Stellate Ganglion Block + Cognitive Processing Therapy for PTSD

This trial aims to determine if combining two treatments can better assist people with posttraumatic stress disorder (PTSD). It examines whether Stellate Ganglion Block (SGB), an injection in the neck that may help manage stress responses, combined with Cognitive Processing Therapy (CPT), a talking therapy, can more effectively reduce PTSD symptoms. Participants will receive different combinations of these treatments in groups. This trial may suit those who have experienced a traumatic event, have a PTSD diagnosis, and have not tried SGB before. As an Early Phase 1 trial, this research focuses on understanding how the treatment works in people, offering participants a chance to explore this innovative approach.

The trial requires that you have been on a stable dose of psychotropic medication for at least one month before starting and that you do not plan to change your medications within 3 months of starting the study. If you are on blood-thinning medications, you cannot participate in the trial.

Research has shown that Stellate Ganglion Block (SGB) is generally safe. A review of 12 studies found that SGB can help reduce pain and is well-tolerated. One study reported a very low complication rate of 0.17%, meaning fewer than 2 out of 1,000 people experienced issues, suggesting that side effects are rare. Another study found that two SGB treatments, administered two weeks apart, improved PTSD symptoms without major safety concerns. Overall, SGB appears to be a safe option for managing PTSD symptoms.¹²³⁴⁵

Researchers are excited about these treatments for PTSD because they combine Cognitive Processing Therapy (CPT) with Stellate Ganglion Block (SGB) injections, which could offer faster relief than traditional methods. Unlike standard PTSD treatments, such as prolonged exposure therapy or medications like SSRIs, SGB targets the stellate ganglion to potentially modulate the sympathetic nervous system, offering a novel mechanism of action. This combination aims to enhance the effects of CPT by possibly reducing anxiety and hyperarousal more effectively. Additionally, the use of SGB with daily symptom monitoring could provide valuable insights into symptom fluctuations, helping tailor individual treatment plans.

Studies have shown that Stellate Ganglion Block (SGB) can effectively reduce PTSD symptoms. One study found that SGB led to significant improvements, with rapid improvement rates between 70% and 75%. Another study reported that two SGB treatments, given two weeks apart, effectively reduced symptoms over eight weeks. In this trial, one group will receive active SGB injections alongside Cognitive Processing Therapy, while another group will receive SGB with daily symptom monitoring. Research also indicates that symptom reduction for those receiving SGB was twice as large compared to those receiving a placebo. These findings suggest SGB may be a promising option for managing PTSD symptoms.¹²³⁵⁶