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RE: Ketamine and Stellate Ganglion Blocks
Dear Provider,
I want to briefly talk to you about two innovative treatments offered at Edelica Health.
IV Ketamine Infusions for Depression and PTSD
Since 2017, Edelica has been providing ketamine infusions for treatment-resistant depression and PTSD. At this point we have safely administered well over 7,000 ketamine treatments.
We are grateful to hear stories like this one from Michelle regarding her daughter’s ketamine response (from a recent Google review):
“With treatment, we went from deep depression to breathing life again. Wanting to attend school, coaching volleyball, engaging in activities with friends and family, and enjoying life are a part of daily life again. We cannot thank Edelica Health enough for providing … hope to those who don’t have great response from medications. (Edelica Health) is providing life changing treatments!”
Stellate Ganglion Blocks (SGB) for PTSD
The Stellate Ganglion Block (or cervical sympathetic block) is an injection of local anesthetic to the neck to temporarily block cervical sympathetic chain, which control the body’s fight or flight response.
It is an outpatient procedure that can serve as a valuable adjunct to trauma-focused psychotherapy by targeting dysfunction in the autonomic nervous system. As a medical procedure, it can also be an attractive option for patients like first-responders who may be worried about a perceived stigma of psychotherapy.
SGB is performed under ultrasound guidance, and can have immediate, and lasting effects.
- For example, a series of 166 combat veterans showed that SGB led to a clinically significant improvement in over 70% of PTSD patients which lasted beyond 3 months. (1)
- A RCT of active-duty servicemen published in Jama Psychiatry found significant improvements in CAPS-5 scores at 8-weeks compared to placebo, along the same order of magnitude as seen in CPT and written exposure therapy. (2)
However, the benefits of stellate ganglion blocks are not limited to combat-related PTSD. In a study of 327 consecutive patients, “statistically significant improvements in PTSD symptoms were noted independent of the causative trauma type, gender, age greater than 20, previous suicide attempts, or use of prescription medications for PTSD.” Mean change in PCL scores across all patients in the study was -28.6 points – nearly 3x the minimally clinically significant standard. (3)
As noted, Stellate ganglion blocks do not need to be a stand-alone treatment. They are best used in conjunction with standard trauma-focused care and have been called a “therapy catalyst.”
In a survey of behavioral health clinicians who have experience with SGB as an adjunct to their trauma-focused psychotherapy, 95% of respondents would recommend the block to a colleague as a useful tool for trauma-related disorders. SGB was rated at least as useful as the most valuable interventions listed in the APA Clinical Practice Guideline for the Treatment of Post-traumatic Stress Disorder and 100% of respondents characterized SGB as ‘Very Beneficial’ or ‘Somewhat Beneficial’.
The authors concluded: “Given the feedback from this study, behavioral health providers should consider using SGB in conjunction with standard trauma-focused care.” (4)
For your patients struggling with PTSD symptoms in spite of current trauma-focused care, who are unable to commit to therapy due to pain of processing the trauma, or who are resistant to psychotherapy due to perceived stigma, please consider adding Stellate Ganglion Blocks to their current treatment plans.
Three Ways to Refer a Patient
To refer patients for ketamine or SGB:
- Simply fill out our online referral form.
- Ask our office to fax you a referral form,
- Direct Referral. Call us at (414) 206-1606 to speak to me or one of our nurse practitioners directly.
If you have questions about ketamine or SGB, or suitability of an individual patient, feel free to contact me.
Kind regards,
Kevin J. Kane, MD
Founder and Medical Director, Edelica Health
(formerly Ketamine Milwaukee)
(1) Mulvaney, et al: Mil Med 2014; 179(10):1133-40
(2) Rae Olmsted, et al: JAMA Psychiatry. 2020;77(2)130-138.