Understanding PTSD
Post-traumatic stress disorder (PTSD) develops after exposure to actual or threatened death, serious injury, or sexual violence — either directly or as a witness. PTSD affects 3.5% of U.S. adults annually. Symptoms fall into four clusters: intrusion (flashbacks, nightmares), avoidance, negative alterations in mood and cognition, and hyperarousal. PTSD is highly treatable with the right approach.
Signs & Symptoms
- Intrusive memories, flashbacks, or nightmares of the traumatic event
- Avoidance of trauma-related thoughts, feelings, or reminders
- Negative beliefs about oneself or the world ("I am bad," "the world is dangerous")
- Emotional numbing, feeling detached from others
- Hypervigilance — constantly scanning for danger
- Exaggerated startle response
- Sleep disturbances, irritability, angry outbursts
- Difficulty concentrating
How Dr. Agresti Treats This Condition
Dr. Agresti uses a trauma-informed approach that combines evidence-based psychotherapy — including Cognitive Processing Therapy (CPT) — with targeted medication management. First-line medications include SSRIs (Zoloft, Paxil) and SNRIs. For treatment-resistant PTSD, Spravato (esketamine) has shown promising results and is FDA-approved for MDD with suicidal ideation, a common comorbidity in PTSD.
Medication Options
- SSRIs (FDA-approved for PTSD): Zoloft (sertraline), Paxil (paroxetine)
- SNRIs: Effexor XR (venlafaxine)
- Prazosin for trauma-related nightmares
- Adjunctive: atypical antipsychotics for severe symptom clusters
- Spravato (esketamine) for comorbid treatment-resistant depression
The Concierge Advantage
With Dr. Agresti's concierge model, medication adjustments happen quickly when you need them — not at your next appointment weeks away. Text him directly if symptoms worsen. Get same-day refills. Reach him directly when you're having a difficult day. This level of access makes a meaningful difference in psychiatric treatment outcomes.
Frequently Asked Questions
Many patients achieve full remission with appropriate treatment — particularly with evidence-based psychotherapy like CPT or EMDR combined with medication when needed. Partial response is also common and meaningful: significant reduction in symptom severity even without full remission dramatically improves quality of life.
Research shows that trauma-focused psychotherapy (CPT, Prolonged Exposure, EMDR) is the most effective intervention for PTSD. Medication helps with specific symptom clusters — particularly sleep, hyperarousal, and depression — and can make therapy more accessible by reducing acute symptoms.
Evidence-based PTSD therapies like CPT involve processing (not simply reliving) the traumatic memory — but the work is structured and paced to your readiness. Dr. Agresti approaches trauma-informed care with sensitivity to each patient's capacity and readiness.
Related Conditions & Services
Ready to Take the First Step?
Appointments available within 24 hours. Direct cell access. No membership fee.