, so you stay in control of what is passed along.

With your permission, our psychiatrist and a therapist on our team can coordinate care. If your therapist is elsewhere, ask both offices how they share information, and which details you are comfortable having shared. You can give as little or as much detail about your experience as you choose.

1. 1Name your teamGive each clinician the other's name and contact details, and say what you would like them to share.
2. 2Keep one listKeep a single, current list of your medicines and supplements, and bring it to both.
3. 3Say when something changesLet both know about a new medicine, a change in sleep, or a therapy phase that feels harder than usual.

A note on EMDR

The National Center for PTSD describes EMDR as an individual therapy in which you call the memory to mind while paying attention to a back-and-forth movement or sound. It says that early on you learn about reactions to trauma and new coping skills, and you and your provider discuss readiness. It says you may feel uncomfortable when focusing on trauma memories, and that these feelings are usually brief. That readiness conversation is a natural time to mention your medicines.

The same page says that EMDR does not require homework, and that in most cases you will not be asked to talk through the details of your trauma. If EMDR is new to you, those are good points to raise with your therapist.

Getting support with us

A licensed psychiatrist on our team treats trauma by secure video for people physically located in Pennsylvania or New York during each visit. See online trauma treatment and medication management. Whether any medicine is an option for you is a decision for you and your prescriber. Ask us whether our psychiatrist can help through our medication care contact form.

Trauma therapy with our team is available in Pennsylvania, West Virginia, Arizona and Colorado, and a member of the team is certified in EMDR. Our trauma and PTSD therapy page explains that option. We do not offer therapy in New York, so a New York reader would need a therapist elsewhere. If you are in crisis, call or text 988, or call 911, or see our crisis resources. Locascio Wellness does not provide emergency services.