Posttraumatic stress disorder (PTSD) is a prevalent disorder with significant negative impacts on health, quality of life, and healthcare utilization.1 Lifetime prevalence of PTSD is estimated to be six percent in American civilians2,3 and seven to nine percent in Veterans.4,5 Since PTSD was first included by the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III) in 1980, there have been over 500 published randomized controlled trials (RCTs) evaluating a vast number of treatments and treatment modalities (e.g., psychotherapy, psychopharmacotherapy, complementary approaches, etc.). Given the large and varied body of evidence, even some of the most comprehensive systematic reviews on PTSD have excluded some intervention types (e.g., complementary and integrative approaches) due to the prohibitively large number of studies that would have to be reviewed.6 Without a comprehensive database containing all published RCTs on PTSD, clinicians and researchers may need to consult multiple reviews in order to synthesize evidence across studies and evaluate the effectiveness and comparative effectiveness of treatments. However, heterogeneity of review methods, scope, and data presentation make it difficult to synthesize across reviews and have led to variation in conclusions.7,8 Methodological differences, such as data coding approaches and combining treatment categories for analysis, further limit the generalizability of findings.
Systematic reviews typically abstract a small number of data elements pertinent to the scope of the review due to resource constraints. Furthermore, even when abstracted data are made publicly available, they may be presented in a format that does not readily lend itself to re-analyses without reformatting or re-entry. Hence, there is a need for a single source that provides up-to-date, detailed, comprehensive data on existing PTSD trials to better address current clinical, research, and policy stakeholders’ needs.
To meet this need, databases were initially developed in two previous AHRQ reports, a 2019 report (Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: Groundwork for a Publicly Available Repository of Randomized Controlled Trial Data) and subsequent 2020 report (Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: An Update of the PTSD-Repository Evidence Base).9,10 These databases were then converted into an online, accessible, interactive data repository disseminated by the National Center for PTSD (NCPTSD), called the PTSD Trials Standardized Data Repository, or “PTSD-Repository.”11 Since then, the database was updated in reports released in 202212 and 2023,13 and will be updated again through this evidence review. The PTSD-Repository could (1) serve as a data source for future systematic reviews, meta-analyses, or other cross-study comparisons; (2) help identify research gaps to determine future research priorities; (3) encourage researchers to adopt standard data elements in research and reporting; (4) serve as a source for clinicians seeking information on effectiveness of interventions for patients with particular demographics or exposures; (5) provide the public a source to search for evidence on interventions they or their loved ones are considering; (6) provide policymakers with an up-to-date accounting of evidence to respond to inquiries; and (7) augment and inform the use of existing patient education tools such as PTSD mobile applications14 or the online PTSD Treatment Decision Aid.15
This review will update the literature base and build on the PTSD-Repository by adding newly-published studies, assessing risk of bias using the Cochrane risk-of-bias tool for randomized trials (RoB 2),16 and calculating standardized effect sizes. As part of the update process, corresponding authors of publications added in the 2022 update12 will be notified of their study’s inclusion and invited to submit any corrections to the study team. These data will be available through the resulting report and excel files, as well as the PTSD-Repository.
Key Question. What interventions have been studied for the treatment of PTSD alone or with comorbid substance use disorder (SUD)?
This review will update the literature for this Key Question from previous reviews.9,10,12,13 The PICOTS (Populations, Interventions, Comparators, Outcomes, Timing, Settings, Study Design) criteria are:
- Adults (≥18 years old) diagnosed with PTSD by a clinician or through patient-reported assessment tool
- Pharmacologic and nonpharmacologic interventions, including complementary and integrative approaches, for PTSD or comorbid PTSD/SUD
- Any comparator, including another intervention, waitlist/minimal attention, usual care, or placebo
- Overall PTSD outcome, PTSD diagnostic change, PTSD clinically meaningful change
- Other outcomes - anxiety, anger, depression, functioning, quality of life, sleep, substance use, suicide and self-directed violence, withdrawal due to adverse events, serious adverse events
- No limitation on study duration or length of follow up
- No limitation on study setting
- Study Design:
- Randomized controlled trials
The analytic framework (Figure 1) illustrates how PTSD treatments may be associated with health and functional outcomes including PTSD symptoms and diagnosis, substance use, anxiety, depression, and quality of life; as well as how these interventions may be associated with harms.
