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The Place of Medication and Psychotherapy in the Treatment of Combat PTSD

January 2, 2014 Harry Croft, M.D.

Both medication and psychotherapy are often used in the treatment of combat-related post-traumatic stress disorder (PTSD). Psychotherapy in combat PTSD treatment is more common than the use of medication; nevertheless, medication can be important for many. Both types of treatment have their place and should be considered by those suffering from combat-related PTSD.

Psychotherapy in Combat PTSD Treatment

Psychotherapy is the most common form of combat-related PTSD treatment and is appropriate for everyone seeking treatment. Veterans often worry that this will mean sitting around talking about their childhood, but the most common types of psychotherapy for combat PTSD focus on skill building and dealing with the specific trauma. Common forms of psychotherapy that have shown effectiveness in treating combat PTSD include cognitive behavioral therapy, exposure therapy and eye movement desensitization and reprocessing (EMDR).

The type of psychotherapy chosen in combat PTSD treatment has a lot to do with the preference of the patient and availability of treatment. The United States Department of Veterans Affairs (VA) provides two forms of cognitive behavioral therapy: cognitive processing therapy and prolonged exposure therapy. Other types of therapy are available through private practice.

Medication in Combat PTSD Treatment

Understanding Combat PTSDMedication is appropriate in some cases of combat-related PTSD but it is almost always combined with psychotherapy for the best outcome. It is most often used in severe cases of combat PTSD or in cases where the PTSD manifests in significant physiological symptoms, such as depression and anxiety. Medication in combat PTSD treatment can effectively treat the physiological symptoms that prevent the veteran from processing the emotional trauma through therapy. Medications can make a patient feel less sad and worried as well.

Selective serotonin reuptake inhibitor (SSRI) antidepressants are typically the medication chosen in combat-related PTSD treatment. These medications can be effective whether the veteran is suffering from depression or not. Common SSRIs include: citalopram (Celexa), fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft). A full list of SSRI antidepressants is here.

Medication vs. Psychotherapy in Combat PTSD Treatment

The selection of medication and type of psychotherapy in combat PTSD treatment must be specific to the individual. What’s important to remember about combat PTSD treatment is that there are a variety of options and if one doesn’t work, there are many more to try. It’s critical to work with your doctor and/or therapist to ensure the right treatment is chosen for you.

Dr. Croft is the co-author of a heralded book on combat-related PTSD called I Always Sit With My Back to the Wall. Find Dr. Croft on Facebook, on Twitter, on Google+ and on his homepage.

APA Reference
Croft, H. (2014, January 2). The Place of Medication and Psychotherapy in the Treatment of Combat PTSD, HealthyPlace. Retrieved on 2024, November 14 from https://www.healthyplace.com/blogs/understandingcombatptsd/2014/01/medication-psychotherapy-treatment-combat-ptsd



Author: Harry Croft, M.D.

susan bevis
January, 2 2014 at 5:28 pm

My daughter is 26 and has been on about 15 mind altering chemicals and none have worked. She is a trauma victim and has had appalling care in the UK. By the way I as a mother do not recognise stigma and am proud to have two daughters both have been affected but one despite a diagnosis that is a serious diagnosis is proof that mistakes can be made as this person has graduated from university and is on top of the world. My elder daughter is on a Section 3. She is supposedly treatment resistant but that to me as a mother amounts to "failure". So the drugs have not worked and that is because the underlying causes from the trauma have not been dealt with. What I have proven is the harm the drugs are doing to my daughter's physical health and my campaign for better mental health care in the UK has brought me in touch with some of the world's leading experts including some in the UK who have been advising me. I now want the correct treatment for my daughter and that is intensive trauma therapy. What is more if the drugs are ineffective I have been advised of research that is not widely known to the public and when a last resort drug mixed with contra indicated Metformine is given it could be that the drugs are ineffective for good reason and should be stopped very very slowly over a period of 4 years with the involvement of professionals. I understand that when someone develops a serious physical illness like diabetes they are taken off the drugs. So how come a patient has to remain on drugs that do not work for years on end one after the other, sometimes several at a time - needless to say now that I have had top level advice and seen research that has been carried out here in the UK by some leading professors then I as a mother want the correct treatment and an end to all of these drugs that have proved useless and are no substitute for humane and decent care in my opinion. I have educated myself also by reading lots of books on the subject to see what is really going on and I totally disagree with the pushing of psychiatric drugs to children as well as enforced drugging and ECT.

Dr Musli Ferati
January, 12 2014 at 1:51 am

PTSD as frequent and common mental disorder of modern dynamic time indicates serious and careful observation from professional and non-professional community, as well. Moreover, when it is known that we live in epoch with stressful and subsequent traumatic psycho-social events. So, it is necessary to reprocessing psychiatric treatment and management of this mental entity.Your recommendation of simultaneous psychotherapeutic and medication treatment of PTSD exhibits motivation psychiatric approaching. On the other hand, we risk to push patients with PTSD in serious mental implication; such is depressive and others psycho-somatic complications. In order to prevent these and many others health outcomes, it should to treat PTSD for long time, minimum one year. On extraordinary cases, it is preferable to lengthen this period of psychiatric treatment by antidepressant medication in association with different psycho-social interventions. Premature disruption of antidepressant medication leads to serious mental and somatic disorder.

Ally Green
May, 27 2014 at 2:06 am

I have ptsd but due to my autism this isn't officially recognised in the uk. I xannot take antidepressants due to my autism. My only saving grace has been gluten and dairy free living. This helps with the depression. I am now fighting toget rrisperdal quicklets on long term for sleep, eating and intrusive thoughts symptoms. I have to pay for counselling that respects my autism diagnosis. I have fought for every scrap of help available my entire adult life. 18 years later and I may finally get a ptsd diagnosis.

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