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If you or someone you love is struggling with PTSD or anxiety and wondering which treatment to pursue, you’re not alone in feeling overwhelmed by the options. There are some very promising, innovative interventions which have emerged in the past decade. Ketamine. Spravato. TMS. Talk therapy. Medications. The options can be confusing. So let me cut through the noise and look at what the latest data actually says — because one specific treatment from this large dataset rises to the top when it comes to PTSD and anxiety.
That treatment is the Stellate Ganglion Block, or SGB.
Stella Mental Health just released their 2026 Outcomes Report, covering over 16,000 patients treated since 2020.* While not published in the peer-reviewed literature, this report is one of the most comprehensive real-world datasets on interventional psychiatry available. And when you look at the numbers side by side, a clear picture emerges.
Let’s Talk Anxiety First
The GAD-7 measures anxiety severity. This is where SGB starts to separate itself:
- SGB: 76% responded, with anxiety scores dropping 63%
- Ketamine: 65% responded, with scores dropping 55%
- Spravato: 65% responded, with scores dropping 51%
- TMS: 64% responded, with scores dropping 60%
- Therapy: 49% responded, with scores dropping 54%
- Medication Management: 54% responded, with scores dropping 56%
For anxiety, SGB is the clear leader — both in how many people got better AND by how much. That 76% response rate is significantly higher than any other single-modality treatment in this dataset.
The Full Picture: Why SGB Makes Sense for Both Anxiety and PTSD as a First Choice
Many people with PTSD don’t just have PTSD. They have poor sleep and concentration. They have anxiety symptoms. They have depressive symptoms. They carry the weight of trauma across multiple symptom domains. SGB simultaneously delivers top-tier results for anxiety and strong results for trauma — in a single outpatient procedure, without daily pills, without weeks of infusions, and without the dissociative experience that ketamine or Spravato involves.
Here’s the other piece that the numbers don’t fully capture: SGB works by calming the overactivated sympathetic nervous system — the biological alarm system that gets stuck in the “on” position after trauma. It’s addressing a root cause of why anxiety and PTSD feel so relentless. When that alarm system gets reset with an SGB treatment, patients often describe feeling calmer in their body for the first time in years. That calm creates space for therapy to actually work, where the real healing happens.
A Word on Talk Therapy
Talk therapy is the foundation of long-term healing, and we strongly encourage this modality alongside any procedural treatment. At our clinic, we view SGB as an adjunct to talk therapy and encourage all of our patients to continue their regular therapy after SGB treatment. SGB allows someone to be calmer in their mind and calmer in their body, so that the work they do with their therapist is more effective.
A Word on Ketamine and Spravato
To be fair, ketamine and Spravato showed the highest rates of PTSD response and the deepest symptom reductions among those who responded in this report. For patients with severe, treatment-resistant depression combined with PTSD, they deserve serious consideration. But they require repeated sessions, medical monitoring during administration, and come with a dissociative experience that not everyone tolerates well.
They are powerful tools — just not necessarily the right first tool for everyone with PTSD or anxiety based on a several considerations including required time of treatment, risks, costs, etc.
How Long Does Treatment Actually Take? And When Will I Feel Better?
When people are suffering, time matters. Here’s an honest look at the real-world time commitment for each of these treatments — from the first appointment to when you might actually start feeling better.
SGB (Stellate Ganglion Block) — One or two injections, each taking less than 10 minutes in an outpatient setting. Many patients notice meaningful relief within 1-3 days. Total time investment from consultation to completion: typically, one to two visits. That’s it.
Ketamine Infusions — A standard protocol involves six IV infusions given over two to three weeks, each lasting about 40 minutes to an hour. Add in monitoring time before and after, and each appointment runs two to three hours. Noticeable, lasting results typically appear after the full series of six sessions (~ 3 weeks). Following the initial series, many patients require booster infusions every one to three months to maintain results.
Spravato (Esketamine Nasal Spray) — FDA protocol requires twice-weekly sessions for four weeks, then weekly for four weeks, then every one to two weeks ongoing — indefinitely for many patients. Each session requires a two-hour monitoring period at the clinic. That adds up to a significant ongoing time commitment. Patients using Spravato may notice substantial relief after ~ 4 to 6 weeks.
TMS (Transcranial Magnetic Stimulation) — Standard TMS requires five sessions per week for six weeks — 30 sessions total, each lasting 20 to 40 minutes. That’s a meaningful daily commitment for a month and a half. Most patients require 4 to 6 weeks (roughly 20–30 sessions) to experience clinically significant symptom relief. Newer accelerated protocols compress this timeline but are not universally available.
