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Sunday, August 10, 2008

Can Local Anesthesia Knock Out Anxiety of PTSD?

William Hageman of the Chicago Tribune reports today on an area doctor using a novel approach to treating the anxiety that surfaces in many PTSD sufferers.

Estimates of how many veterans suffer from PTSD range as high as 50 percent. What's not disputed is that most of them are undiagnosed. Dr. Eugene Lipov refers to the growing problem as "the reverse surge."

Lipov is the president and medical director of Advanced Pain Centers, with offices in Hoffman Estates and Westmont. He believes he has found a way to combat the feelings that come with PTSD through a seemingly simple injection that calms the section of the brain that becomes overactive in PTSD patients.

The treatment is called a stellate ganglion block [more info: general | clinical], an injection of the local anesthetic bupivacaine around a group of nerves in the neck.

"The medication we're using is the same numbing medication that has been used for decades for pregnant women during labor and delivery," explains Dr. Jay Joshi, director of research at Advanced Pain Centers. But using it against PTSD is a new idea. Lipov made another connection between the medication and the body's reaction.

"I found that one part of the brain that works on hot flashes and PTSD is the same ... the insular cortex," he explains. The injection, he says, "reboots" the insular cortex. "It resets the nerve system the way God built it," he says.

View the procedure, and learn of the experience of the first Iraq veteran to receive this new treatment in extended.

In educational interest, article(s) quoted from extensively.


[Dr. Deborah Little, assistant professor of neurology and director of magnetic resonance research at the University of Illinois at Chicago], who is designing the clinical trials to test the safety and efficacy of the procedure, points out that the injection is not a treatment for PTSD; "it's a treatment for anxiety that comes out of PTSD."

So far, five patients have been treated. The first was the victim of an armed robbery, and a paper on the case will be published in the September issue of the Annals of Clinical Psychiatry.

The procedure itself takes only 5 or 10 minutes. One of its biggest benefits it that it works immediately, unlike antidepressant drugs and psychotherapy, the most commonly used treatments, which may not take effect for months.

Brown's first injection was about two months ago.

"It had an immediate effect," he says. "I noticed I wasn't tense, I wasn't looking around. I was just calm."

"His sleeping was definitely better [after the first treatment]," agrees his wife, Amanda, whom he married two days before he left for Iraq. "He didn't have as many nightmares."

The treatments do need to be repeated, though Lipov and Little say the time between them appears to get longer.

Lipov, Joshi and Little are continuing to research this new procedure, and actively seeking funding for a larger clinical study. There's more information at their Stop Post Traumatic Stress Disorder website.

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