Fix PTSD with "A Jab to the Neck"

With the incidence of PTSD expected to rise with increased combat and military deployment during the past ten years, research into alternative ways to treat this disease are likely to keep appearing in the literature.

As reported in the current issue of Pain Practice, researchers at  Walter Reed Army Medical Center have tried a Stellate Ganglion nerve block instead of anti-anxiety drugs to treat the disorder. As far as I can tell the sample size was all of two, but the research was based on prior reports of success by a Chicago based anesthesiologist, Dr. Eugene Lipov. The authors of the study concluded:

 Selective blockade of the right stellate ganglion at C6 level is a safe and minimally invasive procedure that may provide durable relief from PTSD symptoms, allowing the safe discontinuation of psychiatric medications.

Traditional treatment with therapy and antidepressants can take months to relieve PTSD symptoms, and can cause side effects such as impotence, weight gain, and sedation, Lipov told ABCnews.com. But the block offers another way -- it works within 30 minutes and does not have those side effects. 

While these local nerve blocks have been around for almost a century, they are not without risk. 

Why would a local nerve block work in treating an mental health problem rooted in a traumatic experience? Lipov speculates that traumatic events cause a spike in nerve growth factors.

Other experts cautioned that more research is needed - with a sample size of two, I'd hope so.  Although the ABCnews.com report states the study was placebo controlled, the abstract of the journal article says both subjects got SGB and reported relief. (maybe there's a different study ABC news if referring to, but I'm not seeing it.)

For his part, Lipov is hoping the neve blocks prove a cheap, quick and easy way to address PTSD.

With so many veterans returning from combat plagued by psychological disorders like PTSD, Lipov told ABCnews.com  "I think it's going to be huge in addressing the 'reverse surge' -- all these vets coming back to the country with these psychological problems."

Abstract of the article HERE

Psychology - Either Mindless or Brainless

Interesting article from the New York Times Magazine about the evolution of clinical psychology over the years. Where once it was all on-the-couch type stuff, now a lot of mental health MDs reach straight for the scripts. As Daniel Carlat writes, (Mind Over Meds) the newer generation of headshrinkers educated after the 1980s, came into the profession skeptical of therapy and more focused on neurochemical causes of mental illness.

"Leon Eisenberg, an early pioneer in psychopharmacology at Harvard, once made the notable historical observation that “in the first half of the 20th century, American psychiatry was virtually ‘brainless.’ . . . In the second half of the 20th century, psychiatry became virtually ‘mindless.’ ” The brainless period was a reference to psychiatry’s early infatuation with psychoanalysis; the mindless period, to our current love affair with pills. J.J., I saw, had inadvertently highlighted a glaring deficiency in much of modern psychiatry. Ultimately, his question would change the way I thought about my field, and how I practiced." As a result  "psychiatry has been transformed from a profession in which we talk to people and help them understand their problems into one in which we diagnose disorders and medicate them. This trend was most recently documented by Ramin Mojtabai and Mark Olfson, two psychiatric epidemiologists who found that the percentage of visits to psychiatrists that included psychotherapy dropped to 29 percent in 2004-5 from 44 percent in 1996-97. And the percentage of psychiatrists who provided psychotherapy at every patient visit decreased to 11 percent from 19 percent."

That's what attracted me to psychology twenty years ago -- the complex chemistry of the brian that expressed itself through changes in behavior, cognition and perceptions of reality. I didn't follow that career path because I didn't want to listen to people tell me their problems day in and day out. Yet, over the years there has developed a whole specialty of psychiatry now that JUST focuses on the meds. Carlat wonders if that isn't doing the patients, and the profession, more harm than good.