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ABSTRACTObjective: To evaluate the efficacy of amitriptyline and paroxetine in soldiers with combat-related post traumatic stress disorder (PTSD).Method: Fifty patients who were admitted to Gülhane Military Medical Academy Psychiatry Inpatient Clinic and who were diagnosed as chronic PTSD were enrolled. The primary outcome measures for the study was 17-item total severity score of the Clinician-Administered PTSD Scale (CAPS), Investigator-rated Clinical Global Impression (CGI-S) and CGI-Improvement Scales (CGI-I). Patients were randomized to 12 weeks of treatment with either paroxetine (25 patients) or amitriptyline (25 patients). Twenty-two patients from paroxetine group and 20 patients from amitriptyline group completed the study protocol.Results: Treatment response rates for paroxetine and amitriptyline was 31.8% and 55%, respectively. While there was a significant difference for CAPS-2 total score changes between the groups, no statistically significant difference was found for CGI severity, CGI progress, change in depression and anxiety scores.Conclusions: Both amitriptyline and paroxetine seem to be effective in the treatment of combat related PTSD cases. Despite no statistically significant difference between both groups, treatment response with amitriptyline seems to be higher. When we look at the changes in symptom patterns in terms of CAPS 2 scores, it was found that amitriptyline have decreased intrusive and increased arousal symptoms more than paroxetine.