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Non-pharmacological and non-psychological approaches to the treatment of PTSD: results of a systematic review and meta-analyses.

European journal of psychotraumatologyยทAugust 2020ยทJonathan I Bisson, Marieke van Gelderen, Neil P Roberts et al.
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Key Finding

Acupuncture showed emerging evidence of efficacy as one of six non-pharmacological, non-psychological interventions that may benefit patients with PTSD who do not respond to or prefer alternatives to conventional treatments.

What This Means For You

Researchers conducted a comprehensive review to examine whether non-drug and non-talk therapy approaches could help people with post-traumatic stress disorder (PTSD). PTSD is a mental health condition that can develop after experiencing or witnessing a traumatic event, causing symptoms like flashbacks, nightmares, severe anxiety, and intrusive thoughts. The study analyzed 30 randomized controlled trials involving both adults and young people who received various alternative treatments. Among the approaches studied, six showed promising results: acupuncture, neurofeedback (brain training), a Japanese herbal medicine called saikokeishikankyoto, somatic experiencing (body-focused therapy), transcranial magnetic stimulation (brain stimulation), and yoga. The researchers found emerging evidence that these treatments may benefit people with PTSD, though more research is still needed. For patients with PTSD, this is encouraging news because not everyone responds well to standard medications or traditional psychotherapy. Some people experience unwanted side effects from medications, while others may not be comfortable with talk therapy or simply prefer alternative approaches. These six treatment options provide additional choices for those seeking help. The authors concluded that while it's too early to recommend these treatments as routine first-line options, they represent valuable alternatives for patients who haven't found relief with conventional treatments or who prefer non-pharmaceutical approaches. If you're considering acupuncture for PTSD, seek out a licensed acupuncturist with specific experience treating trauma-related conditions.

Clinical Notes for Practitioners

This systematic review and meta-analysis, conducted according to Cochrane Collaboration guidelines with GRADE quality assessment, examined non-pharmacological and non-psychological interventions for PTSD. The analysis included 30 RCTs (28 adult studies, 2 pediatric/adolescent studies) evaluating heterogeneous interventions. Six modalities demonstrated emerging efficacy evidence: acupuncture, neurofeedback, saikokeishikankyoto (herbal preparation), somatic experiencing, transcranial magnetic stimulation, and yoga. The authors applied pre-determined clinical importance criteria to assess effect sizes. While evidence quality suggests these interventions should not yet be considered routine first-line treatments, they represent clinically relevant alternatives for treatment-resistant cases, patients with medication intolerance, or those declining conventional evidence-based therapies. This review identifies a significant gap in PTSD treatment research and supports the need for additional high-quality trials investigating complementary and integrative approaches. Clinicians may consider these modalities as adjunctive or alternative options within individualized treatment planning for PTSD patients.

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