Treatment Options for PTSD

PTSD can be treated. With treatment trauma survivors can feel safe in the world and live happy and productive lives. Effective treatments for PTSD include different types of psychotherapy (talk therapy) or medication.

Recommended Treatments:
Treatments with the Most Research Support

Trauma-focused Psychotherapies

Trauma-focused psychotherapies are the most highly recommended type of treatment for PTSD. "Trauma-focused" means that the treatment focuses on the memory of the traumatic event or its meaning. These treatments use different techniques to help you process your traumatic experience. Some involve visualizing, talking, or thinking about the traumatic memory. Others focus on changing unhelpful beliefs about the trauma. They usually last about 8-16 sessions. The trauma-focused psychotherapies with the strongest evidence are:

• Prolonged Exposure (PE)
  Teaches you how to gain control by facing your negative feelings. It involves talking about your trauma with a provider and doing some of the things you have avoided since the trauma.
• Cognitive Processing Therapy (CPT)
  Teaches you to reframe negative thoughts about the trauma. It involves talking with your provider about your negative thoughts and doing short writing assignments.
• Eye-Movement Desensitization and Reprocessing (EMDR)
  Helps you process and make sense of your trauma. It involves calling the trauma to mind while paying attention to a back-and-forth movement or sound (like a finger waving side to side, a light, or a tone).

There are other types of trauma-focused psychotherapy that are also recommended for people with PTSD. These include:

• Brief Eclectic Psychotherapy (BEP)
  A therapy in which you practice relaxation skills, recall details of the traumatic memory, reframe negative thoughts about the trauma, write a letter about the traumatic event, and hold a farewell ritual to leave trauma in the past.
• Narrative Exposure Therapy (NET)
  Developed for people who have experienced trauma from ongoing war, conflict, and organized violence. You talk through stressful life events in order (from birth to the present day) and put them together into a story.
• Written Narrative Exposure
  Involves writing about the trauma during sessions. Your provider gives instructions on the writing assignment, allows you to complete the writing alone, and then returns at the end of the session to briefly discuss any reactions to the writing assignment.
• Specific cognitive behavioral therapies (CBTs) for PTSD
  Include a limited number of psychotherapies shown to work for PTSD where the provider helps you learn how to change unhelpful behaviors or thoughts.

Antidepressants (SSRIs and SNRIs)

Medications that have been shown to be helpful in treating PTSD symptoms are some of the same medications also used for symptoms of depression and anxiety. These are antidepressant medications called SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors). SSRIs and SNRIs affect the level of naturally occurring chemicals in the brain called serotonin and/or norepinephrine. These chemicals play a role in brain cell communication and affect how you feel.

There are four antidepressant medications that are recommended for PTSD:

• Sertraline (Zoloft)
• Paroxetine (Paxil)
• Fluoxetine (Prozac)
• Venlafaxine (Effexor)

Note: Medications have two names: a brand name (for example, Zoloft) and a generic name (for example, Sertraline)

There are other types of antidepressant medications, but these four medications listed above are the ones that are most effective for PTSD.

If you decide try one of these medications, your provider will give you a prescription. Once you fill your prescription, you will begin taking a pill at regular time(s) each day. You will meet with your provider every few months or so. Your provider will monitor your response to the medication (including side effects) and change your dose, if needed.

Suggested Treatments:
Treatments with Some Research Support

Some psychotherapies do not focus on the traumatic event, but do help you process your reactions to the trauma and manage symptoms related to PTSD. The research behind these treatments is not as strong as the research supporting trauma-focused psychotherapies (listed above). However, these psychotherapies may be a good option if you are not interested in trauma-focused psychotherapy, or if it is not available:

• Stress Inoculation Training (SIT)
  A cognitive-behavioral therapy that teaches skills and techniques to manage stress and reduce anxiety.
• Present-Centered Therapy (PCT)
  Focuses on current life problems that are related to PTSD.
• Interpersonal Psychotherapy (IPT)
  Focuses on the impact of trauma on interpersonal relationships.

There are also other medications that may be helpful, although the evidence behind them is not as strong as for SSRIs and SNRIs (listed above). These include:

• Nefazodone (Serzone)
  A serotonin reuptake inhibitor (SRI) that works by changing the levels and activity of naturally occurring chemical signals in the brain.
• Imipramine (Tofranil)
  A tricyclic antidepressant (TCA) which acts by altering naturally occurring chemicals which help brain cells communicate and can lift mood.
• Phenelzine (Nardil)
  A monoamine oxidase inhibitor (MAOI) which inactivates a naturally-occurring enzyme which breaks down the neurotransmitters serotonin, norepinephrine and dopamine.

Other Treatments: Treatments That Do Not Yet Have Research Support

There may be other options available such as certain complementary and integrative medicine approaches (like yoga, meditation, or acupuncture), biological treatments (like hyperbaric oxygen therapy or transcranial magnetic stimulation), or online treatment programs. These treatments do not have strong research behind them at this time, but you and your doctor can discuss the benefits and risks of these options to determine whether or not they are right for you.

Choosing a Treatment

No one treatment is right for everyone. You can discuss treatment options with your health care provider, and determine which ones are best for you based on the benefits, risks, and side effects of each treatment. Some people are uncomfortable with the idea of seeking treatment because of concerns with stigma or worries about having to talk about difficult life experiences. However, treatment provides the opportunity to improve symptoms, personal and professional relationships, and quality of life.

To learn about evidence-based treatments, take a look at the National Center for PTSD's Understanding PTSD and PTSD Treatment (PDF) or compare treatments using their PTSD Treatment Decision Aid.

For more information about available treatments for PTSD please visit The Treatment Hub.