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PTSD Treatments: Which is the Best and Which is Right For You?

Post-traumatic Stress Disorder (PTSD) is a mental health condition that affects individuals directly affected by a traumatic event or witnessed it. PTSD can cause many symptoms, including flashbacks, nightmares, and anxiety, significantly impacting an individual’s quality of life.

While there is no cure for PTSD, several treatment options can help individuals manage their symptoms and improve their quality of life. The following article will review some of the most common and effective approaches for PTSD treatment.

Medications for PTSD

The U.S. Food and Drug Administration (FDA) has approved two medications specifically for PTSD: sertraline (Zoloft) and paroxetine (Paxil), both selective serotonin reuptake inhibitors (SSRIs), which means they work by increasing serotonin levels in the brain. Serotonin is a chemical in the brain (neurotransmitter) which plays important functions, like regulating moods.

Other medications that may be used to help manage PTSD symptoms include:

  • Fluoxetine (Prozac)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Venlafaxine (Effexor XR) [12,13]

It’s important to note that medication is not always necessary or appropriate for treating PTSD. Psychotherapy, such as cognitive-behavioral therapy (CBT), is often the first-line treatment for PTSD and may be used alone or in conjunction with medication. If you or someone you know is struggling with PTSD, it’s important to seek professional help to determine the best course of treatment.

Related: Types of Psychiatric Medications

Spravato for PTSD

Spravato is esketamine nasal spray that the FDA has licensed for treating major depressive disorder (MDD) and treatment-resistant depression (TRD). It has also shown promise in treating PTSD symptoms in patients who havenโ€™t found relief with other medications.

This newly developed treatment binds to the brain’s N-methyl-D-aspartate (NMDA) receptors. This receptor regulates mood and is believed to play a role in developing PTSD. By working on this receptor, Spravato can help alleviate the symptoms of PTSD.

Studies have shown that Esketamine may benefit individuals with long-term PTSD and help lessen the symptoms of some anxiety disorders, PTSD, and treatment-resistant depression (TRD).[5,7] and some studies have shown that Spravato may provide rapid and sustained improvement for at least six months in individuals with TRD and PTSD. [11]

Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) is a non-invasive technique that stimulates brain nerve cells with magnetic fields to alleviate the symptoms of various mental diseases. TMS helps PTSD by focusing on the brain’s prefrontal cortex, which controls emotions and behavior. This region of the brain may be underactive in people living with PTSD, contributing to the disorder’s symptoms.

During a TMS session, a magnetic coil is applied to the scalp over the prefrontal cortex. The coil transmits magnetic pulses to the brain, causing the targeted area to become more active and the brain’s nerve cells to be stimulated. This increased exercise may result in better emotional and behavioral control, which will lessen the symptoms of PTSD.

TMS is typically used to treat PTSD when other therapies, such as medication and talk therapy, have not worked. TMS is considered relatively safe with few adverse effects. However, patients should discuss their medical history with their healthcare provider before undergoing TMS.

The most common side effects are mild and include headache and scalp discomfort. However, as with any medical treatment, discussing the potential risks and benefits with a healthcare professional before undergoing TMS therapy is essential. Transcranial Magnetic Stimulation (TMS) therapy is a non-invasive, drug-free, FDA-cleared treatment with no downtime. TMS has fewer adverse effects than other PTSD treatments, and in some circumstances, none.

TMS helps some people feel better, especially patients who have tried other treatment options, like medications but continue to experience symptoms. TMS may also be a good option for patients who prefer not to use medications. TMS is non-invasive and has fewer side effects than Medications. Some studies have shown TMS’s overall positive therapeutic impact for treating General Anxiety Disorder (GAD) and PTSD. [6,10]

TMS is considered a safe treatment option, with few side effects reported, but it isnโ€™t recommended for everyone. People with some health conditions or implanted electronic devices, such as pacemakers, should not undergo TMS. [10]

If you or someone you know is struggling with PTSD, TMS therapy may be a useful treatment option. Neuro Wellness Spa offers TMS therapy for PTSD, which has been shown to provide relief for those who have not responded to traditional treatments. Our experienced professionals will work with you to create an individualized treatment plan that fits your needs. Don’t wait to seek help – contact Neuro Wellness Spa today to learn more about how TMS therapy can benefit you or your loved one.

