Injection helps treat PTSD in war veterans

All it takes is one loud noise to trigger a flood of awful memories.

Post-traumatic Stress Disorder haunts one in every six soldiers coming back from Iraq and nearly 8 million Americans in all.

Standard treatment means therapy and meds that do not always work and have side effects.

Now, one doctor is treating PTSD with an injection that he says can block the painful memories.

Some say more research needs to be done, but one soldier wants relief now.

"I was firing a rocket-propelled grenade, RPG. When I pulled the trigger, it malfunctioned, and it blew up in the tube. Injured seven marines and killed three, all good friends of mine," says John Sullivan, an Iraq veteran.

Thirteen surgeries, several skin grafts and two years of therapy later, this marine is in a much more peaceful place.

However, that does not mean he is safe from the effects of war.

"I was riding on a bus with my uncle going to a baseball game, and the tire blew out -- started having a panic attack," says Sullivan.

John was diagnosed with Post-traumatic Stress Disorder. Anti-anxiety meds did not work, so he is trying an experimental treatment: an injection to the neck to stop PTSD.

"The way I look at PTSD, it's a biological problem,” says Dr. Eugene Lipov, medical director at the Advanced Pain Center. “It's no different than a broken arm."

Dr. Lipov is the first to use a local anesthetic to treat PTSD. It is called stellate ganglion
block -- SGB. It has been used since the 1920s to treat pain.

"It works in 30 minutes. What else works in 30 minutes?"

Lipov says when a traumatic event is experienced, nerves in the brain sprout like flowers. By applying the local anesthetic, the nerve growth factor returns to normal. In a recent study at Walter Reed Army Medical Center, doctors found the shot provided "immediate, significant and durable relief" for two soldiers who did not respond to pills. Other doctors say more safety studies need to be done before the treatment is widely used.

John says, for him, it worked.

"I'm not really taking any more anxiety medication or sleeping medication. I can sleep through the night without having panic attacks," he says.

There are risks of any injection into the neck, including seizures and lung problems.

Doctor Lipov says one injection could last years -- even a lifetime.

It costs between $500 and $1,000.


REPORT: MB #3163

BACKGROUND: Post-traumatic stress disorder (PTSD) is a type of anxiety disorder. It can occur after you've seen or experienced a traumatic event that involved the threat of injury or death.
According to the National Center for PTSD, statistics indicate that approximately 7 to 8 percent of people in the United States will likely develop PTSD in their lifetime. For combat veterans and rape victims, the chance of developing PTSD is as high as 30 percent.

LIVING WITH PTSD: Untreated PTSD can have devastating, far-reaching consequences. It can prevent someone from functioning in daily life and can ruin relationships. Economically, PTSD can have significant consequences as well. As of 2005, more than 200,000 veterans were receiving disability compensation for this illness, at a cost of $4.3 billion. This represents an 80-percent increase in the number of military people receiving disability benefits for PTSD.

TREATMENTS: Treatments for PTSD usually include psychological and medical therapies.

NEW VACCINE: Dr. Eugene Lipov is the first doctor to use a local anesthetic, called stellate ganglion block (SGB), to treat PTSD. Stellate ganglion block is an injection of a local anesthetic into the front of the neck, next to the stellate ganglion, a collection of nerves in the neck. In small studies, the 10-minute procedure appears to provide immediate relief to patients.

Dr. Lipov says when a traumatic event is experienced, it leads to an increase in the nerve growth factor. This spike causes nerves to sprout, leading to feelings of anxiety. By applying the local anesthetic to block the specific nerve group in the neck, the growth factor returns to normal and symptoms subside.

Doctors at Walter Reed Army Medical Center recently replicated Dr. Lipov's results and found that the injection provided immediate and durable relief for two soldiers who didn't respond to pills. "It works in 30 minutes; what else works in 30 minutes? The drugs take two to three months, maybe six months if ever," Dr. Lipov told Ivanhoe. Lipov isn't sure how long the injection lasts but says it could last several years or even provide a lifetime of relief in some cases. Other doctors say more studies need to be done before this treatment is widely used.

Kevin E. Burkhardt
Chief Operations Officer
Advanced Pain Centers, S.C.

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