PTSD 2026

What are the four major symptom domains of PTSD?

Re-experiencing

Avoidance

Hyperarousal

Negative Symptoms

Do you need to directly experience death, serious injury or sexual violence to develop PTSD?

No, can be threatened or witnessed

How long do the symptoms need to persist to be diagnosed with PTSD?

At least one month

What are first line treatment options for PTSD according to the VA/DOD 2023 guidelines?

Trauma focused psychotherapy

What are second line options for PTSD according to the VA/DOD 2023 guidelines?

SSRI: paroxetine, sertraline

SNRI: venlafaxine

(remember first line options are therapy, though other guideliens do have SSRIs/SNRIs as first line, it is more of a semantic difference but the VA is just stressing to offer therapy first, then meds, but can do meds if therapy isn't feasible or can do both)

Which of the following is recommended against in the treatment of PTSD?

a. Cannabis

b. Psilocybin

c. Escitalopram

d. Prazosin

a. Cannabis

The guidelines strongly recommend against cannabis and benzodiazepines

Hallucinogens like psilocybin are being studied in the treatment of PTSD

Which SSRIs are FDA approved for PTSD?

Paroxetine and Sertraline

Remember PTSD has a P and S in it (Paroxetine and Sertraline start with P and S)

Which medication can specifically be used for nightmares?

Prazosin

Which of the following is the best counseling point for a patient starting prazosin for PTSD nightmares?

a. take in the morning

b. take your time getting out of bed

c. this medication is controlled and addiction can occur

d. take as needed when you wake up from a nightmare

b. take your time getting out of bed

Prazosin is a blood pressure medication, orthostasis can occur

A patient has been taking sertraline 200 mg for 6 months for PTSD. He develops sexual dysfunction and would like to stop and begin therapy. Which of the following should you recommend?

a. stop sertraline today and begin Eye Movement Desensitization and Reprocessing Therapy

b. stop sertraline today and begin Accelerated Resolution Therapy

c. taper off sertraline and begin Eye Movement Desensitization and Reprocessing Therapy

d. taper of sertraline and begin Accelerated Resolution Therapy

c. taper off sertraline and begin Eye Movement Desensitization and Reprocessing Therapy

The patient has been on sertraline for 6 months, it is important to taper because of the risk of discontinuation syndrome.

The first line therapies include: Cognitive Processing Therapy, Eye Movement Densensitization and Reprocessing Therapy, and Prolonged Exposure Therapy

What is the generic name of Zoloft?

Sertraline

What is the generic name of Paxil?

Paroxetine

What is the generic name of Effexor?

Venlafaxine