Sympathetic nerve block shows no major benefit for PTSD in randomized controlled trial

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Fan_of_Meehl

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Link to article describing the study and results:

http://www.news-medical.net/news/20...-for-PTSD-in-randomized-controlled-trial.aspx

Yup. This kind of stuff happens all the time. Lots of hype/fanfare and dramatic claims for a particular bio-neuro-electro-magico-whizzbang therapy ('magico' more in terms of the public's perceptual lens of anything involving nerve injections or other physical interventions for mental disorders--I know that there was at least some semi-plausible proposed mechanism of action for this stuff put forth by the proponents) for treating mental disorders in the popular media (and among poorly trained mental health administrator classes). We were sent a link to a glowing news article describing this miraculous therapy by our non-doctoral level trained Mental Health Overlord (sorry, mental health product line service chief) in which one veteran testimonial read something to the effect of "Sargeant X suffered from crippling symptoms of depression including daily severe suicidal ideation but two hours after receiving the stellate ganglion block injection his depression lifted and he reported feeling no depression for the first time in over five years." On the bright side, this procedure may have promise as part of a battery to detect overreporting, feigning, and malingering in the context of a mental health compensation and pension examination.

On another score, what are some of your experiences/thoughts about the 'alpha-stim' therapy provided at the VA for reducing stress, decreasing anxiety, 'treating insomnia,' etc.? Other providers I have talked to said that vets often express that it has helped them shortly after starting therapy but, like any other good placebo response, the 'treatment effect' peters out over time. I remembering doing a quick lit search on it a couple of years ago while working inpatient (and one vet asked me about it and was amazed that I wasn't familiar with the procedure) and finding very little reputable research/commentary on it but there was a sham experiment that essentially found no difference whether the electrical stimulation was turned on or off (pretty damning for the procedure, I thought). However, more recently, I came across a study that appeared decently well controlled (though small sample size) indicating some moderate efficacy (though they did not include a 'sham' control condition). Do ya'll have any personal experiences or thoughts on the whole alpha-stim therapy?

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similar to you, I have not come across any well-designed, adequately powered studies for Alpha Stim. At the moment,there is no compelling evidence for CES types of therapy. Most of the "supporting" studies are not blinded, under-powered, and released by the companies selling these products. I will not refer for its use until its been adequately looked at, and by independent research groups.
 
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We are actually discussing an article that started the whole idea of giving an injection of Propranolol to reduce risk of PTSD development. It's in the early stages, and obsviously, ethical concerns. In its rudimentary stages in terms of neurobiology, there is some credence to be given since it works as an antagonist within central and basolateral amygdala functionality.
 
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