Phase IIa Trial of a Selective Glucocorticoid Receptor Antagonist in the Treatment of Veterans With Posttraumatic Stress Disorder (PTSD) (Seven Study)

Inclusion Criteria:

* History of US military service
* Capable of reading and understanding English
* Able to provide written informed consent
* Symptoms of PTSD (must score 23 or greater on the CAPS-5 assessment at screening visit)
* Men and pre-menopausal women must agree to use two forms of reliable contraception, one of which is a barrier method.
* Participants who use an SSRI or SNRI medication for PTSD must be on a stable dose for 8 weeks before enrollment.
* Participants who use trazodone for sleep must be on a stable dose.
* Participants who use opiate pain medication must be on a stable dose.
* For participants who are in psychotherapy, treatment must be stable for 6 weeks.

Exclusion Criteria:

* Alcohol use that meets criteria for Alcohol Use Disorder in past 3 months.
* Marijuana or other drug use that meets criteria for Substance Use Disorder in past 3 months.
* Ever diagnosed with: Bipolar Disorder, Schizophrenia, Schizoaffective Disorder, Obsessive-Compulsive Disorder, or Major Depressive Disorder with Psychotic Features
* Experienced any psychologically traumatic event in the past 3 months
* Currently using certain antidepressant medications such as doxepin or tricyclics
* Currently using certain mood stabilizers, such as lithium
* Currently using antipsychotic medication
* High risk for suicide or violent behavior
* Has sleep apnea and not using any treatment, such as CPAP
* Currently using corticosteroid medication (oral or inhaled)
* History of neurological disease
* Angina, congestive heart failure or low blood pressure
* Heart attack in the past 6 months
* Heart block or irregular heartbeat
* Kidney failure, liver failure or pancreatitis
* Severe chronic obstructive pulmonary disease (COPD)
* History of liver disease with lab results on AST or ALT more than 2 times the normal readings
* History of kidney disease with lab results on eGFR less than 60 ml/min
* History of additional risk factors for Torsades de pointes, such as heart failure, low potassium, or family history of a heart rhythm disorder called long QT syndrome
* Use of certain medications that can affect heart rhythm
* Use of certain medications that can interfere with the effects of the study drug
* High blood pressure that is not controlled by medication
* Diabetes that is not well-controlled
* History of certain types of head injuries
* Mild cognitive impairment