VA Long Beach Healthcare System
Emerging Therapy for Posttraumatic Stress Disorder
A novel treatment for Posttraumatic Stress Disorder (PTSD) that is available to Veterans for whom traditional approaches have not worked will be featured on the national news program 60 Minutes this Sunday, June 16, at 7 p.m. on CBS.
Despite medications and evidence-based psychotherapies, remission of PTSD is only achieved in about 30 percent of Veterans. This means that many Veterans continue to suffer from PTSD symptoms and varying degrees of disability. There is an urgent need to develop new treatments.
Stellate ganglion blockade (SGB) is a common treatment for upper extremity pain syndromes, and it involves injecting a local anesthetic into a nerve bundle in the neck. Its benefit for PTSD was accidently discovered by an anesthesiologist who was treating Veterans for pain complaints. Some of these Veterans had PTSD and after the block they reported immediate and prolonged improvement in PTSD symptoms. SGB is not a cure, and its benefit generally lasts only 1 to 3 months. However, in many cases the symptom relief can be dramatic, and subsequent repeated blocks will again provide relief.
Four years ago, three Doctors of Medicine – psychiatrist Chris Reist, anesthesiologist Michael Alkire, and psychiatrist Michael Hollifield – began a clinical research project to evaluate SGB for PTSD at VA Long Beach Healthcare System. They treated 17 Veterans who had failed trials of medication and psychotherapy observing significant clinical improvements, often within 24 hours. As a result of this research, the VA Center for Compassionate Care Innovation (CCI) approached them about making SGB available more broadly to Veterans. The mission of CCI is to explore emerging therapies that are safe and ethical to enhance Veteran physical and mental well-being when other treatments have not been successful. With support of the CCI, VA Long Beach Healthcare System initiated a SGB clinical program in 2017 and now have treated over 60 Veterans. The clinical team consists of psychiatrists Chris Reist and Nima Fahimian, who do evaluations and anesthesiologists Michael Alkire and Rostam Khoshsar who provide treatment. Mahmood Novin and Erik Bieznieks provide program support.
The upcoming 60 Minutes piece chronicles the treatment of a Veteran, including the actual treatment procedure. Drs. Reist and Alkire hope to expand this program in addition to planning new research projects to understand how SGB is working to help.
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