Is he taking too many drugs?

I recently moved back to the area I grew up in and looked up a dear old friend.  I was soooooooo shocked to find that he looked terrible and was really out of touch with reality.  I knew something was seriously wrong.  This was a man who had tremendous potential and he was so good looking.  Last I had heard, he was in college.  Well, he dropped out.  He says he is suffering from Post Traumatic Stress Disorder - from going to the Vietnam War.  He said it started six years after he returned to the states, that he has violent dreams at night and wakes up hitting his wife.  He said he became very depressed and used to lock himself in rooms, that he never knew his children because of this behavior.  He kept loosing his train of thought and his memory was poor.  His behavior was immature and he has let himself go.  So sad - because he was one of my best friends who helped me years ago through some very difficult times.  He goes to the VA hospital once a week for group counseling.  The doctor there has him on:  Lithium, Valium, Prozac and Trazodone.  I wonder if all of these drugs are making him worse than he really is - can someone possibly need ALL of these medications?  Valium is very addictive, but he says he can't function without it.
Isn't Trazodone a downer, Lithium an upper?  What can I do for him?  We are located near Pittsburgh.
Thank you.

[HFHS M.D.-SW]

Dear Maggie,

It must be difficult to see your friend going through all this pain.
PTSD as you mentioned is related to a stressful event.  The event may be war experience, rape, personal violence or an attack.
Fortunately your friend is in treatment.
Lithium is a mood stabilizer and has many uses. It may be used in bipolar disorder, intermittent explosive disorder (possibly occurring with your friend) and also as augmentation strategy in depression.
Trazadone is an antidepressant with sedating side effects that may be used as an aid in treating sleep disturbances or as an antidepressant.
Valium is a benzodiazepine used for anxiety.  As you mentioned it may be come habit forming, although it can be used to treat disabling anxiety.
Prozac is an antidepressant which maybe used for depression, anxiety, obsessive compulsive disorder and other uses.
It is not unusual for patients with PTSD to be on multiple medications, as long as they are responding appropriately and have been refractory to single agent treatments.
It is difficult to say if these are the right medications for your friend.  As you mention, it is possible that they may cause adverse effects in some individuals.  You might discuss this with your friend, or see if you can accompany him to an appointment with his doctor, or suggest a second opinion.
Best wishes to you and your friend.

Sincerely,

HFHS M.D.-SW

*Keywords;  Prozac, Lithium, Valium, Trazadone