Military doctors try to replace therapy for PTSD with 'combat cocktails.' The practice has been linked to suicide risk.

Veterans are 50% more likely to commit suicide than civilian 
adults. (Medication-Induced Suicide Prevention graphic)

Although there is no data to support the practice, many military doctors prescribe "combat cocktails" to veterans with Post- traumatic stress disorder. "The practice, known as 'polypharmacy,' can tranquilize patients to the point of numbness, cause weight gain and increase suicidal thoughts when it involves pharmaceuticals that target the central nervous system," report Shalini Ramachandran and Betsy McKay of The Wall Street Journal. Because roughly a third of military veterans live in rural areas, the post-combat treatment may have a disproportionate impact on rural families and communities.

Medical guidelines for the Department of Veterans Affairs don't recommend giving patients simultaneous mixes of psychiatric medications, and the Food and Drug Administration warns against the practice. And yet, "prescribing cocktails of such drugs is one of the VA’s most common treatments for veterans with PTSD (post-traumatic stress disorder)," the Journal reports. "And the number of veterans on multiple psychiatric drugs is a growing concern at the agency."

Polypharmacy definitions vary, but "the VA defines it as taking five or more medications at the same time," Ramachandran and McKay explain. A growing number of VA physicians and researchers believes such dosing can have disastrous results, because powerful drugs can interact with patients' nervous systems and each other in unpredictable ways.

While talk therapy is considered the best PTSD treatment, therapists are often in short supply, so medical providers have turned to medicine to treat PTSD symptoms. "Nearly 60% of VA patients with PTSD were taking two or more central nervous system drugs at the same time in 2019," the Journal reports. "The VA declined requests from The Wall Street Journal to provide more recent polypharmacy numbers for veterans in its care."

Given that suicide rates among veterans are much higher than those of civilian adults, how the VA treats PTSD is under scrutiny from Congress, advocacy groups and veterans. "Studies by VA researchers link the simultaneous use of multiple psychiatric drugs to suicide risk among veterans," Ramachandran and McKay write. "Yet the agency has been slow to mandate changes."