How promising is the Stellate Ganglion Block for PTSD?
WHAT DOES THE RESEARCH SHOW?
Let's first look at the first two promising case studies where we first learned that SGB could help PTSD:
1990: Lebovits (Case Report)
- Surprise findings while treating a patient with Multiple war wounds with resulting Sympathetic Dystrophy, Pain, and PTSD - It all started in 1990 when an author by the name of Lebovits published a case report of a young woman who was the war victim of multiple wounds and ended up having chronic regional pain syndrome as well as PTSD, not surprisingly. She was administered a series of SGBs to treat her pain, and to everyone's surprise, her PTSD got better as well. It's important to note here that SGB has been used in interventional pain medicine for nearly a century to treat pain syndromes, particularly chronic regional pain syndromes. So at the time, in 1990 SGB was a very standard treatment for CRPS but not for PTSD. It was a surprise to everybody when the young woman's PTSD got better!
In this first case, the patient was administered a series of SGBs to treat her Severe Pain, and to everyone's surprise, her PTSD got better as well.
2008: Lipov et al. (Case Report)
Dr. Lipov, Chief Medical Officer of Stella, has been credited with modifying and innovating the 100-year-old Stellate Ganglion Block (SGB) to alleviate PTSD symptoms. In 2008 Dr. Eugene Lipov published a case report of a person who experienced immediate symptom reduction, between 80% and 90%.
- Immediate symptom reduction between 80% and 90% 2015: Mulvaney et al. (Case Series; n=166)
- More than 70% had clinically significant symptom reduction at 3–6 months.
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Those with more severe symptoms reported greater improvements.
This case study emphasized Clinically significant PTSD Symptom Reduction!
RESULTS from larger trials and Outcomes data:
2015: Mulvaney et al. (Case Series; n=166)
The largest to-date study included 166 people; it was case series of active duty service members where more than 70% saw clinically significant symptom reductions three to six months out. This was the first indication that something was going on here that warranted further study.
- More than 70% had clinically significant symptom reduction at 3–6 months.
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Those with more severe symptoms reported greater improvements.
Clinically significant PTSD symptom reduction 3-6 months out.
Lasting results!
Source: https://www.youtube.com/watch?v=w7aD-QrJkWQ
In 2019 in the JAMA Psychiatry published the first Large Scale, 8-week, study on SGB for PTSD with 113 participants.
Reference: Rae Olmsted KL, Bartoszek M, Mulvaney S, et al. Effect of Stellate Ganglion Block Treatment on Posttraumatic Stress Disorder Symptoms: A Randomized Clinical Trial. JAMA Psychiatry. 2020;77(2):130–138. doi:10.1001/jamapsychiatry.2019.3474
Effect of Stellate Ganglion Block Treatment on Posttraumatic Stress Disorder Symptoms: A Randomized Clinical Trial
- Primary reported result: The mean improvement in CAPS-5 score 8 weeks post treatment among patients treated with SGB (-12.16 points) was significantly greater than the improvement in patients treated with sham (-5.79 points).
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Secondary result: Those receiving SGB had improved PTSD, depression, distress, anxiety, and pain symptoms, and physical and mental functioning, compared to those receiving the sham procedure.
The mean improvement in not just PTSD, but also PTSD related symptoms (depression, anxiety, pain, physical and mental functioning) was significantly greater than in patients treated with placebo.
In qualitative review participants reported significant improvement from their usual "Hyperarousal" state. Here are some reported comments:
SGB gave me a buffer between the 0 to 10 zone.
Many participants in the study reported having an easier time with Psychotherpy after SGB Injection. Here are examples of some comments from participants - Ability to Address things: in psychotherapy
[SGB] removed the negative physical aspects and allows you to think about mental health.
SGB took away the internal anxiety so I could feel safe enough to process.
Outcomes Data from Dr. Lipov et al, CMO of the Stella Center in Chicago, IL
Note from The Stella Team: The below Data has been reviewed by an IRB and submitted to a peer reviewed journal for publication (acceptance pending).
Eugene Lipov, MD
80% of People Treated by SGB Found Relief From Their PTSD and related symptoms.
Based on the data from a sample of 327 patients treated between December 2016 and February 2020.
