What is considered first-line pharmacotherapy in PTSD?

What is considered first-line pharmacotherapy in PTSD?

• A. MAOI
• B. SSRI or SNRI
• C. Tricyclic antidepressant
• D. Antipsychotic

Answer: (B)

In PTSD, the first-line pharmacotherapy are selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). This class has the strongest and most consistent evidence showing reduction in core PTSD symptoms—reexperiencing, avoidance, negative mood/cognition, and hyperarousal—and includes commonly used agents like sertraline, paroxetine, and venlafaxine. They are FDA-approved for PTSD and generally well tolerated, offering a better safety profile compared with older antidepressants. Other options like MAO inhibitors and tricyclic antidepressants have more burdensome side effects and safety concerns, and show less robust evidence for PTSD. Antipsychotics may be used as augmentation in refractory cases or for specific symptoms, but they are not considered first-line for PTSD treatment.

In PTSD, the first-line pharmacotherapy are selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). This class has the strongest and most consistent evidence showing reduction in core PTSD symptoms—reexperiencing, avoidance, negative mood/cognition, and hyperarousal—and includes commonly used agents like sertraline, paroxetine, and venlafaxine. They are FDA-approved for PTSD and generally well tolerated, offering a better safety profile compared with older antidepressants.

Other options like MAO inhibitors and tricyclic antidepressants have more burdensome side effects and safety concerns, and show less robust evidence for PTSD. Antipsychotics may be used as augmentation in refractory cases or for specific symptoms, but they are not considered first-line for PTSD treatment.