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Prasad S, Jain N, Umar TP, Radenkov I, Ahmed SK, Sakagianni V, Kollia S, Hingora MJ, Kumari N, Akbari AR, Renemane L, Bachu A. Sympathetic nerve blocks for posttraumatic stress disorder: an evidentiary review for future clinical trials. Front Psychiatry 2023; 14:1309986. [PMID: 38188052 PMCID: PMC10771322 DOI: 10.3389/fpsyt.2023.1309986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/30/2023] [Indexed: 01/09/2024] Open
Abstract
Posttraumatic stress disorder (PTSD) is a chronic disorder resulting from exposure to traumatic events. In recent years, sympathetic nerve blocks have gained interest as an emerging treatment modality for PTSD. They have been shown to reduce autonomic dysfunction associated with PTSD symptoms, particularly in refractory and treatment-resistant patients. However, there is limited evidence regarding the technique's effectiveness in PTSD patients. Therefore, this scoping review was designed to update and summarize the current literature on this topic to inform the design of future clinical trials and studies. Our review of 22 studies (mostly case reports and series) included 1,293 PTSD patients who received sympathetic nerve blocks, primarily military service members and veterans, with a median age of 42.2 years. 0.5% Ropivacaine was the preferred anesthetic, and the right sided stellate ganglion block was the most commonly used technique. Relapse of symptoms was reported commonly, resulting in additional nerve block sessions. Most reported side effects were mild and transient. Despite the encouraging results, we remain cautious in interpreting the benefit of the technique due to the lack of sufficient standardized clinical trial data, heterogeneity in reported results, and the potential for bias in reporting. Future studies should focus on evaluating and addressing the technique's effectiveness, safety, tolerability, and indications.
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Affiliation(s)
- Sakshi Prasad
- Faculty of Medicine, National Pirogov Memorial Medical University, Vinnytsia, Ukraine
| | - Nityanand Jain
- Faculty of Medicine, Riga Stradinš University, Riga, Latvia
| | - Tungki Pratama Umar
- UCL Centre for Nanotechnology and Regenerative Medicine, Division of Surgery and Interventional Science, University College London, London, United Kingdom
| | - Igor Radenkov
- Faculty of Medicine, St. Cyril and Methodius University, Skopje, North Macedonia
| | - Sirwan Khalid Ahmed
- Department of Adult Nursing, College of Nursing, University of Raparin, Rania, Sulaymaniyah, Kurdistan, Iraq
| | - Virginia Sakagianni
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sofia Kollia
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Nikita Kumari
- Sindh Medical College (SMC), Jinnah Sindh Medical University (JSMU), Karachi, Pakistan
| | - Amir Reza Akbari
- Emergency Department, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, United Kingdom
| | - Lubova Renemane
- Department of Psychiatry and Narcology, Riga Stradinš University, Riga, Latvia
| | - Anil Bachu
- Baptist Health– UAMS Psychiatry Residency Education Program, North Little Rock, AR, United States
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