I have severe PTSD and daily night terrors. Therapy is not helping, my PM Dr won't prescribe?

Hi, Steve!
I agree with everyone that you need a psychiatrist if you aren't already seeing one. The problem is with the buprenorphine because it can interact with the standard medications used to treat anxiety disorders. This might be why your doctor is hesitant to prescribe.
Are you doing talk therapy? CPT (Cognitive Processing Therapy) is specific for PTSD and related conditions and is used extensively by the VA hospitals. You'd need a referral to a licensed therapist who is familiar with this technique. I did the full course and it was amazing how much it helped!
Just for the record, I take an antidepressant and Lamictal, and buspirone for anxiety.
Best regards and I hope you feel better soon.
Wildcat

I have had extensive trauma therapy including domestic violence therapy and recovery. I only take sertraline. I do take lamotrigine for seizure prophylaxis: only Tylenol and some Advil for pain. I stopped expecting meds to do the work for me. Can you get assistance with trauma therapy?

I would definitely get a referral to a psychiatrist for help with the PTSD and they can get you on the right medication for it. A PM isn't really the Right Dr to help With PTSD I understand your desperation and really do hope you get the help you need because I deal with chronic pain and several mental disorders myself. It's is a long difficult road with no easy answers to any of it. I wish you the best

I am not quite certain why your PM has chosen Lamictal to treat your PTSD- here is a list of drugs usually used for that : https://www.drugs.com/condition/post-traumatic-stress-disorder.html. You can click on each drug and then click on the "Interactions" to see if they interact with buprenorphine and most don't. I think the problem here is that most pain docs ( I am one, board certified and retired) aren't really up on how to treat psych conditions. It takes all our time to keep up to date on treating pain conditions. He/she should refer you to a psychiatrist for treatment for the PTSD and just treat the pain condition. That's what I would do. Buprenorphine is really a fairly innocuous drug that "plays" well with other drugs. I ended up retiring because I, myself, have chronic pain and took Belbuca for a number of years. It's a great drug for pain.