Figure 1. Analytic Framework for Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder
Criteria for Inclusion/Exclusion of Studies in the Review
Detailed inclusion and exclusion criteria for the Key Question are listed in Table 1 and are consistent with the PICOTS described above in Section II.
Table 1. PICOTS: Inclusion and exclusion criteria
PTSD = posttraumatic stress disorder; RCTs = randomized controlled trials; SUD = substance use disorder
Literature Search Strategies to Identify Relevant Studies to Answer the Key Questions
Publication Date Range: Electronic databases will be searched for evidence from March 1, 2023 to present, subsequent to the last database search for the prior update report.13 An updated literature search will be conducted concurrently with the peer review and public comment process and any new literature identified that meets inclusion criteria will be incorporated into the report.
Literature Databases: PTSDpubs (formerly PILOTS), Ovid® MEDLINE®, Cochrane CENTRAL, Embase®, the Cumulative Index to Nursing and Allied Health Literature (CINAHL®), SCOPUS, and PsycINFO®. Search strategies are in Appendix A.
Gray Literature: A gray literature search will not be conducted. Due to the nature of the project, a portal for submission of Supplemental Evidence And Data for Systematic review (SEADS) will not be opened for this project.
Hand Searching: Reference lists of relevant, recent, high-quality systematic reviews or meta-analyses identified in the search will be reviewed to identify RCTs eligible for inclusion.
Process for Selecting Studies: PICOTS described in Section II and criteria in Table 1 will be used to determine eligibility for inclusion and exclusion of abstracts. One investigator will determine eligibility at the title/abstract review stage and a second investigator will review excluded studies. For studies included at the title/abstract review stage, the full-text will be retrieved and reviewed independently for eligibility by two investigators. Any disagreements will be resolved by consensus of the team of investigators.
Contacting Study Authors: The EPC will send an email to the list of corresponding authors for all new studies included in the prior update report,13 notifying them of the inclusion of their study and providing the report public link on the AHRQ website. If study authors respond and report missing study data, corrections, or other study information relevant to evidence table variables, the EPC will document this information in the updated evidence tables, including information obtained from published materials in the evidence table, and reporting unpublished information provided by study authors in evidence table notes or other sections of the final report indicating the unpublished source(s).
Data Abstraction and Data Management
After studies are screened and determined to meet inclusion criteria, we will abstract study design, year, setting, country, sample size, eligibility criteria, source(s) of funding, study characteristics, population characteristics, intervention characteristics, and results using the Microsoft® Excel evidence table template used in the previous two updates12,13 (see Appendix B for detailed list of data elements). All study data will be verified for accuracy and completeness by a senior investigator. A record of studies excluded at the full-text level with reasons for exclusion will be maintained.
Assessment of Methodological Risk of Bias of Individual Studies
The EPC will conduct a risk of bias (RoB) assessment for each of the new studies identified in this update using RoB 2.16 RoB will be assessed by one person on the research team and checked for accuracy by a second, with any disagreements resolved through consensus. To ensure transparency and ease of future updating, the EPC will include detailed definitions related to how RoB was assessed, and abstract RoB-related data into additional columns focused on documenting the analysis type (e.g., intent to treat, per protocol), the overall percent of missing primary PTSD outcome assessment data (i.e., overall attrition from measurement), and the percent of missing primary PTSD outcome data in each of the arms of the study (i.e., differential attrition from measurement).
Characteristics of included studies, such as number of publications by year, study sample size, proportion of studies enrolling community versus military population, and distribution of studies by PTSD assessment method, will be summarized in descriptive tables and text, though no formal data synthesis will be completed as part of this project. All studies, regardless of overall RoB rating, will be incorporated in the descriptive summaries. Results from studies will not be synthesized quantitatively.
Grading the Strength of Evidence (SOE) for Major Comparisons and Outcomes
Strength of evidence will not be assessed as a part of this project, nor will we assess applicability.
- Giacco D, Matanov A, Priebe S. Symptoms and subjective quality of life in post-traumatic stress disorder: a longitudinal study. PLoS One. 2013;8(4):e60991. doi: 10.1371/journal.pone.0060991. PMID: 23585868.
