A possible new paradigmn in the treatment of depression - Stellate ganglion blocks
While the data for Stellate Ganglion blocks (SGB) in treating PTSD is very promising, there may be potential benefits for depression as well.
With nearly one-third of patients with major depressive disorder being resistant to available antidepressants, there is a need to develop new treatments for this population. Stellate ganglion block is a procedure used to block sympathetic input to the brain and calm any overactivty.
In march of 2023, a pilot study called LIFT-MOOD or Local Injection For Treating Mood Disorders study was completed to investigate the effects of SGB on treating depression. A double-blind, randomized, placebo-controlled pilot trial was conducted with 10 participants randomized 1:1 to either active treatment or placebo (saline) group. This is the first randomized controlled trial (RCT) to date examining the use of SGB in depression. Each participant was offered 2 right sided SGB blocks and their response monitored.
What’s the takeaway?
The primary goal of the study was to assess the feasibility of using this approach. The authors looked at recruitment, withdrawal, adherence, missing data, and adverse events.
This is a fascinating study because it represents a fundamental shift towards viewing depression as a problem in brain connectivity, and the role of the stellate ganglion in mental health. This is also the first study (versus anecdotal report) ever to look at a peripheral nerve block as a treatment for depression. The sample size of the study, a total of 10 subjects, was too low to try and make statements about efficacy. We look forward to a bigger trial with more patients. This pilot trial demonstrated a reasonable recruitment rate and tolerability.
