Who Doesn’t Want To Feel Better Faster? 

By James Lynch, MD

. https://drjameslynch.com

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Who Doesn’t Want To Feel Better Faster? 

A landmark study published last month in the Journal of Psychotherapy and Psychosomatics demonstrates a novel combination therapy that greatly improved symptoms of posttraumatic stress disorder (PTSD). 

This study adds to the broader body of work over the past 15 years on a medical procedure called stellate ganglion block (SGB) used to treat anxiety and PTSD. In this randomized controlled trial (RCT), we examined whether adding SGB to cognitive processing therapy (CPT)—a well-established talk therapy—improved PTSD symptoms. We tested whether giving SGB before CPT works better than giving CPT alone, and whether SGB can help people who still have symptoms after therapy.

SGB is an injection of local anesthetic along a nerve in the side of the neck that helps reset the body’s “fight-or-flight” system. It has been used safely for 100 years to treat pain and over the past 15 years has also been used to reduce anxiety and PTSD symptoms.

Eighty-six people with PTSD took part. One group received SGB before starting two weeks of daily CPT sessions. The other group completed CPT first and received SGB three months later if they were still struggling.

What we found:

• Everyone improved, but people who got SGB before CPT improved much faster.
• Those who received SGB first had quicker and greater reductions in PTSD symptoms, as well as depression, anxiety, and physical (body-related) symptoms—reducing scores by roughly 50% on PCL-5, GAD-7, PHQ-9, and PHQ-15 symptom checklists.
• By week 8, 48% of SGB-before-CPT participants reached good end-state functioning, compared to 16% in the SGB-after-CPT group. 
• For people who did not improve enough with CPT alone, receiving SGB afterward led to significant symptom relief, showing it can help even when therapy by itself is not enough.
• By week 52, 81% of SGB-before-CPT participants showed reliable improvement in PCL-5 scores, while 62% of SGB-after-CPT participants did.
• This study adds evidence that SGB can be both an effective symptom-reducing procedure on its own and a valuable adjunct that enhances the impact of proven therapies like CPT.

Why This Matters

Faster symptom relief may help people better engage in therapy, feel less overwhelmed, and return to daily functioning sooner. 

Bottom Line

SGB is a helpful add-on to PTSD therapy. Getting SGB before intensive therapy leads to faster improvement, and getting it afterward can still help those who need more support. 

Reference: Effectiveness of combined cognitive processing therapy with stellate ganglion block: an open-label randomized wait-list clinical trial