- Goldstein RB, Smith SM, Chou SP, et al. The epidemiology of DSM-5 posttraumatic stress disorder in the United States: results from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Soc Psychiatry Psychiatr Epidemiol. 2016;51(8):1137-48. PMID: 27106853
- Schein J, Houle C, Urganus A, et al. Prevalence of post-traumatic stress disorder in the United States: a systematic literature review. Curr Med Res Opin. 2021 Dec;37(12):2151-61. doi: 10.1080/03007995.2021.1978417. PMID: 34498953.
- Smith SM, Goldstein RB, Grant BF. The association between post-traumatic stress disorder and lifetime DSM-5 psychiatric disorders among veterans: data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III). J Psychiatr Res. 2016;82:16-22. PMID: 27455424
- Wisco BE, Nomamiukor FO, Marx BP, et al. Posttraumatic Stress Disorder in US Military Veterans: Results From the 2019-2020 National Health and Resilience in Veterans Study. J Clin Psychiatry. 2022 Feb 22;83(2) doi: 10.4088/JCP.20m14029. PMID: 35192748.
- Forman-Hoffman V, Middleton JC, Feltner C, et al. Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder: A Systematic Review Update. Comparative Effectiveness Review No. 207. (Prepared by the RTI International–University of North Carolina at Chapel Hill Evidence-based Practice Center under Contract No. 290-2015-00011-I for AHRQ and PCORI.) AHRQ Publication No. 18-EHC011-EF. PCORI Publication No. 2018-SR-01. Rockville, MD: Agency for Healthcare Research and Quality; May 2018. doi: 10.23970/AHRQEPCCER207. PMID: 30204376.
- Cipriani A, Williams T, Nikolakopoulou A, et al. Comparative efficacy and acceptability of pharmacological treatments for post-traumatic stress disorder in adults: a network meta-analysis. Psychol Med. 2018;48(12):1975-84. doi: 10.1017/S003329171700349X. PMID: 29254516.
- Stein DJ, Ipser JC, Seedat S. Pharmacotherapy for post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2006 Jan 25;2006(1):CD002795. doi: 10.1002/14651858.CD002795.pub2. PMID: 16437445.
- O'Neil M, McDonagh M, Hsu F, et al. Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: Groundwork for a Publicly Available Repository of Randomized Controlled Trial Data. Technical Brief No. 32. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 290-2015-00009-I.) AHRQ Publication No. 19-EHC018-EF. Rockville, MD: Agency for Healthcare Research and Quality; May 2019. doi: 10.23970/AHRQEPCTB32.
- O’Neil ME, Cheney TP, Hsu FC, et al. Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: An Update of the PTSD-Repository Evidence Base. Comparative Effectiveness Review No. 235. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 290-2015-00009-I.) AHRQ Publication No. 20(21)-EHC029. Rockville, MD: Agency for Healthcare Research and Quality; November 2020. doi: 10.23970/AHRQEPCCER235.
- National Center for PTSD. PTSD-Repository. Accessed September 1, 2021.
- O’Neil ME, Cheney TP, Yu Y, et al. Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: 2022 Update of the PTSD Repository Evidence Base. Systematic Review. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 75Q80120D00006.) AHRQ Publication No. 22(23)-EHC040. Rockville, MD: Agency for Healthcare Research and Quality; October 2022. doi: 10.23970/AHRQEPCPTSD2022.
- O’Neil ME, Cheney TP, Yu Y, et al. Pharmacologic and Nonpharmacologic Treatments for Posttraumatic Stress Disorder: An Update of the Evidence Base for the PTSD Trials Standardized Data Repository. Evidence Report No. XX. (Prepared by the Pacific Northwest Evidence-based Practice Center under Contract No. 75Q80120D00006.) AHRQ Publication No. XX. Rockville, MD: Agency for Healthcare Research and Quality; Month 2023. doi: XX.
- National Center for PTSD. PTSD Mobile Applications (for Veterans, General Public, Family and Friends). Washington, DC: U.S. Department of Veterans Affairs; 2017. Accessed March 16, 2018.
- National Center for PTSD. PTSD Treatment Decision Aid: The Choice is Yours. U.S. Department of Veterans Affairs. Accessed March 16, 2018.
- Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898.
If the EPC needs to amend the protocol, we will give the date of each amendment, describe the change, and provide rationale in this section. Changes will not be incorporated into the protocol.
