A Glimmer of Hope for PTSD Victims

As many as 25% of homeless Americans are war veterans, and, according to VA statistics, 3 out of every 4 of them have a mental condition – often PTSD, or post-traumatic stress disorder.  The numbers are increasing, too, as deployments in Afghanistan lengthen. Treatment of PTSD often involves lengthy “talk” therapy (6-12 weeks of cognitive behavioral therapy), with or without medications.  So a report from Walter Reed Army Medical Center is particularly interesting.  It’s posted in Pain Practice, an online medical journal, and describes the use of stellate ganglion block in two PTSD patients.

Stellate ganglion block is a 10-minute procedure in which local anesthetic is injected next to the stellate ganglion, a nexus of nerves in the neck.  Dr Eugene Lipov, a Chicago anesthetist, pioneered the use of the procedure in PTSD, having gained experience in its use in hot flashes and some chronic pain syndromes.  The Walter Reed study involved two military patients with chronic combat-related PTSD.  Symptoms were quantified using the PTSD Checklist before and the day after the treatment, along with other psychometric tests. 

Both patients experienced immediate, significant and durable relief in their symptoms, as measured by the Checklist; their scores fell into the “no-PTSD” level.  One patient requested a repeat treatment after 3 month; his post-treatment score remained below the PTSD cutoff for 7 additional months.  Both patients were able to discontinue all antidepressant and other medications.

The Walter Reed physicians conclude that, even though they only treated two patients, stellate blockade was a safe procedure that was able to provide durable relief from PTSD symptoms.  We want to see a few more positive results before we can agree with them, but their independent findings represent important support for Dr Lipov’s concept, and justify further clinical studies.  This sort of dramatic  “breakthrough” requires speedy confirmation or refutation.