These patients found significant, over 80%, relief in their PTSD related symptoms-
Depression / Anxiety, Agitation / Nervousness, Issues Concentrating / Remembering, Mood Swings, Panic, Paranoia, Suicidal Thoughts / Attempts, Weakness / Dizziness / Vertigo, Tremors / Shakiness, Frequent Headaches and more
89% of Stella patients experienced symptoms of Depression/Anxiety. Success rate of Stella patients experiencing these symptoms: 82%
80% of Stella patients experienced symptoms of Agitation/Nervousness. Success rate of Stella patients experiencing these symptoms: 84%
70% of Stella patients experienced Issues Concentrating/Remembering.
Success rate of Stella patients experiencing these symptoms: 81%
63% of Stella patients experienced Mood Swings. Success rate of
Stella patients experiencing these symptoms: 85%
62% of Stella patients experienced symptoms of Panic/Paranoia. Success rate of Stella patients experiencing these symptoms: 86%
49% of Stella patients experienced Suicidal Thoughts/Attempts.
Success rate of Stella patients experiencing these symptoms: 84%
42% of Stella patients experienced Weakness/Dizziness/Vertigo.
Success rate of Stella patients experiencing these symptoms: 85%
30% of Stella patients experienced Frequent Headaches.
Success rate of Stella patients experiencing these symptoms: 86%
80% of people treated with SGB at the Stella Center found relief in their PTSD Symptoms. Here is the data from a sample of 327 patients treated between December 2016 and February 2020.
Sample of 327 patients treated between December 2016 and February 2020. Data has been reviewed by an IRB and submitted to a peer reviewed journal for publication (acceptance pending).
Per the US Department of Veteran Affairs guidelines, a successful outcome is defined as a 10 or more point drop in the DSM-IV PCL questionnaire (the PTSD Symptom Checker). The average score drop in this dataset of Stella patients was 28.9.
27% of Stella patients experienced this symptom. Success rate of Stella patients experiencing these symptoms: 85%
80% of people treated with SGB at the Stella Center found relief in their PTSD Symptoms. Here is the data from a sample of 327 patients treated between December 2016 and February 2020.
Sample of 327 patients treated between December 2016 and February 2020. Data has been reviewed by an IRB and submitted to a peer reviewed journal for publication (acceptance pending).
Per the US Department of Veteran Affairs guidelines, a successful outcome is defined as a 10 or more point drop in the DSM-IV PCL questionnaire (the PTSD Symptom Checker). The average score drop in this dataset of Stella patients was 28.9.
Wondering if SGB can help you or a loved one?
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Take the first step to addressing your Trauma.
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It's time to conquer PTSD
References:
1. Lebovits, Allen H.; Yarmush, Joel; Lefkowitz, Mathew Reflex Sympathetic Dystrophy and Posttraumatic Stress Disorder, The Clinical Journal of Pain: June 1990 - Volume 6 - Issue 2 - p 153-157
2. Lipov, Eugene & Joshi, Jay & Lipov, Sergei & Sanders, Sarah & Siroko, Michelle. (2008). Cervical Sympathetic Blockade in a Patient with Stress Disorder: Post-Traumatic A Case Report. Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists. 20. 227-8. 10.1080/10401230802435518.
3. Sean W. Mulvaney, MC USA, James H. Lynch, MC USA, Jason de Leeuw, MSC USA, Matthew Schroeder, MPH, PhD, Shawn Kane, MC USA, Neurocognitive Performance is Not Degraded After Stellate Ganglion Block Treatment for Post-Traumatic Stress Disorder: A Case Series, Military Medicine, Volume 180, Issue 5, May 2015, Pages e601–e604, https://doi.org/10.7205/MILMED-D-14-00504
4.. Rae Olmsted KL, Bartoszek M, Mulvaney S, McLean B, Turabi A, Young R, Kim E, Vandermaas-Peeler R, Morgan JK, Constantinescu O, Kane S, Nguyen C, Hirsch S, Munoz B, Wallace D, Croxford J, Lynch JH, White R, Walters BB. Effect of Stellate Ganglion Block Treatment on Posttraumatic Stress Disorder Symptoms: A Randomized Clinical Trial. JAMA Psychiatry. 2020 Feb 1;77(2):130-138. doi: 10.1001/jamapsychiatry.2019.3474. Erratum in: JAMA Psychiatry. 2020 Jan 2;: Erratum in: JAMA Psychiatry. 2020 Sep 1;77(9):982. PMID: 31693083; PMCID: PMC6865253.
4. Outcomes Data from our Partner, Dr. Lipov at Stella Center in Chicago, IL shared by Dr. Lipov et al (Reshared with permission). For more information visit https://stellacenter.com/results/
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Please note: SGB is not for everyone and not all ptsd patients are candidates. Individual results can vary.