This article presents the results of a study of clinical features of the development and course of alcohol dependence in patients with posttraumatic stress disorder (PTSD) in comparison with alcohol-dependent patients without PTSD. The highly progressive course, continuous alcohol consumption, high alcohol tolerance, rapidly emerged altered forms of alcohol intoxication, alcohol amnesias, alcohol withdrawal with the prevalence of psychopathological component, and more pronounced social and somatic consequences of alcohol abuse were characteristic of the PTSD group. At the same time, the alcohol-dependent patients with PTSD had the best outcome to the end of 12-month treatment with intramuscular injections of vivitrol.