Efficacy and Safety of Stellate Ganglion Block for Post-traumatic Stress Disorder in Veterans
Posttraumatic Stress Disorder (PTSD) is a debilitating condition that affects about 15% of Veterans. Current treatments for Veterans with PTSD include medications and psychological therapies that help to process and desensitize to traumatic events. While effective for many, these treatments do not work for all patients, and many may refuse them. Stellate Ganglion Block (SGB), established to treat pain and other conditions, has shown promise for PTSD: early small studies show it may work fast and greatly reduce symptoms. However, data from larger studies are not clear about SGBs effects. A definitive trial is needed, especially for the Veteran population. This large, well-powered, randomized, sham-controlled trial of SGB for PTSD will assess the short-term efficacy of this intervention, the durability of the effects and the safety of the treatment. Additionally, this study will provide critically important information about biological effects of SGB and potential mechanisms of action. This timely study is critical to help VA clinicians better decide about the merits of SGB for PTSD.
• Veterans of any military branch
• DSM-5 criteria for chronic PTSD on the Clinician Administered PTSD Scale (CAPS-5)
• at least moderate PTSD with a total CAPS-5 score of \> 26
• having had at least one trial of an evidence-based treatment (EBT) for PTSD
∙ Verification of an EBT trial will be by:
• subject report of engaging in the EBT (whether it be psycho- or pharmaco-therapy)
• CPRS or other medical record system (if outside VA) verification to determine that the dose and time (applies to both meds and therapy) was an adequate trial OR that they clearly did not finish the EBT due to clear aversion
‣ They will be eligible if they did not finish the EBT due to aversion, but they must have had a trial and be fully informed during informed consent for this study of the available clinical treatment options
⁃ Eligible persons may have other symptoms that are commonly comorbid with PTSD (e.g., anxiety, moderate depression)
⁃ Severe primary depression will be an exclusion (see Exclusion criteria below)
⁃ This strategy will provide a feasible and generalizable sample
⁃ Women and minorities will be recruited