Can a Single Injection Conquer PTSD?

[GJM]

https://www.wsj.com/articles/can-a-single-injection-conquer-ptsd-the-army-wants-to-find-out-1497279572

Snippet:

FORT BELVOIR, Va.—The U.S. Army has commissioned a study to determine whether an anesthetic injection to the neck alleviates symptoms of post-traumatic stress disorder—a treatment that, if proven effective, could be a big step toward easing an affliction affecting hundreds of thousands of troops who have returned from combat.

[TAZ]

Alleviates the symptoms seems like a short sighted approach, unless it's to allow for other forms of therapy to work. What's the rest of the article say. Not going to register.

I don't think it's a bad idea on the whole, but if a you're doing is masking symptoms without actually dealing with the underlying causes doesn't seem like a hot idea. Kind of like passing out happy pills and letting folks loose thinking they are cured.

[DocGKR]

It is actually an excellent idea...if it is validated to work.

[StraitR]

TAZ

Link through FOX News for those without access to WSJ..

http://www.foxnews.com/us/2017/06/13/can-single-injection-conquer-ptsd-army-wants-to-find-out.html

[TAZ]

Thanks for the link to the free article. Seems like a good idea if it pans out AND is used as intended. The idea of being able to offer relatively quick relief for symptoms that make it difficult for longer term treatment options to take hold is awesome. Lots of folks could benefit from it if it pans out. Hopefully it doesn't become bastardized over the years into a symptom band aid and we forget to treat the underlying issues cause no symptoms exist.

I wish them the best of luck as some good folks need all the help we can muster for them.

[Irelander]

I wish they'd take the D off of PTSD. It is not a disorder. It is a natural reaction to traumatic experiences. I personally do not think dangerous drugs are the answer but there are times when temporary relief is needed and if this opens the door to other forms of therapy then it could be good thing.

[Sensei]

It is actually an excellent idea...if it is validated to work.

I do not subscribe to the WSJ, so I cannot tell if the article is referring to the Stellate Ganglion Block. If so, the procedure did not perform well in this randomized trial published last year: https://www.ncbi.nlm.nih.gov/pubmed/27187898

[Wondering Beard]

I wish they'd take the D off of PTSD. It is not a disorder. It is a natural reaction to traumatic experiences. I personally do not think dangerous drugs are the answer but there are times when temporary relief is needed and if this opens the door to other forms of therapy then it could be good thing.

It is a disorder in that it affects your cognitive capabilities on an ongoing basis, if not treated.

That injection is, per the article, not a final solution but something that can help those suffering from PTSD to get the various therapies (talk, meds etc..) to work well.

From the article:
"The shot isn’t a cure, he said, but eases symptoms enough to allow talk therapy, pharmaceuticals and other approaches to achieve long-term improvements."

[Wondering Beard]

I do not subscribe to the WSJ, so I cannot tell if the article is referring to the Stellate Ganglion Block. If so, the procedure did not perform well in this randomized trial published last year: https://www.ncbi.nlm.nih.gov/pubmed/27187898

It does.

[Sensei]

Be very cautious with preliminary studies touting amazingly spectacular results. They almost never live up to rigorous scrutiny. This holds true for diagnostic procedures and therapies.

[StraitR]

The article says the shot is temporary, enabling other long-term solutions to be put into place, but didn't mention any duration or frequency of dose. There are prescription drugs that do the same, so I'm wondering what benefits are to this vs a pill.


It seems the Army is attacking this from all sides, as they just finished a study on increasing the Omega-3 index in soldiers via diet. There are a lot of benefits to increasing Omega-3 index, one of the biggest is it's positive affects on stress, anxiety, and depression (suicide).

For those interested in the study...


