For patients with PTSD, the effective initiation of additional therapeutic modalities to ongoing individual psychotherapy is challenging. When pharmacologic agents are added, the therapist must carefully consider and monitor the impact of medications on PTSD core symptoms and on adjunctive symptoms such as depression. Further considerations include issues of countertransference, the possible symbolic meaning of medications for both the patient and the therapist, and the appropriate staging of medications. When nonphysician treaters work together with a medical back-up, both parties should frequently communicate with one another in order to avoid unnecessary treatment distortions and disruptions.