Psychiatry

Answer 3 Sertraline. Sertraline is an SSRI indicated for the treatment of PTSD. Research evaluating individuals with PTSD has demonstrated that sertraline is significantly more effective than placebo in reducing the PTSD symptoms of avoidance/numbing and increased arousal.2 Alprazolam may be helpful in reducing symptoms of overall anxiety, but like most benzodiazepines, it is best used on a short-term basis. There is no solid research supporting the role of benzodiazepines as a first-line treatment of PTSD. Bupropion is an antidepressant that tends to be highly activating and can actually increase anxiety in patients. It is generally avoided as a first-line choice for patients with anxiety disorders. Buspirone, a non-benzodiazepine anxiolytic, is indicated for the treatment of generalized anxiety disorder. No positive controlled trials support its use as a first-line agent, although it may be a helpful adjunct, particularly in patients with a history of substance abuse in whom benzodiazepines would be contraindicated. Lithium, a mood stabilizer, may also be helpful as an adjunctive medication for PTSD, particularly in combination with a serotonergic antidepressant. It is not recommended as a first-line treatment. REFERENCE 2. Brady K, Pearlstein T, Asnis GM, et al: Efficacy and safety of sertraline treatment of posttraumatic stress disorder. JAMA 2000;283: 1837-1844. Click here to return to the questions

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