Nutritional Armor: US Army explores boosting omega-3 levels with food and supplements
By Stephen Daniells+, 08-Jun-2017
Replacing omega-6 foods and ingredients on US military garrison menus with products with increased omega-3 contents may boost the omega-3 profile of soldiers, says a new study exploring the practicality of such an approach.
http://www.nutraingredients-usa.com/Research/Nutritional-Armor-US-Army-explores-boosting-omega-3-levels-with-food-and-supplements

[Poconnor]

When are they going to address the low testosterone issue? Too many vets have this symptom and they ignore the cause

[Sensei]

When are they going to address the low testosterone issue? Too many vets have this symptom and they ignore the cause

A number of studies have looked at testosterone and PTSD. While some early studies suggested any association between low T and PTSD, more rigorous analysis showed that these associations disappeared when co-morbid conditions (particularly alcohol use) were taken into consideration.

[Poconnor]

How many vets have low T? How many diagnosed with PTSD have low T? How many TBI have these issues? They have the burn pit registry; but what about the electronic jammers?

[RevolverRob]

At least they are exploring alternate approaches. Frankly, I wish we would explore "non-traditional" medical methods in conjunction with therapy.

By that I mean, for instance, there appears to be some clinical use for certain types of hallucinogens like LSD for guided therapeutic purposes. Said with the caveat that we cannot be sure that they work like we believe they do, because research isn't really legal in this country. As we start to explore alternate drugs like those proposed here, we can at least start to making headway in finding other things.

Will things like this work permanently? No, but they might open the gateway to alternative medicinal therapy approaches.

[Mike C]

Great idea, more ways to medicate Soldiers! Seriously thought, I sure as crap wouldn't stand in line to get stuck in the neck. Maybe a shot can help but that IMHO remains to be seen especially with the abuse going on already. Meds are a very short term solution for PTSD and they have the tendency to be used as a long term solution. Guys get stuck on them for too long and end up fucked up as a result from the side effects. The Army as a whole is too quick to dump meds down everyones throat without a second thought. I've seen first hand the havoc it creates while wading through the waters at a Wounded Warrior Unit on my way out, over medicating was a huge issue while I was getting out and knowing the Army it still probably is. Personally I would be hesitant as fuck to give anyone another tool to medicate Soldiers regardless of what wonder drug gets introduced.

[ranger]

How many vets have low T? How many diagnosed with PTSD have low T? How many TBI have these issues? They have the burn pit registry; but what about the electronic jammers?

Tell me about the jammers concerns, as I spent a lot of time around them.

[Erick Gelhaus]

... but what about the electronic jammers?

Wow. Thank you for that. Had not even considered the potential effects from all of the EW gear in pretty close proximity.

[Drang]

How many vets have low T? How many diagnosed with PTSD have low T? How many TBI have these issues? They have the burn pit registry; but what about the electronic jammers?

Wait! What?17391

[Poconnor]

I used to love standing three feet from the antennae that said do not touch

[Drang]

I used to love standing three feet from the antennae that said do not touch

What was it's output? Because I'd bet the output of the TLQ17 (thing I have my foot on) was significantly higher. How much higher? "No sir, I can't jam full power on this exercise, the norks would call it an act of war."
Didn't stop me at Pinion Canyon, though...:cool:

[Poconnor]

I found this on lightfighter. Pinion canyon- good times

[Nephrology]

A number of studies have looked at testosterone and PTSD. While some early studies suggested any association between low T and PTSD, more rigorous analysis showed that these associations disappeared when co-morbid conditions (particularly alcohol use) were taken into consideration.

Weren't they piloting post-exposure propranolol for PTSD prophy at some point too? Seems a lot less involved than a ganglion block. No idea if that was ever advanced to an RCT of any flavor


Be very cautious with preliminary studies touting amazingly spectacular results. They almost never live up to rigorous scrutiny. This holds true for diagnostic procedures and therapies.

My mom texted me the other day asking if she should have the length of her telomeres measured because of a documentary she watched on Amazon Prime. My response was verbatim "lol no"

[Sensei]

Several drugs have been tried with mixed results depending on enrollment criteria. To answer the thread title - no. There will not be a single injection, drug, or therapy that conquers PTSD just like there will not be a single cure for cancer. Complex disease processes generally require multimodal treatments.

[Odin Bravo One]

I got a shot as a kid, and never got polio.

I'll try this too....... who do I call?

[Sensei]

I got a shot as a kid, and never got polio.

I'll try this too....... who do I call?

