Inclusion Criteria:  DSM-5 diagnosis of Postraumatic Stress Disorder military veteran fluent in English willing to participate in PE, pharmacotherapy, or both capable of providing informed consent  Exclusion Criteria:  suicidal ideation with intent and/or plan, or suicidal behavior in the past month active psychosis history of manic episode(s) a failed trial of Prolonged Exposure therapy or paroxetine and venlafaxine XR ongoing medical conditions or treatments that would contraindicate initiating these treatments (e.g., medications that have potential interactions with paroxetine and venlafaxine such as MAO inhibitors)