Key Treatment

Acutely, nonbenzodiazepine sleeping medications may be used as first-line treatment for insomnia (Bradley et al., 2005; NICE, 2005) (SOR: B).

PTSD is often effectively treated with SSRIs, including sertraline, paroxetine, venlafaxine, and fluoxetine, though this effect may be less in older veterans (APA, 2004; Benedek et al., 2009; Stein et al., 2006) (SOR: A).

The antidepressant mirtazapine and the anticonvulsants topira-mate and tiagabine may be beneficial in PTSD therapy (Benedek et al., 2009) (SOR: B).

For PTSD nightmares, prazosin may be effective (SOR: B). Risperidone and olanzapine may be effective augmentation to SSRIs for persistent PTSD symptoms (Benedek et al, 2009) (SOR: B).

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