Stellate ganglion block in disparate treatment-resistant mental health disorders: A case series

Abstract Objectives A significant subset of patients with mental health disorders (MHDs) fail to respond to standard management and are termed as treatment-resistant. This cohort has limited options for managing their condition. Autonomic dysfunction has been reported in the neurobiology of MHDs including anxiety, depression, obsessive-compulsive disorder (OCD), panic disorder, and bipolar disorder (BD). Stellate ganglion block (SGB) is an emerging treatment that dampens sympathetic activity and has been shown to be of benefit in the management of post-traumatic stress disorder. Methods Patients with treatment-resistant disparate MHDs were reviewed by a multidisciplinary team comprising a psychiatrist, a clinical psychologist, and a pain medicine physician. Patients were offered SGB as a novel strategy in the management of treatment-resistant conditions. Validated outcome measures were completed at baseline, 4 weeks, and 16 weeks post-intervention. Results Four patients with heterogenous treatment-resistant MHDs who received SGB are presented in this report. SGB resulted in an improvement in BD, OCD with alcohol addiction, opioid addiction, and health anxiety. Conclusion SGB could have a role in the management of treatment-resistant MHDs.