Current Status of Treatment for Posttraumatic Stress Disorder: Focus on Treatments Combining Pharmacotherapy and Cognitive-Behavioral Therapy

The purpose of this review is to give an overview of randomized controlled trials (RCTs) concerning the efficacy of psychological and pharmacological treatments of posttraumatic stress disorder (PTSD), with a focus on treatments combining both. Psychological treatments, in particular exposure-based interventions, have been shown to be efficacious in reducing PTSD symptoms as have pharmacological agents, in particular several antidepressants, but the efficacy of either treatment modality needs to be improved. Attempts to enhance the efficacy of psychotherapy or pharmacotherapy by combining one type of treatment with the other have remained scarce, and the results of adding one to the other have been mixed. All in all, exposure-based psychological interventions have emerged as the best treatment option, either alone, or, if and when appropriate, in combination with a second-generation antidepressant. Recent new treatment directions, involving use of cognitive enhancers such as d-cycloserine to improve exposure-based treatments have shown promising results.