Expanding the evidence-base for alternative and complementary health practices: Advancing treatment options for post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is among the most common Axis I disorders, with an estimated lifetime prevalence of 7% in the U.S. Significantly higher prevalence rates are observed among combat-exposed service members and veterans. Current evidence-based PTSD therapies have limited reach and impact, leading physicians to explore the potential benefits of alternative and complementary health practices (ACHP). More commonly known ACHP for PTSD include acupuncture and virtual reality. An emerging ACHP for PTSD is stellate ganglion block (SGB), a well-established pain management procedure. In relation to PTSD, a growing body of empirical evidence suggests that >1 SGB treatments result in rapid symptom improvements. Similar to other ACHP, positive outcomes are not universally documented nor mechanistically well understood for SGB. Nonetheless, SGB appears to have a “calming effect” in PTSD. This session will present (a) an overview of ACHP for PTSD, (b) differential patient-reported outcomes for leading ACHP for PTSD including results specific to SGB's impact on improving PTSD symptoms in >100 case reports among military, veteran and civilian patients, and (c) a discussion about future directions for research to address the many remaining questions about ACHP for PTSD such as efficacy, comparative effectiveness, mechanism(s) of actions, dosing, and differential responses among subgroups. The session will conclude by conveying the important message that although the current ACHP evidence-base for PTSD precludes our ability to draw definitive conclusions to inform clinical practice or public policy, the available evidence points to a promising opportunity for a much needed paradigm shift in PTSD treatment.