Treatment Options for PTSD

National Center for PTSD, U.S. Department of Veterans Affairs
PTSD Treatment Options

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.

Posted on BrainLine September 1, 2017. Reviewed December 5, 2018.

From the National Center for Posttraumatic Stress Disorder, US Department of Veterans Affairs. www.ptsd.va.gov.

Comments (8)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

How do you handle a person during an episode?My husband has frequent ones and,I do not know how to handle it. I do not know what to expect or if I CAN talk him out of it or not. I get very scared especially late at night.Can someone give me some advise,please?
If he is a veteran even if not check out militaryministry.org hope this helps take care and God Bless
Please try not to become angry yourself, even if he is feeling violent towards you. Whenever someone is feeling very depressed or very scared, the normal reaction is to become angry or violent. He needs reassurance that he is still loved and cared about. He probably feels guilty after he's had an 'episode', so explain to him that it's not his fault, and that he's going to come through the pain eventually, with help. Learn Transactional Analysis, it will help you to understand what his mind is going through, and how to best proceed. CBT counselling is a good therapy for some people, but others don't get on with it. Transactional Analysis is a great tool - use it! My best wishes to you both.
Neurofeedback is a drug-free brain training regimen with profound effects on PTSD. Find a provider at EEGInfo.com. The training is provided free of charge for all military personnel through hc4v.org. John Mekrut The Balanced Brain Studio City, CA
A small number of persons (not everyone) benefit from a med which works for ADHD (central nervous system stimulant/alerting agent) or a med for epilepsy. Also, good nutrition is an important factor for overall health (for everyone, not only those with brain injuries).
I have been through a series of dysfunctional experiences beginning in my childhood and moving into adulthood. While I am on several medications, and have fought hard to heal through PTDS therapy, group therapy, and psychiatric consultation. As well I try to make each day as positive as I can. I have lived an interesting and courageous life although I am burdened with horrific panic as I awake each day. Things like exercise, taking on challenges I fear, and working on my interpersonal relationships provide some relief. In the past I have always worked hard and my performance has been positively acknowledged. Is there anything more I can do, because I presently find it hard to hold down a job. I'm not sure if its my medication or my mental illness that is causing this problem. I would be nice to hear from others who are going through the same thing, so that I don't feel alone. I would be very happy to hear about your experiences.
Veterans are all different. some of them you can talk to them but it is not a good idea to scream at them or try to fight them because they are having flash backs and in this time they are remembering there overseas fighting and they are fighting for there life you have to try to talk to him/her calmly. I know its hard at first but you also might need to try to get them a ptsd service dog that is trained to stop them from getting to that point. you shouldn't have to fear your loved ones because of what they went through. they need someone who will be strong for them in their time of need. a lot of them feel like they are alone and they need you to let them know you are there for them. my fiance was in the marine corps. he was jn Afghanistan twice and he has ptsd. at night when we are sleeping I can feel that hes having a bad dream or I wake up and can see he is and sometimes it helps to put my head on his chest and put my hand over his heart and I just hold him and let him know that he isn't alone im there for him and he will calm down. but if your husband/wife whoever is physical with their ptsd you need to call the va if you cant get them to snap back from it easy because they can hurt you. they are not trying to. to them at that time you are not you you are someone they had to fight for there life overseas and so they are fighting for their life but getting them to talk about it helps when they are fully awake and all. if you cant handle knowing what they did or what they went through dont ask them to tell you. ask them to talk to the va drs or another veteran. just let them know you love them and are going to be with them through their hard time

pls i have been suffering lack of sleep for more than 9yrs now,
pls what treatment can i take ..
pls i need help