Technical Experts constitute a multi-disciplinary group of clinical, content, and methodological experts who provide input in defining populations, interventions, comparisons, or outcomes and identify particular studies or databases to search. The Technical Expert Panel is selected to provide broad expertise and perspectives specific to the topic under development. Divergent and conflicting opinions are common and perceived as healthy scientific discourse that fosters a thoughtful, relevant systematic review. Therefore, study questions, design, and methodological approaches do not necessarily represent the views of individual technical and content experts.
Technical Experts provide information to the EPC to identify literature search strategies and suggest approaches to specific issues as requested by the EPC. Technical Experts do not do analysis of any kind; neither do they contribute to the writing of the report. They do not review the report, except as given the opportunity to do so through the peer or public review mechanism.
Members of the TEP must disclose any financial conflicts of interest greater than $5,000 and any other relevant business or professional conflicts of interest. Because of their unique clinical or content expertise, individuals are invited to serve as Technical Experts and those who present with potential conflicts may be retained. The AHRQ TOO and the EPC work to balance, manage, or mitigate any potential conflicts of interest identified.
Peer reviewers are invited to provide written comments on the draft report based on their clinical, content, or methodological expertise. The EPC considers all peer review comments on the draft report in preparing the final report. Peer reviewers do not participate in writing or editing of the final report or other products. The final report does not necessarily represent the views of individual reviewers.
The EPC will complete a disposition of all peer review comments. The disposition of comments for systematic reviews and technical briefs will be published 3 months after publication of the evidence report.
Potential peer reviewers must disclose any financial conflicts of interest greater than $5,000 and any other relevant business or professional conflicts of interest. Invited peer reviewers with any financial conflict of interest greater than $5,000 will be disqualified from peer review. Peer reviewers who disclose potential business or professional conflicts of interest can submit comments on draft reports through the public comment mechanism.
EPC core team members must disclose any financial conflicts of interest greater than $1,000 and any other relevant business or professional conflicts of interest. Direct financial conflicts of interest that cumulatively total more than $1,000 will usually disqualify an EPC core team investigator.
This project was funded under Contract No. 75Q80120D00006 from the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. The AHRQ Task Order Officer reviewed the EPC response to contract deliverables for adherence to contract requirements and quality. The authors of this report are responsible for its content. Statements in the report should not be construed as endorsement by either the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.
Because this is a data abstraction and evidence base expansion project and not a systematic review, this protocol will not be registered in the international prospective register of systematic reviews (PROSPERO).
Database: Ovid MEDLINE®, Ovid MEDLINE® In-Process & Other Non-Indexed Citations
1 stress disorders, post-traumatic/
2 ("posttraumatic stress disorder" or "post traumatic stress disorder" or PTSD).ti,ab.
3 exp Drug Therapy/
5 (medication* or pharmacologic* or pharmaco-therap* or pharmacotherap*).ti,ab.
6 (drug* adj2 (therap* or treatment*)).ti,ab.
7 exp Adrenergic alpha-Antagonists/ or Sympatholytics/ or Doxazosin/ or Prazosin/
8 ("adrenergic alpha antagonist*" or "adrenergic receptor block*" or "alpha adrenergic antagonist*" or "alpha block*" or antiadrenergic* or doxazosin or prazosin or sympatholytic* or terazosin).ti,ab.
9 exp Antipsychotic Agents/
10 ("anti-psychotic*" or antipsychotic* or FGA* or SGA* or aripiprazole or asenapine or brexpiprazole or cariprazine or chlorpromazine or clozapine or fluphenazine or haloperidol or iloperidone or loxapine or lurasidone or olanzapine or paliperidone or perphenazine or pimozide or quetiapine or risperidone or thioridazine or thiothixene or trifluoperazine or ziprasidone).ti,ab.
11 exp Benzodiazepines/
12 (alprazolam or benzodiazepine* or benzodiazepinone* or chlordiazepoxide or clonazepam or clorazepate or diazepam or estazolam or flurazepam or lorazepam or midazolam or oxazepam or quazepam or temazepam or triazolam).ti,ab.
13 exp Monoamine Oxidase Inhibitors/
14 (("monoamine oxidase" adj2 inhibitor*) or MAOI or isocarboxazid or phenelzine or selegiline or tranylcypromine).ti,ab.
15 carbamazepine/ or clonidine/ or lithium/ or pregabalin/ or valproic acid/
16 exp Anticonvulsants/
17 exp Antimanic Agents/
18 exp Cyclohexanecarboxylic Acids/
19 (anticonvuls* or carbamazepine or clonidine or divalproex or gabapentin or lamotrigine or lithium or oxcarbazepine or pregabalin or tiagabine or topiramate or valproate or "valproic acid").ti,ab.
