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 .
Paroxetine in the treatment of chronic posttraumatic stress disorder: results of a placebo-controlled, flexible-dosage trial.
BACKGROUND The objective of this double-blind , placebo-controlled study was to investigate the efficacy and safety of paroxetine in out patients with posttraumatic stress disorder ( PTSD ) . METHOD Male and female out patients 18 years and older who met DSM-IV criteria for PTSD and had baseline scores of 50 or greater on the Clinician Administered PTSD Scale ( CAPS-2 ) were r and omly assigned to treatment with paroxetine ( 20 - 50 mg/day ) or placebo for 12 weeks . The primary efficacy variables were the change from baseline to the 12-week endpoint in the CAPS-2 total score and the proportion of responders on the Clinical Global Impressions-Global Improvement scale ( CGI-1 ) . Additional key outcome measures were the change from baseline in the reexperiencing , avoidance/ numbing , and hyperarousal scores of the CAPS-2 and in the total scores of the Treatment Outcome PTSD Scale and the patient-rated Davidson Trauma Scale and Sheehan Disability Scale ( SDS ) . Depressive symptoms were assessed with the Montgomery-Asberg Depression Rating Scale . The proportion of patients achieving response and remission was also determined . RESULTS 307 patients constituted the intent-to-treat population . At week 12 , compared with the placebo group ( N = 156 ) , the paroxetine group ( N = 151 ) showed significantly greater reduction of PTSD symptoms on both of the primary and all of the secondary outcome measures . Significantly greater improvement on the CAPS-2 total score was observed for paroxetine compared with placebo from week 4 ( p < .05 ) , and significantly greater proportions of paroxetine-treated patients achieved response ( p < .001 ) and remission ( p = .008 ) by week 12 . The improvement in PTSD symptoms was similar in male and female patients . Functional improvement at the study endpoint was significantly greater ( p < .05 ) in the paroxetine group in all 3 domains of the SDS ( work , social life , family life ) . Treatment with paroxetine was well tolerated , with the frequency and type of adverse events recorded for the paroxetine group corresponding to the known safety profile of this medication . CONCLUSION Paroxetine in doses of 20 to 50 mg once daily is effective as a treatment for chronic PTSD . Improvement is obtained for all 3 symptom clusters ( reexperiencing , avoidance/numbing , hyperarousal ) and is associated with significant reduction in disability after 12 weeks of treatment
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 .