Understanding Interventional Psychiatry and Advanced Treatment Options

How Stellate Ganglion Blocks Work

The Dual Sympathetic Reset (DSR), Stella's advanced stellate ganglion block (SGB) is an interventional technique used to treat anxiety and post-traumatic stress disorder (PTSD).

It involves injecting a local anesthetic near the stellate ganglion, a collection of nerves in the neck. This procedure can disrupt the sympathetic nervous system activity that's often heightened in PTSD and anxiety disorders.

By temporarily blocking these nerve signals, the body can regain control of the healthy pathways and prune the extra nerve fibers created during overactivity.

DSR SGB is minimally invasive and typically performed on an outpatient basis. It's an example of how interventional psychiatry can offer immediate relief for resistant mental health conditions.

DSR SGB What To Expect

During the DSR SGB procedure, patients can expect a quick and straightforward process. The medical professional will use imaging guidance to ensure accurate placement of the injection. Side effects are rare but can include temporary Horner's syndrome, which resolves on its own.

After the procedure, patients may notice an improvement in their symptoms within hours or days. Patients may experience a reduction in symptoms like hyperarousal and panic attacks.

Identifying DSR SGB vs SGB

It's important to note that Stella's DSR SGB protocol is not a traditional stellate ganglion block. Patients who receive SGB at a location outside of Stella may not be receiving a dual-injection for PTSD, which was pioneered by Stella's Chief Medical Officer, Dr. Eugene Lipov, alongside Dr. Sean Mulvaney and Dr. James Lynch.

We want you to find relief, no matter where you seek help from. For patients seeking care outside of Stella Mental Health, Dr. Mulvaney or Dr. Lynch, we highly recommend asking their provider the following questions:

• Do you do a single injection or a dual injection for PTSD, anxiety and/or Long COVID?
• How many dual-level SGBs have you performed?
• Do you use ultrasound guidance?
• How do you diagnose if I need one treatment, or two treatments?
• What are your patient's outcomes and how will you track if my treatment was a success?

How Ketamine Works in the Brain

Ketamine therapy has emerged as a revolutionary treatment for major depressive disorder, especially in cases resistant to traditional antidepressants. Ketamine acts on the brain's glutamate system, promoting synaptic growth and enhancing neural connectivity. Unlike typical antidepressants that take weeks to work, ketamine can reduce depressive symptoms rapidly.

Administration methods include intravenous infusions and nasal sprays, such as esketamine nasal spray approved by the FDA. By targeting different receptors than conventional medications, ketamine offers a new avenue for brain stimulation and mood regulation.

Success Rates and Patient Outcomes

Clinical trials have shown that ketamine therapy can lead to significant improvements in mood and functioning. Patients often report feeling relief after just one or two treatments. Medical professionals at multispecialty psychiatry clinics are incorporating ketamine therapy into their services due to its effectiveness.

While side effects can include dissociation or elevated blood pressure, these are generally manageable. Accessibility is increasing as more psychiatric hospitals and outpatient services offer ketamine therapy. Coverage by commercial insurances is also expanding, making it a viable option for many.

Non-Invasive Brain Stimulation Technology

TMS is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain. It's primarily used to treat depression but has applications for other mental health conditions as well. The treatment involves placing an electromagnetic coil against the patient's scalp, delivering painless pulses to specific brain areas.

This brain stimulation technique can adjust neural activity to improve mood and reduce symptoms of mental health disorders. TMS sessions are typically conducted daily over several weeks at psychiatric care facilities or outpatient psychiatric services centers.

Conditions Treated with TMS

Beyond depression, TMS has shown effectiveness in treating obsessive-compulsive disorder and anxiety disorders. It's a valuable option for patients who haven't responded to medication or psychotherapy. Since TMS is non-invasive, it's associated with fewer side effects compared to more invasive brain stimulation methods.

Facilities and university hospitals are adopting TMS as part of their interventional psychiatry offerings. It's also becoming more accessible through psychiatric hospitals and urgent care centers specializing in mental health.

Emerging Research and FDA Approvals

Psychedelic-assisted therapy involves using substances like psilocybin or MDMA under professional supervision to treat mental health conditions. Research from institutions indicate promising results for conditions like PTSD and depression.

The FDA has granted breakthrough therapy status to certain psychedelic substances, expediting research and potential approvals. Clinical trials are ongoing to establish safety and efficacy. These advancements could lead to new interventional treatments for resistant mental health disorders.

Supervised Treatment Environments

Psychedelic-assisted therapy is conducted in controlled settings with medical professionals present. This ensures patient safety and maximizes therapeutic benefits. The treatment typically involves preparatory sessions, the supervised administration of the psychedelic, and integration sessions afterward.

Access to this therapy is currently limited but may expand as clinical trials progress. Facilities like Haven Hospital and other psychiatric hospitals may eventually offer these services. Including psychedelic-assisted therapy in interventional psychiatry could further revolutionize mental health care.

Major depressive disorder is a debilitating mental health condition that affects mood, energy, and interest in activities. Interventional treatments like TMS and ketamine therapy have shown significant effectiveness in alleviating depressive symptoms, especially in resistant cases.

PTSD can result from traumatic experiences and leads to severe anxiety, flashbacks, and emotional distress. Treatments like stellate ganglion block and psychedelic-assisted therapy are offering new avenues for relief. These interventions can reduce hyperarousal and improve quality of life.

Complex PTSD arises from prolonged trauma and can include symptoms beyond those of PTSD, such as emotional regulation difficulties. Interventional psychiatry can address these complex symptoms through targeted brain stimulation and other advanced therapies.

Panic and anxiety disorders involve overwhelming feelings of fear and worry. Techniques like vagus nerve stimulation and TMS can help regulate the nervous system. These treatments offer alternatives for patients not responding to medications.

OCD is characterized by intrusive thoughts and repetitive behaviors. Deep brain stimulation has been used to target specific brain circuits involved in OCD. Interventional psychiatry provides options when traditional therapies are insufficient.