20 exp "hypnotics and sedatives"/ or exp anti-anxiety agents/
21 ("anti anxiety" or antianxiety or buspirone or diphenhydramine or eszopiclone or guanfacine or hydroxizine or hypnotic* or ramelteon or sedative* or suvorexant or tasimelteon or zaleplon or zolpidem or zopiclone).ti,ab.
22 exp Antidepressive Agents/
23 (antidepressant* or "anti-depressant*" or "selective serotonin" or (serotonin adj3 reuptake) or SNRI* or SSRI* or tricyclic or amitriptyline or amoxapine or bupropion or citalopram or clomipramine or desipramine or desvenlafaxine or doxepin or duloxetine or escitalopram or fluoxetine or fluvoxamine or hydroxizine or imipramine or levomilnacipran or maprotiline or milnacipran or mirtazapine or nefazodone or nortriptyline or paroxetine or protriptyline or sertraline or trazadone or trimipramine or venlafaxine or vilazodone or vortioxetine).ti,ab.
24 exp Amphetamines/
25 (amphetamine or armodafanil or atomoxetine or dexmethylphenidate or dextroamphetamine or lisdexamphetamine or MDMA or methamphetamine or methylphenidate or modafanil).ti,ab.
26 exp Steroids/
27 (DHEA or hydrocortisone or steroid*).ti,ab.
28 exp Cannabinoids/
30 Medical Marijuana/
31 (cannabi* or marijuana or tetrahydrocannabinol or THC).ti,ab.
36 exp Randomized Controlled Trials as Topic/
37 exp Randomized Controlled Trial/
38 double-blind method/ or random allocation/ or single-blind method/
40 (random* or control* or trial or sham or placebo* or blind* or dumm* or mask*).ti,ab,kw.
41 (1 or 2) and (or/3-35)
42 41 and (or/36-40)
43 (202303* or 202304* or 202305* or 202306* or "2023 03 *" or "2023 04 *" or "2023 05 *" or "2023 06 *" or "2023 mar" or "2023 apr" or "2023 may" or "2023 jun").dt,dp.
44 42 and 43
1 stress disorders, post-traumatic/
2 ("posttraumatic stress disorder" or "post traumatic stress disorder" or PTSD).ti,ab.
4 exp Psychotherapy/
5 exp Complementary Therapies/
6 exp Convulsive Therapy/
7 Hyperbaric Oxygenation/
8 Transcranial Magnetic Stimulation/
9 exp Rehabilitation/
10 exp Dietary Supplements/
11 exp "Delivery of Health Care, Integrated"/
12 exp Self-Help Groups/
13 exp peer group/
14 exp social support/
15 exp Telemedicine/
16 telephone/ or exp cell phone/
17 (therap* or psychotherap* or counsel* or nonpharma* or non-pharma*).ti,ab.
18 ("alternative medicine" or acupuncture or "animal assist*" or art or "cell phone" or "cognitive behavior*" or CBT or complementary or dance or drama or electroconvulsive or ECT or exercise or "eye movement desensitization and reprocessing" or EMDR or family or "hyperbaric oxygen*" or integrated or meditation or "mind body" or mindfulness or music or "prolonged exposure" or relaxation or "seeking safety" or "self help" or "tai chi" or "tai ji" or "text messag*" or "transcranial magnetic stimulation" or TMS or yoga).ti,ab.
19 exp Randomized Controlled Trials as Topic/
20 exp Randomized Controlled Trial/
21 double-blind method/ or random allocation/ or single-blind method/
22 (random* or control* or trial or sham or blind* or dumm* or mask*).ti,ab,kw.
23 (1 or 2) and (or/3-18)
24 23 and (or/19-22)
25 (202303* or 202304* or 202305* or 202306* or "2023 03 *" or "2023 04 *" or "2023 05 *" or "2023 06 *" or "2023 mar" or "2023 apr" or "2023 may" or "2023 jun").dt,dp.