Psychotherapy for PTSD

Among the most effective treatments for PTSD is psychotherapy, also referred to as talk therapy. PTSD can be difficult to treat with medications and alternative treatments like TMS therapy alone. Utilizing effective therapeutic modalities proven to help treat and manage post-traumatic stress disorder is the best course of action to take. There are three main types of therapy that are primarily used for PTSD including cognitive behavioral therapy, cognitive processing therapy, and prolonged exposure therapy.

Cognitive Behavioral Therapy (CBT):

Cognitive Behavioral Therapy (CBT) is a type of psychotherapy specifically designed to address the symptoms and underlying causes of PTSD. These therapies aim to provide individuals with the necessary tools to cope with and overcome the challenges associated with PTSD.

Cognitive Processing Therapy (CPT):

Cognitive Processing Therapy (CPT) is a specific type of cognitive-behavioral therapy that focuses on helping individuals understand and challenge the thoughts and beliefs developed due to their traumatic experiences. CPT treatment is typically conducted in 12-16 weekly sessions [1] and involves psychoeducation regarding PTSD, thoughts and emotions, and formal processing of the trauma(s).

During sessions, the therapist works with the individual to identify and challenge negative thoughts or beliefs related to the traumatic event. As part of the therapy, the therapist will help the individual develop effective coping strategies to manage the symptoms they experience and increase their overall functioning. [2] CPT is one commonly recommended treatment option, and several studies have demonstrated the effectiveness of CPT in treating PTSD. [4]

Prolonged Exposure (PE):

Prolonged Exposure (PE) is a type of cognitive-behavioral therapy used to treat post-traumatic stress disorder (PTSD). It is based on the premise that people with PTSD often avoid reminders of their traumatic experiences, which can maintain and worsen their symptoms over time.

The primary goal of prolonged exposure therapy is to help individuals confront and process their traumatic memories, reducing their fear and anxiety. This is achieved through two key components: imaginal exposure and in vivo exposure. [3]

  • Imaginal exposure involves repeatedly reliving the traumatic event through guided imagery. The individual is asked to vividly recount the details of their traumatic experience, focusing on the sights, sounds, thoughts, and emotions associated with it. By repeatedly engaging with the memories in a controlled setting, individuals can gradually process and re-evaluate their thoughts and feelings related to the trauma.
  • In vivo, exposure, however, involves gradually confronting real-life situations that the individual has been avoiding due to trauma. This could include visiting specific places, engaging in activities, or interacting with people that trigger distressing memories or emotions. By gradually exposing themselves to these triggers, individuals can learn to face their fears and that the anticipated adverse outcomes do not occur.

Prolonged exposure therapy typically involves weekly sessions lasting 60-120 minutes for 8-15 weeks, depending on the individual’s needs and progress. [3] It helps individuals regain control over their lives by confronting and processing their traumatic memories, allowing them to move forward and experience greater well-being.

During these sessions, the therapist will guide the individual through a series of exercises designed to help them confront their trauma-related thoughts and emotions. This may include talking about the traumatic event, writing about it, and engaging in exposure exercises such as visiting places or situations that trigger the traumatic memories.

Research has shown that prolonged exposure therapy is an effective treatment for PTSD, with significant reductions in symptoms reported by many individuals. The American Psychiatric Association (APA) strongly recommends PE as an effective treatment for PTSD, and substantial evidence backs up its efficacy in treating PTSD.

Research shows the average patient receiving PE performed better on PTSD symptoms after treatment than 86% of patients receiving other care used as a study control. [13] Other studies that examined psychological therapies for PTSD discovered strong evidence that supports PEโ€™s effectiveness; one study showed 41%-95% of participants treated with PE no longer had a diagnosis of PTSD at the end of treatment. [13]

Professional Help and Support for PTSD

The best PTSD treatment and the one that is right for you should be determined after working closely with a mental health professional. At Neuro Wellness Spa, we will work with you to understand your unique needs and craft a treatment plan specifically designed for you. Our evidence-based approach utilizes a range of effective mental health treatments.

If you or a loved one is struggling with the effects of post-traumatic stress disorder, contact Neuro Wellness Spa to learn more about your treatment options. From in-person and online psychiatry for medication management to psychotherapy utilizing effective modalities for treating and managing PTSD, or alternative treatments like TMS therapy which stimulates regions of the brain that have been affected by PTSD. Our team of expert clinicians is ready and available to help you on your journey toward mental wellbeing.

