More than 7 million adults throughout the United States suffer from posttraumatic stress disorder (PTSD). Most commonly thought of as associated with military combat, PTSD can occur following any traumatic event—including natural disasters, terrorist incidents, serious accidents, or physical or sexual assault. The disorder is often compounded by depression and substance abuse. Those who suffer from PTSD can also experience interpersonal and relationship difficulties as well as problems at work.
The U.S. Department of Veterans Affairs estimates that PTSD affects or has affected as much as 20 percent of those who served in the Vietnam War, Desert Storm, and Operations Iraqi Freedom and Enduring Freedom. Recent evidence suggests that PTSD is increasing among service members—rising from 7 percent of active duty service members in 2005 to 11 percent in 2008.
The Search for Effective Therapies for PTSD
The ideal PTSD treatment—safe, effective, and fast-acting, with few side effects—has been elusive. And as with many mental-health issues, patients sometimes have trouble accepting or adhering to some of the options that are available. The Department of Defense and healthcare researchers have pursued a variety of solutions for years.
In the early 2010s, some military medical centers began offering patients with PTSD a procedure that had been used for decades to relieve pain. The procedure, called stellate ganglion block, or SGB, involves injecting a local anesthetic into the stellate ganglion. This group of nerve cells and nerves in the neck helps regulate the body’s “fight or flight” mechanism.
As more and more patients tried the stellate ganglion block, the reports seemed promising. But the medical community still needed evidence of its effectiveness. RTI in 2014 launched a randomized, controlled trial of SGB, and in fall 2019, we found that it is indeed effective.
Combining Clinical Data with Patient-Centered Perspectives
Our study was the first multi-site randomized controlled trial of SGB for treatment of PTSD. The trial determined that the SGB procedure decreases the severity of PTSD symptoms. Our researchers are still evaluating whether it affects other conditions such as anxiety, suicidal thoughts, pain, and alcohol use.
RTI coordinated all aspects of the study at three U.S. military facilities:
- Womack Army Medical Center in North Carolina
- Tripler Army Medical Center in Hawaii
- Landstuhl Regional Medical Center in Germany.
This included developing the study protocol and monitoring its execution to measure patient health outcomes for 8 weeks after injections.
Study participants received either the SGB injection or what’s referred to as a sham procedure (akin to a placebo), during which the patient received an injection of saline near the stellate ganglion instead of the SGB medication.
We also conducted focus groups and interviews with service members, spouses, and healthcare providers to explore how SGB is perceived in comparison to other treatments for PTSD, which should predict whether SGB could be widely accepted as an option for the many service members, veterans, and civilians who suffer from PTSD.
Expanding Treatment Options and Addressing the Stigma of PTSD
The study ran through 2018, and gathered and analyzed clinical and qualitative data to inform recommendations for U.S. military medical centers and private practitioners who treat patients with PTSD symptoms.
SGB is a true breakthrough in PTSD treatment. It is a powerful new option for people suffering from PTSD—one that may be more readily accepted by military service members and veterans, for whom the stigma associated with mental healthcare is often a deterrent to seeking treatment. We hope that our study is the first step to healing for millions of veterans and others for whom PTSD symptoms have long been a barrier to a better life.