PTSD treatment has long relied on talk therapies like prolonged exposure and cognitive processing therapy, with two SSRIs as the only FDA-approved medications. That is changing — MDMA-assisted therapy, ketamine, and stellate ganglion blocks are all in advanced research, and digital and group-based therapies are expanding access.
What's actually going on in research
Trials are testing MDMA-assisted therapy, ketamine and esketamine, brain stimulation approaches, virtual reality exposure therapy, and stellate ganglion blocks (a neck injection). Researchers are also studying PTSD in veterans, first responders, and survivors of sexual trauma, and how to reach people who have not responded to standard care.
Psychedelic-assisted therapy
MDMA combined with structured therapy showed strong results in trials, though FDA approval has been delayed. Psilocybin trials for PTSD are also moving forward.
Brain stimulation
Newer forms of TMS and stellate ganglion blocks are being tested for PTSD symptoms that have not improved with therapy or medication. Some show fast relief.
Digital and group therapy
Online cognitive processing therapy and group-based programs are helping reach veterans and survivors who cannot easily access weekly sessions. Studies show similar benefit to in-person care.
What to know before you search
Eligibility often depends on the type and timing of trauma, severity of symptoms, prior treatments, and other mental health conditions like depression or substance use.
What types of trials are currently open
- Therapy trials — Testing structured talk therapies like prolonged exposure or cognitive processing therapy in different formats.
- New medication trials — Testing drugs that target newer brain pathways for PTSD, including fast-acting options.
- Psychedelic-assisted therapy trials — Testing supervised MDMA or psilocybin combined with therapy sessions.
- Device trials — Studies of brain stimulation, virtual reality, and wearable devices for PTSD.
- Prevention trials — Testing early interventions in people who have just experienced trauma to lower the chance of PTSD.
Recently added PTSD trials
Two-week Intensive Outpatient Trauma Treatment.
The objective of the study is to obtain knowledge about the treatment of patients who are offered intensive trauma treatment at Nydalen DPS (NDPS) and Søndre Oslo DPS (SODPS). The treatment takes place on an outpatient basis over two weeks. Up to 42 patients will be recruited. The efficacy of treatment will be investigated using validated self-report forms, which measure PTSD symptoms (PCL-5 and ITQ) and quality of life/function (WHO-5, and WSAS). The measurements will be done before the treatment and one and twelve weeks after treatment.In-depth interviews will also be conducted with up to 30 patients to investigate the outcome and any need for adjustments with focus on patients with minority backgrounds, men and patients with limited benefit. The study uses a mixed methods design, where quantitative measures and information from qualitative interviews are combined to map participants' experience, benefits and feasibility.
Using Exercise to Enhance Fear Extinction Learning
The goal of the current project is to establish the efficacy and mechanisms of exercise-enhanced fear extinction retrieval and generalization in posttraumatic stress disorder (PTSD). Exposure therapy is the gold standard treatment for PTSD, yet is only associated with remission rates of \~55% and in clear need of improvement. Exposure therapy is hypothesized to work through mechanisms of fear extinction learning, and as such, laboratory-based fear extinction paradigms are widely used as models of exposure therapy. Recent data demonstrates that moderate-intensity aerobic exercise, delivered specifically during or after fear extinction learning, can boost the consolidation of fear extinction learning. Consistent with emerging models of exercise's pro-extinction effect, our pilot data among women with PTSD found that moderate intensity aerobic exercise delivered after fear extinction learning leads to a reduction in subsequent fear responding 24hrs later, an effect that was mediated by exercise-induced increases in peripheral brain derived neurotrophic factor (BDNF). Our pilot data using multivariate pattern analyses (MVPA) also identified divided neurocircuitry organization of fear vs safety memories, and that this divided neural organization was altered in PTSD. Building on our pilot data, the current project would 1) compare the impact of different intensities of exercise delivered following fear extinction learning on multimodal measures of fear extinction retrieval and generalization, 2) identify the impact of exercise on MVPA representations of fear vs safety memories, and 3) demonstrate that spontaneous reactivations of extinction encodings in the acute consolidation window operate as candidate mechanisms by which exercise enhances extinction retrieval and generalization. Using a 3-day fear conditioning, fear extinction, and fear extinction retrieval and recognition task during functional magnetic resonance imaging (fMRI), 200 adults with PTSD would be randomly assigned to either resting control or 30min of either light, moderate, or high intensity exercise. Testing dose-response relationships between exercise intensity and fear extinction will inform translation of this research to clinical settings. A one week-follow-up extinction retrieval test would investigate the impact of exercise on longer-term retention. This project would provide a critical evaluation of the impact of aerobic exercise on consolidation and recall of extinction learning in PTSD samples, thereby providing a strong foundation to translate this research to clinical care and enhance clinical outcomes for PTSD. The project would also provide general knowledge regarding dose-response relationships and neural mechanisms that support enhanced extinction, thereby informing development of additional novel treatments.
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