Eugene Lipov
A large number of war veterans have PTSD in US military punctuated by a very high suicide rate of 22 per veterans per day. Current VA gold standard” treatments protocols will effectively reach no more than 20% of all veterans needing PTSD treatment. A recent study reported results multi- center study on off-label use of second-generation (atypical) antipsychotics has gained wide popularity Risperidone and demonstrated no benefit over placebo for military- related PTSD. This leaves practitioners with few weapons in their pharmacotherapeutic arsenal. The risks of SGA’s are significant, such as sudden heart failure and increase the risk of suicidal attempts, pharmaceutical approach may be moving away from this conventional path. New techniques include modulation of the sympathetic nervous system (SNS) which is a part of the autonomic nervous system. It turns out that a possible treatment of physiologic hyper arousal is available by utilizing minimally invasive modulation of sympathetic nervous system. It seems possible to have similar results by using a common anesthetic procedure called Stellate ganglion Block ( SGB) which is much less invasive. Early results of this new approach are very promising, with a success rate of 70 to 75% a very high compliance, acceptance and minimal risk. Considering severity of PTSD and the lack of effective therapeutic interventions available it is time to dispense with established scientific /medical opinions look at the available data and apply SGB to the population most at risk of PTSD related complications.
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