A new treatment for PTSD emerges

By Dr. Elspeth Ritchie

Best Defense guest columnist

Psychiatric Annals recently published the second in a series on new and innovative treatments for PTSD. The series focuses on so-called complementary and alternative medicine (CAM) used in the Department of Defense. I say "so-called" because no one quite agrees on the name; it is also called integrative medicine and/or holistic medicine. CAM generally includes acupuncture, herbal techniques, and meditation. I add canine-assisted therapy, virtual reality, and other innovative therapies in this series in Psych Annals, of which I am the guest editor.

PTSD is an immense problem in the military after 11 years of war. The military is also leading the way in developing new therapies. This article focuses on stellate ganglion block, which is an anesthetic technique traditionally used to treat pain. In brief, an anesthetic is injected into the peripheral nerves. In some cases, it has been found that this technique drastically reduces symptoms of PTSD.

One of the many things that are exciting about this treatment it is that it is biologically based. So, if anyone still thinks that PTSD is "all in their head," or totally psychological, the success of this technique would seem to refute that. Another interesting point is that it seems to work in refractory PTSD that has not responded to other treatments.

This is not yet an evidence-based treatment. In other words, it has not yet been subjected to randomized clinical trials (RCTs), which are the gold standard in research in medicine. However, in the days since the on-line version was published, funders from the Medical Research and Material Command (MRMC) have been reaching out to researchers to see if they can do some of the RCTs. So exciting times in new approaches to treating an age-old problem.

Retired Army Col. Elspeth Ritchie, MD, MPH, is the chief clinical officer, Department of Mental Health, for the District of Columbia. She also is a professor of psychiatry at the Uniformed Services University of the Health Sciences.