In 2024, the U.S. Department of Veterans Affairs (VA) published a review of the latest literature on new PTSD treatment called “Novel Pharmacologic and Other Somatic Treatment Approaches for Posttraumatic Stress Disorder in Adults: State of the Evidence.” As the title implies, the review paper shares the latest evidence on PTSD/Trauma treatment, with a focus on new, novel, or recent approaches that have a solid evidence base, but are not yet widely known nor widely available.
To clarify, the new PTSD treatment approaches the VA discusses in that publication, and the approaches we discuss in this article, exist well within the parameters of evidence-based treatment for mental health disorders. We’ll introduce the treatment, the evidence, and where it fits in with the current PTSD treatments.
First, we’ll quickly review the nature and scope of the problem. We’ll define PTSD, share prevalence facts, and present information that explains why researching new PTSD treatment is necessary for the health of individuals, families, and communities across the U.S. Then, we’ll list and report the evidence base for several new PTSD treatments.
PTSD: What is It? How Many People Have It? Why is Treatment Important?
We’ll start with a simple definition provided by the The Diagnostic and Statistical Manual of Mental Disorders, Volume 5 (DSM-5):
“A disorder that may result when an individual lives through or witnesses an event in which they believe that there is a threat to life or physical integrity and safety and experiences fear, terror, or helplessness.”
It’s important to understand that the symptoms of PTSD can appear weeks, months, or years after the initial trauma. The absence acute stress disorder (ASD) – i.e. a short-term disordered response to stress that fades within a month – does not prevent the subsequent development of PTSD.
Next, the prevalence data, or how many people have PTSD in the U.S. Here’s the latest information from The National Institute of Mental Health (NIMH):
Prevalence of PTSD: Adults in the U.S
- Past year PTSD: 5%
- Lifetime PTSD diagnosis: 6%
- Among women, lifetime diagnosis: 8%
- Among men, lifetime diagnosis: 4%
For that first bullet point, understand that five percent means around 13 million adults. Therefore, it’s reasonable to assume that in any given year, 13 million – and likely more – experience the symptoms of PTSD.
Which brings us to our next question:
Why do we need to keep searching for new PTSD treatment?
The answer is easy to understand. When PTSD goes untreated, people may experience:
- Persistent low/sad/depressed mood
- Extreme anger/aggression
- Problems with anger management
- Problems regulating powerful emotions
- Disordered use of alcohol/drugs
- Difficulty forming and keeping relationships
- Impaired work/academic performance
- Increased likelihood of engaging in risky behavior
When the symptoms of PTSD become severe, they can disrupt or prevent an individual from participating in the basic activities of daily life. This includes everything from getting out of bed and going to work to interacting in healthy way with friends and family. That’s why searching for new treatments is important.
New PTSD Treatment: What’s Available?
We’ll reiterate that the treatments we describe below are not new, per se, but rather, recent additions to the list of effective, evidence-based treatments for PTSD. To learn about the state of the evidence before this most recent VA publication, please navigate to the our blog and read this article:
PTSD Treatment for Veterans
That article reviews and describes the most common effective treatments for PTSD. Standards of care in included psychotherapy, exposure therapy, medication, and peer support. In this article, we’ll discuss several brain stimulation therapies and medications currently in use in some treatment centers around the country, and represent a new generation of PTSD treatment.
Brain Stimulation Therapies for PTSD
- Transcranial magnetic stimulation (TMS):
- Already in use for treatment-resistant depression (TRD) and other disorders
- Safe, non-invasive outpatient treatment
- No systemic side-effects
- May be combined with psychotherapy
- Transcranial direct current stimulation:
- Safe, non-invasive
- Evidence shows effectiveness for depression
- Initial random controlled trial for PTSD showed positive results
- May be most effective when combined with exposure therapy
- Cranial electrical stimulation (CES):
- Safe and affordable
- Weak evidence for anxiety
- No current evidence for PTSD
- Deep brain stimulation (DBS)
- Invasive treatment
- Strong evidence at the preclinical stage for effective PTSD treatment
- No random controlled trials (RCT) published as of 2025
- Evidence indicated DBS may be effective for PTSD that doesn’t respond to other treatments, i.e. treatment resistant PTSD
- Vagus nerve stimulation
- Invasive
- Requires surgery
- Has FDA approval as an effective modality for treatment-resistant depression
- Evidence for PTSD in early, preclinical studies
Next, let’s look at medications.
New Medications for PTSD
- MDMA-assisted psychotherapy
- Highly resource intensive
- Uncertain risk-benefit ratio
- Ketamine/Spravato
- Spravato approved for treatment-resistant depression (TRD)
- Safe, noninvasive
- Growing ketamine use for TRD, off-label
- Intravenous (IV) administration
- Temporary side effects
- For PTSD, may be effective for stabilization before standard treatment
- Spravato approved for treatment-resistant depression (TRD)
- Stellate ganglion block (SGB)
- In use for PTSD since 1990, off label
- Evidence shows SGB highly effective for some patients, less effective for others
- Ongoing research for SBG for PTSD, depression, anxiety, and psychosis
- Cannabidiol-assisted exposure therapy
- Strong mechanistic evidence in rodents and humans
- Two ongoing trials of PE augmented with cannabidiol
- Ketamine-assisted exposure therapy
- Strong mechanistic evidence in rodents and humans
- Two ongoing trials of PE augmented with ketamine
- Psilocybin-assisted psychotherapy
- Strong mechanistic evidence in rodents and humans
- Several ongoing trials
- Cannabinoid monotherapy
- Random controlled trial showed smoked cannabis is not an effective PTSD treatment
- May reduce some PTSD symptoms in some patients
- To date, evidence indicates risk of misuse outweighs treatment benefit for PTSD
According to the Veteran’s Administration report, the treatment above with the most promise as a mainstream modality for PTSD is transcranial magnetic stimulation (TMS). With a proven track record of safety – and pending further study – TMS may become a standard option for PTSD treatment. After TMS, the VA suggests both ketamine and the stellate ganglion block – pending further study – may also become standard options for PTSD treatment.
Current Standard of Care for PTSD
At Crownview Psychiatric Institute, we offer three of the therapies above as adjunct therapies for PTSD. In addition to adjunct therapies, our typical approach to PTSD treatment includes several modalities under one unifying principle:
PTSD treatment is trauma-informed. That means our clinicians know the signs of trauma, have experience working with patients with a history of trauma, and actively work to avoid re-traumatization in every aspect of treatment.
To learn more about trauma-informed care, please read this article on our blog:
What is Trauma-Informed Care for Mental Health Disorders?
Within the context of trauma-informed care, our approach to PTSD treatment includes, in addition to the adjunct therapies we mention, the following:
- Psychotherapy
- Medication (if needed)
- Education
- Lifestyle changes
- Complementary/Expressive Therapies
It’s important for treatment centers to educate patients with PTSD about their options, and the relative strength of evidence associated with the various options. Trauma-informed, trauma-focused psychotherapy, often in combination with medication, is the most common first-line treatment for PTSD, because decades of evidence shows this approach works.
However, some patients have complex, treatment-resistant PTSD that doesn’t respond well to first-line approaches. In those cases, it’s imperative for the patient and their treatment team to communicate and collaborate on what step to take next. They may consider an adjunct therapy, a complementary therapy, or another attempt at a different variation of standard treatment.
In all cases, treatment should be patient-centered and prioritize treatment goals established by the patient and their family, in collaboration with their treatment team.
Gianna Melendez
Jodie Dahl, CpHT