If you feel upset or unsafe after experiencing or seeing something dangerous or scary and that feeling continues, you may have Posttraumatic Stress Disorder (PTSD).

Download this Evidence Update

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Findings from Recent Research

A recent review of research found that several kinds of therapy and medicines can reduce or stop symptoms for most people with PTSD.

How Do I Know if I Might Have PTSD?

People may develop PTSD if they experience or witness:

➤ Violent crime
➤ Serious illness or injury
➤ Military combat
➤ Domestic violence
➤ Sexual assault or rape
➤ Car crashes
➤ Natural or manmade disasters

People with PTSD may:

➤ Have nightmares or flashbacks
➤ Avoid situations that bring up memories of the event
➤ Have more negative feelings and beliefs about life in general
➤ Feel uncomfortable or unsafe in places that remind them of scary or dangerous situations
➤ Feel more irritated or angry in general, or when reminded of scary or dangerous situations

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About the Evidence

Researchers looked at 193 studies on treatments for adults with PTSD. They updated a 2013 report on treatments for PTSD and added findings from new studies published since then.

View the full systematic review update at: www.pcori.org/reviews-PTSD

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Treatments That Research Says Can Reduce PTSD Symptoms

Therapy

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Several kinds of therapy can help people with PTSD. One is cognitive behavioral therapy, or CBT. CBT helps people understand how their thoughts affect how they see the world, and how to change their thoughts so they can see the world differently. CBT can help people when they face a reminder of their trauma.

CBT involves meeting with a trained therapist, alone or in a group of people who also have PTSD. Therapy sessions usually take place every week for 8 to 12 weeks. Each session lasts between 50 and 90 minutes.  Most studies of therapy for PTSD don’t report on side effects, but most people believe therapy does not cause harm.

For therapy to work well, it is important to find a therapist you trust.

Medicines

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Evidence shows that some medicines help reduce symptoms of PTSD, like nightmares and flashbacks, and can also help reduce negative feelings. These medicines come in pill form and are taken once or twice a day. They affect how the brain reacts to fear.

The medicines with the strongest evidence for helping people with PTSD are:

Fluoxetine, which is also sold under brand names like Prozac®, Prozac® weekly, Rapiflux®, Sarafem®, and Selfemra®

Paroxetine, which is also sold under brand names like Brisdelle®, Paxil®, Paxil® CR, and Pexeva®

Venlafaxine, which is also sold under brand names like Effexor® and Effexor® XR

Researchers also studied sertraline, prazosin, topiramate, olanzapine, and risperidone, but the evidence of these medicines helping ease PTSD symptoms was not as strong.

It may take four to six weeks before you can tell whether a medicine is working. If you don’t see benefits after six weeks, you and your doctor may want to increase the dose of the medicine you are taking or change to a different medicine.

Medicines can cause side effects, some of which can be severe. Each medicine has slightly different side effects. Discuss side effects with your doctor or pharmacist.

What Should I Ask My Doctor?

If you think you might have symptoms of PTSD, you might want to talk with your doctor, nurse, or someone else you trust about getting help to feel better.

Here are a few questions you may want to ask:

Do you think medicine or therapy can help my symptoms?
Where can I get the help I need?
How will we decide what treatment is right for me?
How can I find out if my insurance covers the cost of treating PTSD?
How soon can I expect to feel better?

Download this Evidence Update


Sources

1. Forman-Hoffman V, Middleton JC, Feltner C, et al. Psychological and Pharmacological Treatments for Adults with Posttraumatic Stress Disorder (PTSD): A Systematic Review Update. This systematic review was supported by PCORI through a research partnership with AHRQ. Rockville, MD: AHRQ Publication No. 18-EHC011-EF; 2018. Washington, DC: PCORI Publication No. 2018-SR-01; 2018. DOI: https://doi.org/10.23970/AHRQEPCCER207.
2. "Medications for PTSD." National Center for PTSD. August 08, 2018. Accessed May 16, 2019. https://www.ptsd.va.gov/understand_tx/meds_for_ptsd.asp.

The information in this publication is not intended to be a substitute for professional medical advice.

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