Comparing Treatments for PTSD

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Post-traumatic stress disorder (PTSD) is a serious disorder that can lead to difficulty with family, friends, and work and increase the risk of suicide, so getting effective treatment is essential. A typical treatment recommendation is medication plus psychotherapy, but some medical associations recommend starting with medication, while others recommend starting with psychotherapy.

To get a better handle on the best approach, a study published in JAMA Psychiatry in 2019 analyzed data on 922 people from 12 randomized clinical trials that compared these approaches: psychotherapy, medication, and a combination.

The analysis found that all three approaches were equally effective when evaluated up to one month after the end of the treatment period, which lasted from 5 to 24 weeks. But in studies where patients were evaluated between two and 12 months after treatment ended, psychotherapy was more effective than medication at reducing symptoms. Combination treatment also appeared to edge out medication alone in the long term, although results varied depending on the method used to analyze the data. The analysis did not find a difference between combination treatment and psychotherapy in the long term.

Although medication has been shown to help people with PTSD, especially in the shorter term, this analysis indicates that those who need long-term relief may be better off with psychotherapy or a combination of both.