Treatment works. That’s the mantra of the Department of Veterans Affairs when it comes to post-traumatic stress disorder. Numerous studies and years of evidence-based work have shown that VA is a leader in effective treatment of PTSD.
PTSD can take many forms, so treatments also vary widely. Some people benefit from talk therapy; others have found success with medication. And for some, a combination of psychotherapy and medicine — known as psychopharmacology — has helped them conquer their symptoms.
But pinpointing which treatment works best in certain circumstances is the subject of an ongoing research project, and the Milwaukee VA is playing a key role in that research.
“The main purpose of the study is to test some of the front-line treatments for PTSD,” said principal investigator Dr. Sadie Larsen, a psychologist with the VA’s National Center for PTSD and an associate professor with the Medical College of Wisconsin.
“We have these medications that work well, and we have talk therapy … (which) also works well. But there’s very little evidence of which of those works better. They’re not usually tested head-to-head. So that’s what this study is doing, while also looking at the combination of the two.”
Dr. Carol Tsao, a Milwaukee VA psychiatrist and co-investigator on the study, said the treatments being investigated have been “totally proven to be not only effective, but best in class,” she said.
“We know these things work,” Tsao said. “This (study) is going to be a deep data analysis, (looking to) match the patient to the best treatment. … We do this clinically all the time, but this will put some science behind it.”
“We have our guesses, but there’s no research to tell us which person would do best with which treatment,” she said. “It’s like: ‘Here’s your menu. Where do you want to start?’”
Larsen, Tsao and their fellow researchers are about two years into the four-year study, which includes 450 Veterans spread over six VA medical centers across the country. Of the six sites, Milwaukee has the most Veterans enrolled, and they represent a broad age range, Larsen said.
Veterans taking part in the project are assigned to one of three groups: one treated with medication only, one treated with prolonged exposure therapy only and a third receiving both.
They receive treatment for 14 weeks, with regular follow-ups occurring up to 40 weeks after beginning treatment.
“We want to make sure that people are not only getting better during treatment but that those effects are durable over time,” Larsen said, noting there is no placebo group; all Veterans involved are getting active, known treatments.
While pharmaceutical companies and other outside interests often fuel such research, Larsen and Tsao noted that this study is not industry-funded. Instead, it is government-funded, helmed by the Patient-Centered Outcomes Research Institute, so it is unbiased, Tsao said.
While it’s too early to draw conclusions or discuss results, Larsen said the work has been going well locally. She also said the study will be beneficial moving forward in continued treatment of PTSD.
“The hope is that this informs clinical care,” she said. “This could really help us guide Veterans when seeking treatment.”
June is PTSD Awareness Month. Learn more about VA's efforts to combat PTSD.
Come to the Milwaukee VA for a PTSD Awareness Day event on June 27.