Interventional Treatment of Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder (PTSD) is a chronic anxiety disorder caused by experiencing life-threatening trauma. It leads to symptoms such as heightened arousal, increased vigilance, re-experiencing, and avoidance of memories related to the traumatic event.
PTSD symptoms may include:
- Anxious thoughts, feelings, or dreams related to traumatic events;
- Psychological or physical distress;
- Attempts to avoid trauma-related memories;
- Changes in thinking and emotions;
- An increased “fight or flight” response.
PTSD can cause clinically significant distress, functional disorders, and even lead to suicide.
Prevalence of PTSD Among Military Personnel
This disorder is very common among military personnel returning from combat. Studies on service members who returned from Iraq and Afghanistan estimated PTSD prevalence at up to 21.8%. Among those who participated in the Vietnam War, this figure reached 17%.
Given the ongoing combat in Ukraine, bombings by Russian aggressors targeting civilian cities, and mass migration due to life-threatening circumstances, PTSD could become a reality for hundreds of thousands, or even millions, of Ukrainians.
Treatment Methods for PTSD
The modern standards for PTSD treatment include pharmacological therapy, psychotherapy, or a combination of both. While many pharmacological methods are considered evidence-based, their effectiveness remains inconsistent. Antidepressants, such as monoamine oxidase inhibitors and selective serotonin reuptake inhibitors, may have undesirable side effects.
Although psychotherapy is effective, it requires a long-term commitment, and the stigma surrounding psychiatric care complicates seeking treatment, especially among military personnel.
One of the minimally invasive methods that has shown promising results in alleviating PTSD symptoms is the stellate ganglion block (SGB).
This procedure involves injecting a local anesthetic under fluoroscopic or ultrasound guidance into the stellate ganglion, a part of the autonomic nervous system located between the C6 and C7 vertebrae. The procedure is usually performed twice, with an interval of several weeks, predominantly on the right side.
There is a significant amount of scientific literature confirming the effectiveness of this procedure. A major contribution to the research on this method has been made at Johns Hopkins Hospital (Baltimore, USA). A specialist from this institution, Oleg Turkot, shared his experience with SGB and other interventions during a visit to the SPRAVNO Pain Medicine Center.
Mechanism of Action of Stellate Ganglion Block
Mechanism of Action of Stellate Ganglion BlockThe effect of SGB in PTSD is explained by modulation of sympathetic nervous system activity. There are three main scientific explanations:
- Connections with the Amygdala
The stellate ganglion has extensive connections with the amygdala, a brain region whose activation is associated with PTSD. - Regulation of Nerve Growth Factor (NGF)
Through the stellate ganglion, nerve growth factor (NGF) reaches the brain, stimulating neuronal connections. This increases norepinephrine levels, detected in the urine and cerebrospinal fluid of PTSD patients. SGB helps reduce NGF production, which suppresses norepinephrine activity and disrupts pathological molecular cascades. - Reduction of Brain Electrical Activity
SGB reduces brain electrical activity (as seen in electroencephalography, EEG), which is also linked to decreased norepinephrine levels.
Source: Facebook Vadym Biloshytsky
16 reviews
Everything about the doctor’s work was satisfactory. I liked it very much.
He listened to me, clarified all the issues, diagnosed me, said that we would fight the problem, and along the way we would figure out what other issues there might be.
I am satisfied with the consultation with Dr. Vadim Vasilievich Beloshitsky. An attentive doctor who gives proper attention to patients.
Everything suited me. I am very pleased with the consultation and the way both the doctor and Irina Borisovna work were organized.
Attentive, listened to all the symptoms, asked questions. I am satisfied with everything, everything is good.
We received a very good consultation. We were satisfied. A very qualified, very knowledgeable, very experienced doctor.
The doctor is attentive, listened to everything, explained everything. Before the appointment, I was afraid that urgent surgery was needed, but the doctor explained everything as it is and calmed me down. The doctor gave recommendations on what to do, advised leading an active lifestyle; in my case, surgery is not needed. I was satisfied with the visit to the doctor; I heard everything I wanted to hear from the doctor.
Hello, my mother has had headaches (migraine) for over 20 years, and it got to the point where she was taking painkillers several times a day, leading to dependence and the feeling that nothing would help. However, after consulting many doctors and spending a lot of time and money, her condition only worsened because they were treating something entirely different, which only caused side effects. We decided to try the drug Azhovi, or rather botulinum toxin. We chose the SPRAVNO Pain Medicine Center because of their democratic prices, direct supplies, and confirmation of the quality and originality of the drug. Most importantly, the professionalism of Vadym Vasylovych Biloshytskyi, who established the correct diagnosis and prescribed treatment with Azhovi. The treatment is still ongoing, but already from the start, 80% of the pain has disappeared, the quality of life has changed, blood pressure has normalized, and muscle tone has improved.
I sincerely thank the doctor and the SPRAVNO staff! I recommend it.
Sincere thanks to neurosurgeon Biloshytskyi V.V. and the team at the “SPRAVNO” clinic! You have done the incredible, a life without pain is possible! Thank you from the bottom of my heart!
I want to express my immense gratitude to the professionals in their field: neurosurgeon Vadim Vasilievich Biloshytsky and neurologist Marina Vadimivna Biloshytska, as well as the “SPRAVNO” clinic for their responsible and conscientious attitude towards their work and patients, for their high qualifications, and for their help in solving the problem. We succeeded!
I highly recommend them!!
We visited the doctor for the first time, good reception. We started the treatment that the doctor prescribed, there are initial good results, there is an improvement in health, the treatment is ongoing. After the course of treatment, we plan to return for a follow-up appointment.
I recommend, a very good doctor! It is clear that the doctor is educated, understands everything, was able to partially solve our problem, does not impose anything unnecessary, devoted enough time to us, we were satisfied with the doctor.
I am satisfied with the consultation with Dr. Beloshitsky Vadim Vasilievich. A attentive doctor who gives proper attention to patients.
He listened to me, clarified all the issues, diagnosed, said we will fight the problem, and we will find out what other issues may exist in the process.
Everything is wonderful. A high-level professional. Skillfully asks questions, gathers necessary information. Makes diagnoses.
