Transcranial Magnetic Stimulation in Veterans With PTSD

Inclusion Criteria: * Age between 19 and 70 * Eligible for VA healthcare * Moderate to severe PTSD as determined by a total score of at least 25 on the CAPS within 7 days of randomization. * Agree to have CAPS audio recorded. * Ability to obtain a Motor Threshold using the TMS device during screening. * If female with childbearing potential, use of acceptable method of birth control (i.e., use of contraceptives, abstinence). * Able to read, understand, and sign the informed consent document. Exclusion Criteria: * Pregnant or lactating woman. * MRI is contraindicated * Current use of clozapine (any dose) or bupropion (more than 300mg per day). * Cardiac pacemaker or implantable defibrillator. * Presence of any metal object in the head, including cochlear implants, but excluding dental work in the mouth. * Significant central nervous system disorder (stroke, brain mass, epilepsy). * Seizure in past one year. * Current psychosis or mania. * Significant suicidal ideation. * Unstable medical conditions. * Current alcohol or substance use disorder (except nicotine) that interferes with the patient's ability to participate. * CPT or PE for PTSD in the past 2 months. * Changes in Fluoxetine, Paroxetine, Sertraline, or Venlafaxine in the past 2 months. * Color blind * Currently participating in other research studies. * Aneurysm Clip * Ocular foreign body (e.g., metal shavings) * Any implanted device (pumps, infusion devices, etc.) * Shrapnel injuries or metal fragments