Of the medication classes , evidence of treatment efficacy was most convincing for the SSRIs .
In addition , medication was superior to placebo in reducing  comorbid depression and disability .
Medication was also less well tolerated than placebo .
A narrative review of the 3 maintenance trials suggested that long-term medication may be required in treating PTSD .
CONCLUSION Medication treatments can be effective in treating PTSD , acting to reduce its core symptoms , as well as associated depression and disability , and should be considered as part of the treatment of this disorder .
The findings of this review support the status of SSRIs as first-line agents in the pharmacotherapy of PTSD , as well as their value in longterm treatment .
BACKGROUND Post-traumatic stress disorder ( PTSD ) is a prevalent and disabling condition .
Evidence that PTSD is characterized by specific psychobiological dysfunctions has contributed to a growing interest in use of medication in its treatment .
OBJECTIVES To assess the effects of medication in the treatment of PTSD .
Can physiologic assessment and side effects tease out differences in PTSD trials? A double-blind comparison of citalopram, sertraline, and placebo.
Effects of double-blind treatment of chronic posttraumatic stress disorder ( PTSD ) with 2 SSRIs and placebo on emotional symptoms and autonomic reactivity were assessed prospect ively . PTSD subjects received citalopram ( n=25 ) , sertraline ( n=23 ) , or placebo ( n=10 ) for 10 weeks , with psychophysiologic assessment s performed before and after treatment . Intent-to-treat analysis showed that all treatment groups improved significantly in total symptoms of PTSD ( as measured by the Clinician Administered PTSD Scale ) , all 3 PTSD symptom clusters , and sleep time . However , subtle differences in improvements in PTSD symptom clusters , physiologic reactivity , and reported adverse events were identified . Citalopram treated subjects significantly lowered systolic and diastolic blood pressures , while sertraline and placebo treated patients significantly lowered only systolic blood pressure reactivity to individualized trauma scripts . The sertraline group showed significantly more improvement in avoidance/numbing symptoms than both other groups . Considering side effects , subjects on sertraline reported more gastrointestinal problems , with early terminators having more insomnia . Early terminators on citalopram reported more fatigue and appetite changes than other treatment groups , with completers reporting more sexual dysfunction . Results support a class effect of SSRIs in treating PTSD symptoms , but suggest a possible differential effect of drugs on symptom clusters , physiologic parameters , and side effects that may have clinical relevance . Implication s of symptom reduction noted in the smaller placebo group are discussed relative to recent concerns about increasing placebo response in clinical trials
Of the medication classes , evidence of treatment efficacy was most convincing for the SSRIs .
In addition , medication was superior to placebo in reducing  comorbid depression and disability .
Medication was also less well tolerated than placebo .
A narrative review of the 3 maintenance trials suggested that long-term medication may be required in treating PTSD .
CONCLUSION Medication treatments can be effective in treating PTSD , acting to reduce its core symptoms , as well as associated depression and disability , and should be considered as part of the treatment of this disorder .
The findings of this review support the status of SSRIs as first-line agents in the pharmacotherapy of PTSD , as well as their value in longterm treatment .
BACKGROUND Post-traumatic stress disorder ( PTSD ) is a prevalent and disabling condition .
Evidence that PTSD is characterized by specific psychobiological dysfunctions has contributed to a growing interest in use of medication in its treatment .
OBJECTIVES To assess the effects of medication in the treatment of PTSD .