RPC

Section 04 · The Dashboard

Medical Treatment

Pharmacological support for PTSD — used alongside, not in place of, psychotherapy.

Treatment Dashboard

Pharmacological Profile

FDA ApprovedSide Effect Risk

SSRI

Sertraline

(Zoloft)

FDA-approved for PTSD
Typical Dose
50–200 mg/day
Onset
2–6 weeks

First-line pharmacotherapy. Reduces intrusive memories, hyperarousal, and avoidance symptoms.

SSRI

Paroxetine

(Paxil)

FDA-approved for PTSD
Typical Dose
20–50 mg/day
Onset
2–6 weeks

Effective alternative when sertraline is poorly tolerated. Monitor for discontinuation symptoms.

Reported Side Effects · Relative Frequency

Side Effect Profile

Nausea70%
Headache45%
Insomnia40%
Drowsiness35%
Weight change25%
Initial anxiety spike30%

Illustrative educational values. Side effects typically diminish over weeks under physician supervision.

Mechanism · How SSRIs Work

Serotonin in the Synapse

PRE-SYNAPTICPOST-SYNAPTICSSRI BLOCKS REUPTAKEMore serotonin remains in the synapse → mood, sleep, arousal stabilize over weeks

Comparison

Treatment Modalities Side-by-Side

ModalityTargetsOnsetEvidence
Client-CenteredEmotional processing, identity, self-worthGradual★★★
CBTIntrusive thoughts, avoidance, triggers8–16 weeks★★★★★
SSRIsMood, sleep, hyperarousal2–6 weeks★★★★
CombinedBiological + psychological + behavioralCompounding★★★★★+

"Medication does not heal the wound. It quiets the nervous system enough that therapeutic work can begin."

— Clinical Reflection

How SSRIs Work

Serotonin is a neurotransmitter that helps regulate mood, sleep, and emotional responses. In PTSD, serotonin activity may be disrupted, contributing to anxiety, irritability, and intrusive thoughts. SSRIs block the reabsorption (reuptake) of serotonin, leaving more available between neurons. Over several weeks, this can stabilize mood, reduce symptom intensity, and improve sleep (Mayo Clinic, 2024).

For Mr. L, medication is not a cure. It is a tool that lowers the volume on his nervous system so that the harder work of therapy can land.

"Combined treatment often produces better outcomes for PTSD than either approach alone."
— APA · Clinical Practice Guideline, 2017

Strengths

  • +Strong evidence base for reducing PTSD symptoms
  • +Can improve sleep and mood within weeks
  • +Helps clients engage more fully in therapy
  • +FDA-approved indication for PTSD

Limitations

  • −Does not address underlying trauma or beliefs
  • −Possible side effects
  • −Symptoms may return if stopped without other treatment
  • −Requires medical supervision