What are the risk factors for Post-Traumatic Stress Disorder (PTSD) relapse?

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Last updated: May 1, 2025 • View editorial policy

From the Guidelines

Risk factors for PTSD relapse include exposure to trauma reminders, significant life stressors, poor social support, substance abuse, and discontinuation of treatment, as highlighted in the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline 1, 2, 3, 4. These factors can trigger symptom recurrence, and individuals who stop their medications abruptly or cease therapy before developing adequate coping skills are particularly vulnerable. Some key points to consider in preventing PTSD relapse include:

  • Maintaining consistent treatment, including medication adherence if prescribed, and continuing therapy until clinicians determine appropriate termination
  • Developing a relapse prevention plan that identifies personal triggers and coping strategies
  • Regular self-monitoring of symptoms, practicing stress management techniques, and maintaining connections with supportive individuals
  • Avoiding the use of benzodiazepines, cannabis, or cannabis-derived products, as recommended by the clinical practice guideline 1, 2, 3, 4 The revised CPG includes 34 recommendations in the following 5 topic areas: assessment and diagnosis, prevention, treatment, treatment of nightmares, and treatment of posttraumatic stress disorder (PTSD) with co-occurring conditions, with six recommendations on PTSD treatment rated as strong 1, 2, 3, 4. PTSD relapse occurs because trauma alters brain function, particularly in the amygdala and prefrontal cortex, creating persistent fear responses that can be reactivated during periods of vulnerability, as supported by the evidence from the studies 5, 1, 2, 3, 4. Therefore, it is essential to prioritize consistent treatment and develop a relapse prevention plan to minimize the risk of PTSD relapse and optimize individuals' health outcomes and quality of life.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Risk Factors for PTSD Relapse

  • The provided studies do not directly address the risk factors for PTSD relapse, but rather focus on the treatment and management of PTSD [(6, 7, 8, 9, 10)].
  • However, some studies suggest that factors such as symptom severity, childhood sexual trauma, and sexual assault as index trauma may influence treatment response 9.
  • Additionally, the time since index trauma, severity of depression, and severity of anxiety may also predict treatment response trajectories 9.
  • It is essential to note that the studies primarily discuss the efficacy of various medications, including SSRIs, SNRIs, and other pharmacological interventions, in treating PTSD [(6, 7, 8, 10)].
  • While these studies do not explicitly address risk factors for relapse, they imply that effective treatment and management of PTSD can help reduce the risk of relapse [(6, 7, 8, 9, 10)].

References

Research

Evidence-based prescribing for post-traumatic stress disorder.

The British journal of psychiatry : the journal of mental science, 2020

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.