Health

Researchers study injections as PTSD treatment

Director of Landstuhl Regional Medical Center's Interdisciplinary Pain Management Center Dr. Jeffrey Tiede prepares to administer a Stellate Ganglion Block for Master Sgt. Randall Kimble at LRMC Oct. 24. This procedure involves injecting a local anesthetic into a patient's neck and often helps manage certain types of pain. A new study at LRMC is seeking patient volunteers to help determine if the Stellate Ganglion Block can also address symptoms of Post Traumatic Stress Disorder (PTSD).
Director of Landstuhl Regional Medical Center's Interdisciplinary Pain Management Center Dr. Jeffrey Tiede prepares to administer a Stellate Ganglion Block for Master Sgt. Randall Kimble at LRMC Oct. 24. This procedure involves injecting a local anesthetic into a patient's neck and often helps manage certain types of pain. A new study at LRMC is seeking patient volunteers to help determine if the Stellate Ganglion Block can also address symptoms of Post Traumatic Stress Disorder (PTSD).
U.S. Army photo by Stacy Sanning/Released

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A new study will test an unusual approach to treating symptoms of post traumatic stress disorder: injecting a local anesthetic into nerve tissue in the neck.

The study is being being led by scientists at RTI International, a North Carolina-based research and development institute. It has begun recruiting active duty troops who have PTSD at military hospitals in North Carolina, Hawaii and Germany.

In recent years some military doctors have begun using the treatment known as a "stellate ganglion block" for PTSD. Several hundred troops have been treated, though there's no conclusive scientific evidence that it works for that use.

The Army wanted to find out, so it's sponsoring the $2 million study. RTI epidemiologist Kristine Rae Olmsted says patients and PTSD experts are eager to see the results.

"There are reports in the literature of people sitting up on the table and feeling better after receiving a stellate ganglion block," she said. "And that's really very powerful for somebody who's suffering from things like hyper-vigilance and nightmares and not being able to form close bonds with other people."

Army veteran Dennis Oakes, who is not part of the study, is one of those who is already getting the treatment from a military doctor.

Oakes, who lives near Fort Bragg, N.C., was diagnosed with PTSD after a combat tour in Afghanistan in 2011 and 2012.

One night, he blacked out and pinned his wife to the floor as if she were a prisoner he was about to cuff.

That's when he began to worry that he would lose control of himself and hurt someone.

"At that point I was scared," Oakes said in an interview. "What's going to happen if she wakes me up in the middle of the night? Am I going to do this again?"

"I was really worried about my marriage and about the fear I put inside my wife that I could possibly harm her," Oakes said.

Oakes had been treated with standard approaches, including medications that he said turned him into a "zombie."

Then one of his doctors suggested the stellate ganglion block.

He said the effects weren't instant or miraculous, but the procedure, which he gets every three months or so, works.

"It's supposed to give you just a little bit more time to think," Oakes said. "And it worked out."

The day after that first injection, Oakes had an argument with the tenant of a rental house he owns. Before, Oakes said, he almost certainly would have reacted instantly and badly, and gotten physical with the man.

But, he said, the treatment let him pause, think, and then act rationally, keeping the argument verbal.

It's not a cure, he said, but has been an important part of his treatment, and he's now able to use fewer medications.

"It's definitely been one of the key stepping stones of putting my life back together after dealing with issues," he said. "I think it really balances the people out that need balance."

During the procedure, a doctor uses ultrasound to guide the needle carefully into the stellate ganglion, a mass of nerve tissue in the neck, and injects the the local anesthetic.

The injections have long been known to help with certain kinds of pain in the arms, upper torso, face, and neck. It's unclear why they would help with a psychiatric condition like PTSD, though scientists have theories.

The researchers hope to eventually sign up 240 patients for the study, all of them active duty troops.

They will be divided randomly into two groups, with a third of them getting a saline solution injection near the stellate ganglion instead of the actual treatment. Those who get that placebo will later be offered the actual treatment.

The researchers expect to complete the study in 2018.

The ganglion block isn't the only unusual new approach to treating PTSD. Last month, the U.S. Food and Drug Administration approved the illegal party drug Ecstasy, or MDMA, for large-scale clinical trials.

This story was produced by the American Homefront Project -- a collaboration of North Carolina Public Radio-WUNC, Southern California Public Radio, KUOW-Seattle, and WUSF-Tampa.