A 28-Year-Old Man Comes to the Office at His Wife's

A 28-year-old man comes to the office at his wife's insistence.  He reports severe insomnia but otherwise feels physically healthy.  His wife is concerned that the patient is having a difficult time since returning from military duty.  She says, "He used to be so upbeat and easygoing.  Now his moods fluctuate between really tense and on edge to detached and numb."  The patient cannot fall asleep at night because, as soon as he closes his eyes, he sees the horrific scene of his friend being blown up after stepping on a landmine.  During the day, he is hypersensitive to loud sounds 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?

A) Antipsychotic
B) Benzodiazepine
C) Monoamine oxidase inhibitor
D) Mood stabilizer
E) Non-benzodiazepine hypnotic
F) Selective serotonin reuptake inhibitor
G) Tricyclic antidepressant

Correct Answer:

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