A 28-year-old man comes to the workplace at the request of his wife. He complains of terrible sleeplessness but otherwise feels physically OK. His wife is concerned that the patient is struggling since returning from military service. She states, "He used to be so cheery and laid-back. His feelings now range from anxious and on edge to disconnected and numb." The patient can't sleep at night because every time he shuts his eyes, he sees his friend getting blown up after walking on a landmine. He is hypersensitive to loud sounds throughout the day, such as firecrackers or a car backfiring. The patient says, "Sometimes I feel as if I'm back in combat and have to duck and take cover." Vital signs are within normal limits, and physical examination shows no abnormalities. On mental status examination, the patient has an anxious mood and blunted affect. Which of the following is the most appropriate pharmacotherapy?

Question

A 28-year-old man comes to the workplace at the request of his wife. He complains of terrible sleeplessness but otherwise feels physically OK. His wife is concerned that the patient is struggling since returning from military service. She states, "He used to be so cheery and laid-back. His feelings now range from anxious and on edge to disconnected and numb." The patient can't sleep at night because every time he shuts his eyes, he sees his friend getting blown up after walking on a landmine. He is hypersensitive to loud sounds throughout the day, such as firecrackers or a car backfiring. The patient says, "Sometimes I feel as if I'm back in combat and have to duck and take cover."  Vital signs are within normal limits, and physical examination shows no abnormalities.  On mental status examination, the patient has an anxious mood and blunted affect.  Which of the following is the most appropriate pharmacotherapy?

Quizplus · Accepted Answer

Eductional Objective: Trauma-focused cognitive-behavioral therapy and antidepressant medication are utilized as first-line treatments for post-traumatic stress disorder. The best evidence for effectiveness comes from selective serotonin reuptake inhibitors.

A 28-Year-Old Man Comes to the Workplace at the Request