COL Sean Mulvaney, MD at Fort Belvoir Community Hospital - 703-441-7677. If you don't know him already, you will probably like him...

[Odin Bravo One]

Never heard of him. I'll ask my primary care physician if she can hook me up with this dude. Like I said, that polio thing worked. Ain't never got Anthraz either.

[Mike C]

You guys are definitely cut from a different cloth than the rest. I wound be a beta tester for that.

[Sensei]

Never heard of him. I'll ask my primary care physician if she can hook me up with this dude. Like I said, that polio thing worked. Ain't never got Anthraz either.

He is the only Army physician I know authorized to wear a Budweiser, Ranger Tab, and SF tab - a real underachiever.
http://www.socnet.com/archive/index.php/t-20130.html

I'm not sure how old you are, but I think that he is still pretty active in SOCOM/JSOC as a sports medicine doc. He graduated BUDS back in the early 90s (I think) and then switched over to the Army once he got into USUHS.

Best of luck. Keep in mind, my understanding is this trial is looking to enroll those currently with PTSD. Enrolled patients will be randomized to treatment or sham procedure (injection with saline instead of an anesthetic). Also, its for treatment, not prevention, and even the study coordinators will admit that it's one part of a broader treatment strategy instead of a standalone cure.

Feel free to drop me a PM if you have questions about the procedure or clinical trials in general.

[Odin Bravo One]

Well if it's not a vaccination then I guess I can live without it.

[Mike C]

Several drugs have been tried with mixed results depending on enrollment criteria. To answer the thread title - no. There will not be a single injection, drug, or therapy that conquers PTSD just like there will not be a single cure for cancer. Complex disease processes generally require multimodal treatments.

Out of curiosity Sensei, have you read this article? https://www.nytimes.com/2016/06/12/magazine/what-if-ptsd-is-more-physical-than-psychological.html?_r=0 what are your thoughts on PTSD being more physical than psychological, or a combination of both? I don't subscribe to WSJ so I couldn't read the complete article. For those that can or have is the premise of this study focusing more of the physical issues related to PTSD or the psychological ones? Asking because I subscribe to the camp that there is a physical change that occurs with people that have PTSD and the issue is more rooted in that, I'd personally like to see the source be treated rather than the symptoms though I recognize there is a need for both at times.

I have read (sorry can't find the article might be in the one I posted above and a few others) that there are some theories that PTSD diagnosed individuals carry the same type of scarring in brain tissue as people with Alzheimer's and dementia. I do think that PTSD probably carries similar physical changes in the brain like TBI does and that is one of the reasons that there are so many overlapping symptoms. I don't have proof to that theory it is just my uneducated opinion. Has anyone read about the use of blue light therapy being used in some cases of mice with Alzheimer's that cause the brain to be stimulated and heal/regrow cells? Thoughts on application for PTSD long term or as supplemental treatment from those of you that might be in the know? After reading the some of the articles about it wondered if there is a possible crossover application with PTSD/TBI not just for dementia and Alzheimer's. I'd really like to see a permanent solution for PTSD/TBI related issues, I've lost more than a few friends to PTSD/Depression related issues and would certainly like to see a better solution than here are some pills/shots whatever mixed in the some feel good sessions with a shrink. I am not saying that doesn't help or isn't necessary I would just like to see a permanent solution for whatever might be going on physically.

[Sensei]

Although I treat people with PTSD, it is not a topic of my research. However, I have no problem believing that PTSD results in both structural and functional (i.e. neuronal metabolism, gene transcription, etc.) changes in the CNS and other systems. I'd go so far to say that those changes occur in the absence of concomitant TBI but of course other neurologic insults have synergistic effects with PTSD.

PTSD, like some of the other medical topics discussed in GD of late, is an incredibly complex illness. With this complexity comes the need to have realistic expectations. For example, I can cure someone's pneumonia with a 5-day course of antibiotics that destroys all the bacteria living in their lungs, but their body generally does not recover to 100% for months (if ever in some cases). Thus, it is incumbent on the medical community to reset those expectations when people start looking to cure incredibly complex diseases with one shot or pill. Sensational headlines like the title of the WSJ are not helping with those expectations.