Effectiveness of Combined Cognitive Processing Therapy with Stellate Ganglion Block: An Open-Label Randomized...

Area of Science:

• Psychiatry and Behavioral Health
• Trauma and Stressor-Related Disorders
• Anesthesiology

Background:

• Posttraumatic stress disorder (PTSD) significantly impacts military personnel and veterans.
• Cognitive processing therapy (CPT) is a first-line treatment, but some patients require additional interventions.
• Stellate ganglion block (SGB) shows promise in reducing PTSD symptoms by modulating sympathetic arousal.

Purpose of the Study:

• To investigate the effectiveness of SGB as an adjunctive treatment to massed CPT for PTSD.
• To compare the timing of SGB administration (before vs. after CPT) on treatment outcomes.

Main Methods:

• An open-label, randomized wait-list trial involving 86 military personnel and veterans.
• Participants received SGB either before or after a course of massed CPT.
• PTSD symptoms were assessed using the PTSD Checklist for DSM-5 (PCL-5).

Main Results:

• Both SGB-before-CPT and SGB-after-CPT groups showed significant reductions in PCL-5 scores from baseline.
• The SGB-before-CPT group experienced faster symptom reduction.
• Participants in the SGB-after-CPT group who did not achieve remission by week 8 showed significant improvement after receiving SGB at week 12.

Conclusions:

• SGB enhances the effectiveness of CPT for PTSD in military populations.
• Administering SGB before CPT may accelerate treatment response.
• SGB is a viable option for individuals who do not fully respond to an initial course of CPT.