Which medication is often used as a second-line option for PTSD, particularly for its effectiveness in anxiety?

Amitriptyline is often considered a second-line option for the treatment of PTSD primarily due to its efficacy in addressing anxiety symptoms associated with the disorder. Originally developed as a tricyclic antidepressant, amitriptyline has not only been shown to help with mood stabilization but also to alleviate symptoms of anxiety, which is a significant component of PTSD.

While other medications such as fluoxetine and sertraline (both selective serotonin reuptake inhibitors) are first-line treatments for PTSD and have robust evidence supporting their effectiveness, amitriptyline can be useful in cases where patients may not respond well to SSRIs or when additional treatment is necessary. Its impact on serotonin and norepinephrine levels contributes to its anxiolytic effects.

Diazepam, on the other hand, is a benzodiazepine that may provide short-term relief of anxiety symptoms but is not recommended for chronic management of PTSD due to risks of dependence and lack of efficacy in treating the disorder's core symptoms.