26 24 and 25
Database: PTSDpubs (formerly PILOTS)
(MAINSUBJECT.EXACT("PTSD") OR MAINSUBJECT.EXACT("PTSD (DSM-III-R)") OR MAINSUBJECT.EXACT("PTSD (DSM-III)") OR MAINSUBJECT.EXACT("PTSD (DSM-IV)") OR MAINSUBJECT.EXACT("PTSD (DSM-5)") OR MAINSUBJECT.EXACT("Complex PTSD") OR MAINSUBJECT.EXACT("PTSD (ICD-11)") OR MAINSUBJECT.EXACT("PTSD (ICD-10)") OR MAINSUBJECT.EXACT("PTSD (ICD-9)") OR (ptsd OR "posttraumatic stress disorder" OR "post-traumatic stress disorder")) AND (MAINSUBJECT.EXACT("Randomized Clinical Trial") OR ti(random* OR control* OR trial))
Applied filter: 2023-03-1 - 2023-06-30
Database: APA PsycInfo®
1 exp posttraumatic stress disorder/
2 ("post traumatic stress disorder" or "posttraumatic stress disorder" or PTSD).ti,ab.
3 exp treatment/
4 exp stimulation/
5 exp electroconvulsive shock/
6 exp TELEMEDICINE/
7 exp counseling/
8 exp support groups/
9 (therap* or psychotherap* or counsel* or nonpharma* or non-pharma*).ti,ab. (577990)
10 ("alternative medicine" or acupuncture or "animal assist*" or art or "cell phone" or "cognitive behavior*" or CBT or complementary or dance or drama or electroconvulsive or ECT or exercise or "eye movement desensitization and reprocessing" or EMDR or family or "hyperbaric oxygen*" or integrated or meditation or "mind body" or mindfulness or music or "prolonged exposure" or relaxation or "seeking safety" or "self help" or "tai chi" or "tai ji" or "text messag*" or "transcranial magnetic stimulation" or TMS or yoga).ti,ab.
11 (1 or 2) and (or/3-10)
12 treatment effectiveness evaluation/
13 Treatment Outcomes/
14 followup studies/
15 (random* or control* or trial or sham or placebo* or blind* or dumm* or mask*).ti,ab.
16 11 and (or/12-15)
17 limit 16 to english language
18 limit 17 to human
19 (202303* or 202304* or 202305* or 202306*).up.
20 18 and 19
21 limit 20 to yr="2023 -Current"
Database: EBM Reviews - Cochrane Central Register of Controlled Trials
1 Stress Disorders, Post-Traumatic/
2 ("posttraumatic stress disorder" or "post traumatic stress disorder" or "ptsd").ti,ab.
3 (dt or pc or rh or th).fs.
4 exp treatment outcome/ or exp therapeutics/
5 (treatment or therap* or intervention*).ti,ab,hw.
6 (1 or 2) and (3 or 4 or 5)
7 limit 6 to medline records
8 6 not 7
9 (202303* or 202304* or 202305* or 202306*).up.
10 8 and 9
11 limit 10 to yr="2023 -Current"
Database: Elsevier® Embase
('posttraumatic stress disorder'/exp/mj OR 'posttraumatic stress disorder'/exp OR 'posttraumatic stress disorder' OR 'posttraumatic stress disorder':ab,ti OR 'post traumatic stress disorder':ab,ti OR 'ptsd':ab,ti) AND [randomized controlled trial]/lim AND ('randomized controlled trial'/exp OR 'randomized controlled trial') AND [embase]/lim NOT ([embase]/lim AND [medline]/lim) AND [01-03-2023]/sd NOT [01-07-2023]/sd
Database: EBSCO® CINAHL
S1 (MM "Stress Disorders, Post-Traumatic+")
S2 AB "post traumatic stress disorder" OR AB "posttraumatic stress disorder" OR AB "ptsd"
S3 TI "post traumatic stress disorder" OR TI "posttraumatic stress disorder" OR TI "ptsd"
S4 S1 OR S2 OR S3
S5 (TI random* or AB random* or PT clinical trial)
S6 S4 AND S5
S7 S4 AND S5 Limiters - Published Date: 20230301-20230631
Database: Elsevier® Scopus
( ( ( TITLE-ABS-KEY ( "post traumatic stress disorder" OR "posttraumatic stress disorder" OR "ptsd" ) ) AND ( TITLE ( random* OR control* OR trial* OR sham* OR placebo* OR blind* ) ) ) ) AND (PUBDATETXT ( march 2023 OR april 2023 OR may 2023 OR june 2023 ) )