Medication Management — Starting a psychiatric medication is rarely a quick fix. Most antidepressants and anti-anxiety medications take 4 to 8 weeks to reach full effect, and finding the right medication often requires multiple trials over months. Once on a medication, ongoing follow-up appointments are needed to monitor response and adjust dosing.
What About the Risks?
Every treatment carries some risk. Here’s a plain-language breakdown of what to know before you start. None of these should be dealbreakers on their own — but they deserve to be part of the conversation.
SGB (Stellate Ganglion Block) — SGB is a well-established procedure with a strong safety profile determined from 100+ years of use. Performed under ultrasound guidance by a trained physician, serious complications are very rare. The most common side effects are temporary: a drooping eyelid (Horner’s syndrome), hoarseness, or a warm sensation on one side of the face — all of which typically resolve within hours. There is no risk of overdose, no dependence, and no withdrawal. It is not a controlled substance.
Ketamine Infusions — Ketamine is a controlled substance (Schedule III) with real risks of misuse and psychological dependence with repeated or unsupervised use. In a clinic setting it is generally safe, but side effects during infusion include dissociation, elevated blood pressure, nausea, and dizziness. There is a risk of bladder damage with long-term frequent use. Overdose is possible, particularly if used outside a supervised clinical environment — which is why at-home ketamine prescribing has raised serious safety concerns in recent years.
Spravato (Esketamine) — Because Spravato carries risks of sedation, dissociation, and misuse, the FDA requires it to be administered in a certified healthcare setting with two hours of monitoring after every dose — you cannot take it home. Spravato carries the same FDA black box warning for increased suicidal thoughts and behaviors that applies to all antidepressants — a risk that warrants close monitoring, particularly in younger patients. It carries the same dependence and misuse concerns as ketamine.
TMS (Transcranial Magnetic Stimulation) — TMS is non-invasive and carries no risk of overdose or dependence. The most common side effects are headache and scalp discomfort during or after sessions. The most serious rare risk is seizure, which occurs in less than 0.1% of patients. It is not a controlled substance and requires no sedation.
Medication Management — Psychiatric medications vary widely in their risk profiles. SSRIs and SNRIs (the most commonly prescribed class for anxiety and PTSD) are generally well-tolerated, but they carry an FDA black box warning for increased suicidal thoughts and behaviors, particularly in individuals under 25, especially during the first weeks of starting or changing doses. Benzodiazepines (such as Xanax or Klonopin), sometimes prescribed for anxiety, carry significant risks of dependence, withdrawal, and overdose — particularly when combined with alcohol or opioids. These are not reasons to avoid medication altogether, but they are reasons to have an honest, informed conversation with your prescriber.
The Bottom Line
If your primary struggle is anxiety, or if you have PTSD with significant anxiety, SGB delivers the most consistent, broad-spectrum relief of any single treatment in this dataset. A 76% response rate for anxiety and 81% for PTSD is not something you see every day. And it happens in one or two injections that take < 10 minutes each, not a months-long protocol.
Let’s be honest about something: there is no such thing as the best treatment for everyone. The human brain is infinitely complex — shaped by genetics, life history, trauma type, biology, and a hundred other variables we don’t fully understand yet. Anyone who tells you there’s a one-size-fits-all answer to mental health treatment is selling something. The right treatment is always the one that fits you — your symptoms, your lifestyle, your goals, your history.
That said, when you look at the full picture — effectiveness, time commitment, how quickly you’ll feel better, and risk profile side by side — SGB rises to the top as the most compelling first option to try for most people struggling with PTSD or anxiety. Highest response rates. Fastest time to relief. Fewest serious risks. No pills, no dependence, no months-long protocol. If you’re going to start somewhere, the data makes a strong case for starting here.
SGB won’t be the right answer for everyone. Some patients will need the deeper antidepressant effect of ketamine. Others will respond best to the slow, steady work of TMS. Some will do best with a combination of approaches. That’s the reality of how complex we are as human beings. What the data tells us is that for the majority of people with PTSD and anxiety, SGB is not just a reasonable choice — it’s the obvious place to begin.
Calm the body. Calm the mind.
*Stella Mental Health Impact Report 2026. The information conveyed in this 2026 Outcomes Report (“Report”) is for general informational purposes only and does not constitute medical advice, treatment, or the practice of medicine. Data shown on the rates and percentages of individuals with depression, anxiety and PTSI are based on self-reported information from patients collected through clinical surveys and assessments such as the PHQ and GAD survey tools.
