What is considered first-line pharmacologic treatment for post-traumatic stress disorder?

What is considered first-line pharmacologic treatment for post-traumatic stress disorder?

• A. Non-SSRI antidepressants
• B. MAOI therapy
• C. SSRI such as sertraline or paroxetine
• D. Benzodiazepines

Answer: (C)

Selective serotonin reuptake inhibitors are considered the first-line pharmacologic treatment for PTSD because they have the strongest evidence base for reducing the core symptoms—intrusive memories, avoidance, negative mood, and hyperarousal—and two SSRIs, sertraline and paroxetine, are specifically FDA-approved for PTSD. SSRIs help regulate brain systems involved in fear and stress response, leading to meaningful symptom improvement with a tolerable safety profile. Other antidepressants that aren’t SSRIs may be used, but they don’t have the same PTSD-specific efficacy data. MAO inhibitors carry significant dietary and drug interaction risks and are rarely used as first-line due to safety concerns. Benzodiazepines don’t effectively treat the core PTSD symptoms and pose risks of dependence and cognitive impairment, so they’re not preferred for long-term management.

Selective serotonin reuptake inhibitors are considered the first-line pharmacologic treatment for PTSD because they have the strongest evidence base for reducing the core symptoms—intrusive memories, avoidance, negative mood, and hyperarousal—and two SSRIs, sertraline and paroxetine, are specifically FDA-approved for PTSD. SSRIs help regulate brain systems involved in fear and stress response, leading to meaningful symptom improvement with a tolerable safety profile. Other antidepressants that aren’t SSRIs may be used, but they don’t have the same PTSD-specific efficacy data. MAO inhibitors carry significant dietary and drug interaction risks and are rarely used as first-line due to safety concerns. Benzodiazepines don’t effectively treat the core PTSD symptoms and pose risks of dependence and cognitive impairment, so they’re not preferred for long-term management.