References:

  1. (2017, July 31). Cognitive Behavioral Therapy. American Psychiatric Association. https://www.apa.org/ptsd-guideline/treatments/cognitive-behavioral-therapy
  2. (2017, July 31). Cognitive Processing Therapy (CPT). American Psychiatric Association. https://www.apa.org/ptsd-guideline/treatments/cognitive-processing-therapy
  3. (2017, July 31). Prolonged Exposure (PE). American Psychiatric Association. https://www.apa.org/ptsd-guideline/treatments/prolonged-exposure
  4. Asmundson, G. J. G., Thorisdottir, A. S., Roden-Foreman, J. W., Baird, S. O., Witcraft, S. M., Stein, A. T., Smits, J. A. J., & Powers, M. B. (2019). A meta-analytic review of cognitive processing therapy for adults with post-traumatic stress disorder. Cognitive behavior therapy, 48(1), 1โ€“14. https://doi.org/10.1080/16506073.2018.1522371
  5. Borenstein, J. (2021, January 18). Ketamine and Chronic PTSD Symptoms. https://www.psychologytoday.com/us/blog/brain-and-behavior/202101/ketamine-and-chronic-ptsd-symptoms
  6. Cirillo, P., Gold, A. K., Nardi, A. E., Ornelas, A. C., Nierenberg, A. A., Camprodon, J., & Kinrys, G. (2019). Transcranial magnetic stimulation in anxiety and trauma-related disorders: A systematic review and meta-analysis. Brain and behavior, 9(6), e01284. https://doi.org/10.1002/brb3.1284
  7. Derakhshanian, S., Zhou, M., Rath, A., Barlow, R., Bertrand, S., DeGraw, C., Lee, C., Hasoon, J., & Kaye, A. D. (2021). Role of Ketamine in the Treatment of Psychiatric Disorders. Health psychology research, 9(1), 25091. https://doi.org/10.52965/001c.25091
  8. (n.d.). PTSD Treatments. https://www.apa.org/ptsd-guideline/treatments
  9. Neuner, F., Elbert, T., & Schauer, M. (2020). Narrative exposure therapy for PTSD. In L. F. Bufka, C. V. Wright, & R. W. Halfond (Eds.), Casebook to the APA Clinical Practice Guideline for the treatment of PTSD (pp. 187โ€“205). American Psychological Association. https://doi.org/10.1037/0000196-009
  10. Rodrigues, P. A., Zaninotto, A. L., Neville, I. S., Hayashi, C. Y., Brunoni, A. R., Teixeira, M. J., & Paiva, W. S. (2019). Transcranial magnetic stimulation for the treatment of anxiety disorder. Neuropsychiatric disease and treatment, 15, 2743โ€“2761. https://doi.org/10.2147/NDT.S201407
  11. Rothรคrmel, M., Benosman, C., El-Hage, W., Berjamin, C., Ribayrol, D., Guillin, O., Gaillard, R., Berkovitch, L., & Moulier, V. (2022). Efficacy and Safety of Intranasal Esketamine in Patients With Treatment-Resistant Depression and Co-morbid Chronic Post-traumatic Stress Disorder: Open-Label Single-Arm Pilot Study. Frontiers in psychiatry, 13, 865466. https://doi.org/10.3389/fpsyt.2022.865466
  12. Schrader, C., & Ross, A. (2021). A Review of PTSD and Current Treatment Strategies. Missouri medicine, 118(6), 546โ€“551.
  13. Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions. Frontiers in behavioral neuroscience, 12, 258. https://doi.org/10.3389/fnbeh.2018.00258
*TMS is FDA-cleared for depression, migraine, Obsessive-Compulsive Disorder, cigarette cessation, anxious depression, adolescent depression, and chronic post-traumatic/surgical pain. Research indicates that TMS to also be helpful for bipolar depression, anxiety, and cognitive impairment. Other uses for TMS therapy are considered "off-label." However, there is a growing body of research indicating the potential benefits of these off-label applications for a variety of mental health conditions. Please consult with a psychiatrist to learn more about TMS and off-label uses.
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