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Am Fam Physician. 2022;106(6):623-624

This clinical content conforms to AAFP criteria for CME.

Author disclosure: No relevant financial relationships.

Clinical Question

Is pharmacotherapy effective for reducing symptoms of posttraumatic stress disorder (PTSD) in adults?

Evidence-Based Answer

Selective serotonin reuptake inhibitors (SSRIs) improve symptoms of PTSD and are considered first-line pharmacologic agents. (Strength of Recommendation [SOR]: A, consistent, good-quality patient-oriented evidence.) Mirtazapine and amitriptyline also improve PTSD symptoms. (SOR: B, inconsistent or limited-quality patient-oriented evidence.) SSRI use is associated with an increased risk of treatment withdrawal because of adverse effects compared with placebo.1

Practice Pointers

PTSD is characterized by complex behavioral, somatic, and cognitive effects caused by a traumatic event. Psychotherapy and medications are used for treatment of PTSD. The lifetime prevalence of PTSD in North America is more than 9% for the general adult population and may be as high as 17% in U.S. veterans.2,3 The authors of the review sought to identify medications that are effective for reducing symptoms of PTSD in adults.

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These are summaries of reviews from the Cochrane Library.

This series is coordinated by Corey D. Fogleman, MD, assistant medical editor.

A collection of Cochrane for Clinicians published in AFP is available at

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