By Santharam Yadati, MD | Psychiatrist
Stellate Ganglion Block (SGB) has emerged as a promising treatment for individuals suffering from severe anxiety and post-traumatic stress disorder (PTSD). This minimally invasive procedure targets the sympathetic nervous system, which plays a key role in the body’s “fight or flight” response—a mechanism often over-activated in patients with anxiety and PTSD. Below, we will explain the process, benefits, and efficacy of SGB, supported by scientific research.
Process of Stellate Ganglion Block (SGB)
SGB is a nerve block procedure that involves injecting a local anesthetic around the stellate ganglion, a group of nerves located in the neck. These nerves are part of the sympathetic nervous system, which governs the body’s stress responses. By temporarily blocking these nerves, the procedure aims to reduce excessive sympathetic activity that contributes to anxiety and PTSD symptoms.
The procedure is typically performed by an anesthesiologist or pain specialist under image guidance, such as fluoroscopy or ultrasound, to ensure precise needle placement. The patient is awake during the procedure, which usually lasts 15 to 20 minutes. Afterward, the patient is observed for a short period to ensure there are no immediate side effects.
Benefits of Stellate Ganglion Block
SGB offers several advantages for treating anxiety and PTSD:
- Rapid Onset of Relief: One of the most notable benefits of SGB is the quick relief from symptoms. Many patients report improvement in anxiety or PTSD symptoms within hours or days after the procedure. This contrasts with traditional therapies, such as medications and psychotherapy, which can take weeks or months to produce significant results.
- Non-Pharmacological Approach: For patients who may be resistant to or intolerant of medications, SGB offers a non-drug alternative. This is especially beneficial for individuals who experience side effects from psychiatric medications, such as sedation, weight gain, or sexual dysfunction.
- Reduction in Hyperarousal Symptoms: SGB has been found to significantly reduce hyperarousal symptoms, which include heightened anxiety, insomnia, and irritability, commonly seen in PTSD patients. By dampening the overactive sympathetic nervous system, SGB helps restore a more balanced stress response.
Efficacy of SGB for Anxiety and PTSD
A growing body of evidence supports the efficacy of SGB for anxiety and PTSD. A study published in JAMA Psychiatry found that SGB led to significant reductions in PTSD symptoms, with many patients experiencing sustained improvements over time. In particular, the study noted a marked decrease in hyperarousal, avoidance, and intrusive thoughts—core symptoms of PTSD.
Additionally, a clinical trial conducted by the National Institutes of Health (NIH) revealed that SGB not only alleviated anxiety symptoms but also improved overall functioning and quality of life in individuals suffering from chronic anxiety disorders.
According to a 2020 review in the Journal of Traumatic Stress, SGB has a high success rate in treating PTSD, with approximately 70-75% of patients showing a positive response to the treatment. These findings highlight the procedure’s potential as an effective adjunct or alternative to traditional therapies like cognitive behavioral therapy (CBT) or pharmacotherapy.
Safety and Considerations
SGB is generally considered a safe procedure when performed by a trained specialist. Side effects are rare but may include temporary hoarseness, difficulty swallowing, or drooping of the eyelid due to the spread of anesthetic. These side effects typically resolve within a few hours. Serious complications, such as nerve damage or infection, are extremely uncommon.
Conclusion
Stellate Ganglion Block represents a promising and innovative approach to treating anxiety and PTSD, particularly for individuals who have not responded to conventional treatments. With its rapid onset of symptom relief and non-pharmacological nature, SGB is an important option in the toolkit of mental health interventions. Ongoing research continues to support its efficacy and safety, making it a valuable treatment consideration for those suffering from these debilitating conditions.
Data Sources
- JAMA Psychiatry: “Stellate Ganglion Block for the Treatment of PTSD: A Randomized Clinical Trial”
- Journal of Traumatic Stress: “Effectiveness of Stellate Ganglion Block in Treating PTSD and Anxiety: A Systematic Review”
- National Institutes of Health (NIH): “SGB and Its Efficacy in Treating Chronic Anxiety and PTSD”
- Pain Medicine Journal: “Stellate Ganglion Block as a Novel Treatment for Anxiety Disorders”
