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 .
A Placebo-Controlled Study of Nefazodone for the Treatment of Chronic Posttraumatic Stress Disorder: A Preliminary Study
Nefazodone is a unique serotonergic antidepressant that acts as both a presynaptic serotonin reuptake inhibitor and a postsynaptic 5-hydroxytryptamine 2A receptor antagonist . Based on the positive results of open-label trials of nefazodone , including one from our group , we tested nefazodone 's efficacy in the treatment of posttraumatic stress disorder ( PTSD ) under placebo-controlled conditions . Forty-one patients with chronic PTSD , predominantly male combat veterans , were enrolled in a r and omized , double-blind , placebo-controlled 12-week trial of nefazodone . The primary outcome measure was the Clinician-Administered PTSD Scale .  Fifteen patients were r and omized to placebo and 26 were r and omized to nefazodone .  In a repeated- measures analysis of variance with last observation carried forward , patients on nefazodone showed a significant improvement in the percentage change of Clinician-Administered PTSD Scale Total score from baseline compared with those on placebo ( P = 0.04 ; effect size = 0.6 ) . Sample size was not powered to test group differences in the Clinician-Administered PTSD Scale criterion B , C , or D subscale . However , the criterion D subscale showed significant improvement in patients treated with nefazodone compared with those treated with placebo ( P = 0.007 ) . In addition , the Hamilton Rating Scale for Depression showed significant improvement compared with placebo ( P = 0.008 ) . The nefazodone group also reported an improvement on the PTSD Checklist ( self-report scale ; P = 0.08 ) and the Clinician-Administered Dissociative States Scale ( P = 0.06 ) . This pilot study supports the efficacy of nefazodone for the treatment of PTSD . However , larger placebo-controlled studies in more diverse patient population are warranted
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 .