Fluoxetine was given to five nonveteran patients with post-traumatic stress disorder (PTSD). The maximum doses ranged from 20 to 80 mglday, and treatment was continued for between 8 and 32 weeks. In contrast to published reports of other drugs, which were noted to improve only the intrusive symptoms of PTSD, fluoxetine was associated with marked improvement of both intrusive and avoidant symptoms. Facilitative effects of fluoxetine were noted on trauma-focused psychotherapy in two adult victims of childhood sexual trauma. In part, these effects were related to modulating effects of the drug upon the intensity of core PTSD symptoms. Serotonergic drugs appear to hold promise for the treatment of PTSD.