Not equivalent to trauma-focused psychotherapy; does not replace formal treatment
Single-session psychological debriefing
Cochrane review: no benefit and potential harm from mandatory single-session debriefing
Not recommended as universal intervention following trauma
Propranolol for PTSD prevention — not recommended
Cochrane review 2024: no evidence that early pharmacological interventions prevent PTSD
Hydrocortisone post-trauma — insufficient evidence; not standard care
Monitoring and treatment response
PCL-5 at each visit to track symptom trajectory
Clinically meaningful change defined as >=10-point reduction in PCL-5 score
Consider switching strategy if < 10-point reduction at 8–12 weeks at maximum tolerated dose
Adequate trial parameters
Minimum 8–12 weeks at maximum tolerated dose before switching medication
Non-responders to SSRI may respond to venlafaxine
Patient Discharge Instructions
copy discharge instructions
PTSD discharge instructions for patient
What is PTSD?
PTSD stands for Post-Traumatic Stress Disorder
It is a normal brain response to an abnormal event
PTSD is a treatable condition — most people improve with proper treatment
Having PTSD does not mean you are weak or that something is wrong with your character
Your symptoms may include
Flashbacks or intrusive memories of what happened
Nightmares related to the trauma
Avoiding reminders of the event
Feeling constantly on guard or easily startled
Feeling emotionally numb or disconnected
Difficulty sleeping or concentrating
What you should do now
Keep your follow-up appointment with your doctor or mental health provider within 1–2 weeks
If a referral was arranged, contact that provider this week to confirm your appointment
If medication was prescribed, take it as directed — effects may take 4–8 weeks to feel fully
Do not stop medication without speaking with your doctor
What helps recovery
Evidence-based talk therapy (such as PE, CPT, or EMDR) is the most effective treatment
Regular sleep, meals, and physical activity help stabilize symptoms
Connecting with trusted family members or friends provides an important protective factor
Avoid alcohol and drugs — they worsen PTSD symptoms and interfere with treatment
What does NOT help
Alcohol or cannabis used to manage anxiety or sleep — these worsen PTSD over time
Completely avoiding all reminders of the trauma — avoidance makes symptoms worse long-term
Return to the emergency department if you experience
Thoughts of harming yourself or ending your life
Thoughts of harming another person
Severe confusion, disorientation, or feeling completely out of touch with reality
Inability to eat, drink, or care for yourself
Worsening agitation or aggression you cannot control
Symptoms that are rapidly getting worse
Crisis resources
988 Suicide and Crisis Lifeline — call or text 988 (available 24/7)
Crisis Text Line — text HOME to 741741
Veterans Crisis Line — call 988 then press 1 (for veterans and service members)
Local emergency services — call 911 for immediate danger
References
Guidelines and key sources
VA/DoD Clinical Practice Guideline for PTSD and Acute Stress Disorder 2023
Schnurr PP, Hamblen JL, Wolf J, et al. Synopsis of the 2023 VA/DoD CPG. Ann Intern Med. 2024
Benzodiazepines strongly recommended against
PE, CPT, EMDR strongly recommended
Sertraline, paroxetine, venlafaxine recommended for pharmacotherapy
American College of Surgeons Best Practices Guidelines — Mental Health in Acute Trauma Patients 2022
Brasel KJ, deRoon-Cassini TA, Bernard A, et al.
Screening and intervention guidance for ED and trauma settings
APA Clinical Practice Guideline for PTSD 2025
Zoellner LA, Schulz PM, Campbell-Law L, et al.
Conditionally recommends PE, CPT, EMDR as first-line
Updated recommendations for pharmacotherapy
Key trials and systematic reviews
DSM-5-TR Diagnostic Criteria
Jeste DV, Lieberman JA, Fassler D, et al. DSM-5-TR. American Psychiatric Association. 2022
Defines PTSD Criteria A through H with specifiers
Preschool subtype for children under 6 years
Pharmacotherapy evidence
Sartor Z, Kelley L, Laschober R. PTSD: Evaluation and Treatment. Am Fam Physician. 2023
Comprehensive review of pharmacotherapy options and evidence levels
Bajor LA, Balsara C, Osser DN. Evidence-Based Psychopharmacology for PTSD. Psychiatry Res. 2022
Updated treatment algorithm and evidence review
Merz J, Schwarzer G, Gerger H. Network meta-analysis of pharmacological and psychotherapeutic treatments. JAMA Psychiatry. 2019
Psychotherapy superior to pharmacotherapy for PTSD
Seales S, Seales P. Pharmacotherapy for PTSD. Am Fam Physician. 2022
Prazosin and sleep
Mendes TP, Pereira BG, Coutinho ESF, et al. Prazosin for nightmares in PTSD. Prog Neuropsychopharmacol Biol Psychiatry. 2025
Systematic review and meta-regression; mixed efficacy
Psychotherapy evidence
Rothbaum BO, Watkins LE. Update on psychotherapy for PTSD. Am J Psychiatry. 2025
Fortney JC, Kaysen DL, Engel CC, et al. Comparative effectiveness of PTSD treatments in primary care. JAMA Psychiatry. 2025
Screening tools
Williamson MLC, Stickley MM, Armstrong TW, et al. PC-PTSD-5 diagnostic accuracy. J Clin Psychol. 2022
Sensitivity 91%; specificity 72% at cutoff of 3 in civilian primary care
Prevention evidence
Bertolini F, Robertson L, Bisson JI, et al. Early pharmacological interventions for prevention of PTSD. Cochrane Database Syst Rev. 2024
No evidence that early pharmacological interventions prevent PTSD
Bertolini F, Robertson L, Bisson JI, et al. Universal pharmacological prevention of PTSD. Cochrane Database Syst Rev. 2022
Epidemiology
Shalev A, Liberzon I, Marmar C. Post-Traumatic Stress Disorder. N Engl J Med. 2017
Comprehensive pathophysiology and epidemiology review
Moreland AD, Rancher C, Davies F, et al. PTSD in communities after mass violence. JAMA Netw Open. 2024
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.