‘Combat Cocktail’: How America Overmedicates Veterans

By Shalini Ramachandran and Betsy McKay
Design by Audrey Valbuena

The Wall Street Journal
July 31, 2025 9:00 pm ET
 

Hundreds of thousands of veterans with PTSD have been prescribed simultaneous doses of powerful psychiatric drugs. 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, according to scientific studies and veterans’ accounts. 

The VA’s own guidelines say no data support drug combinations to treat PTSD. The Food and Drug Administration warns that combining certain medications such as opioids and benzodiazepines can cause serious side effects, including death.

Nonetheless, prescribing cocktails of such drugs is one of the VA’s most common treatments for veterans with PTSD, and the number of veterans on multiple psychiatric drugs is a growing concern at the agency, according to interviews with more than 50 veterans, VA health practitioners, researchers and former officials, and a review of VA medical records and studies.

Polypharmacy has multiple definitions when it comes to central nervous system drugs. The VA defines it as taking five or more medications at the same time, while some medical researchers say it’s two or more and the American Geriatrics Society defines it as three or more. 

There is an emerging medical consensus among VA doctors and researchers that taking multiple central nervous system drugs can wreak havoc on patients. Interactions between such drugs aren’t well understood, and their effects in combination can be unpredictable and extreme.

The VA maintains that the best treatment for PTSD is talk therapy. But therapists are scarce and wait times are long, so overwhelmed doctors default to pills. Because there is no single drug designed specifically to treat PTSD, veterans often end up on drug cocktails as multiple specialists try to ease a variety of symptoms and prevent harm or suicide, according to VA clinical staff, studies and veterans. 

“When it comes to the challenge of polypharmacy in these populations, it’s constantly chasing your tail,” said Dr. Ryan Vega, a chief healthcare innovation official at the VA until 2023, who still treats veterans. “It is where medicine is more art than science. We have medications that treat those symptoms but are we addressing the root cause?”

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