We are excited to announce the partnership between Stella and RTHM, a research clinic treating complex and post-infectious illnesses, to provide RTHM’s Long COVID patients access to Stella’s Stellate Ganglion Block (SGB) treatment

Changes in sympathetic nervous system function have been documented in those diagnosed with Long COVID. SGB has helped return the sympathetic nervous system to a healthier state after a biological trigger alters its function. The Stellate Ganglion Block treatment offers promising results and is administered by our many board-certified anesthesiologists trained by Stella. 

The path forward for SGB treating Long COVID

Recently, our partners published a case study in the Journal of Neuroimmunology that showed how SGB treatment reduced symptoms of Long COVID.

 “Stella’s SGB is one of the options within our individualized treatment plans, but it’s an important one,” says RTHM’s co-founder, Dr. Jennifer Curtin. “The collaboration between RTHM and Stella provides our patients with a unique and potentially helpful treatment.”

Long COVID affects up to 30% of those who have contracted COVID-19. Yet few clinicians have the background in post-viral disease or can access all the tools required to treat these challenging conditions. RTHM is unpacking the knowledge gained from other, often post-viral diseases like ME/CFS and leveraging that wisdom for those suffering with Long COVID. 

“It’s clear that Stella and RTHM will both continue to innovate like lives depend on it— because they do,” said Michael Gershenzon, Stella’s Co-Founder and Chief Strategy Officer.

RTHM believes in the best outcome

RTHM will collect a wealth of longitudinal biomarker and questionnaire data on patients undergoing SGB, which could help support the efficacy of SGBs in people with Long COVID and potentially other chronic complex diseases.

“Where others see Long COVID as ‘uncharted waters’,” Dr. Curtin says, “we already have a partial map from navigating other post-viral diseases.”

RTHM’s treatment and diagnostic algorithm created by co-founder Dr. Curtin will help clinicians make the best treatment and diagnostic decisions for patients – including Stella’s SGB methodology. RTHM will identify patients that may find relief from SGB and facilitate care with Stella Certified MDs. RTHM will be using apps and biological and biometric data gleaned from wearable devices, which could help support the efficacy of SGBs in people with Long COVID.

“RTHM and Stella have a shared mission: ending needless suffering,” he added.  “The number of people affected by Long COVID represents a major health crisis. Knowing that Stella’s treatment might be able to help an entirely new population is incredible.”

Looking toward a hopeful tomorrow

The only data regarding SGB’s effects on Long COVID are investigative case studies, however, its application in treating Long COVID is novel but promising. And as cases of Long COVID emerge, it’s essential to have attractive therapeutic modalities like SGB and the therapies at RTHM for people to turn to when looking for the appropriate care. 

If you would like to learn more about about RTHM’s Long COVID treatments, visit https://rthm.com/, or to learn more about Long COVID and SGB, please read Stella Certified Doctor Dr. Luke D. Liu’s case study on SGB for Long COVID.

Michael Ergo struggled with post-traumatic stress for more than a decade following that deployment to Iraq in 2005 with 1st Battalion, 8th Marines. But he says he finally found peace last year through a treatment known as stellate ganglion block, or SGB.

While SGB has been used to treat pain for about a century, its use for treating post-traumatic stress is still relatively novel.

After about half an hour of observation after receiving SGB, Ergo was free to leave. He said he noticed the effects right away. He likens the feeling to the immediate aftermath of a good open-water swim in the Pacific Ocean — he felt calm and refreshed.

He half expected that feeling to go away, but a year later, he says he hasn’t experienced a single panic attack since.

“It wasn’t like I was totally blasé,” he said. “I’ll feel the appropriate amount of fear when a situation isn’t right or I need to act immediately. I just don’t sweat the things I used to sweat.”

Researchers hope a newly approved study at New York University will increase understanding of the treatment and help more patients like Ergo find relief.

“Mental health support, familial support, community support are really important around any intervention, including SGB,” Michael Gershenzon said.

While both Ergo and Stella Co Founder and Chief Strategy Officer Michael Gershenzon hope the study will ultimately make it easier for those suffering from post-traumatic stress disorder to try SGB, we emphasized that the treatment shouldn’t be seen as a silver bullet or one-and-done deal.

“This is the closest thing we have to a magic pill,” Ergo said. “But you have to do the supportive therapy with it afterwards to make the changes in your life.”

Read the full article on Coffee or Die

Post-traumatic stress is a prevalent and debilitating condition that doesn’t discriminate against anyone. According to the National Center for PTSD, about 6 of every 10 men (or 60%) and 5 of every 10 women (or 50%) experience at least one trauma in their lives. Regardless of their age, race, gender, and religion, anyone can experience post-traumatic stress. 

PTSD is a mental health condition that some people develop after experiencing or witnessing a life-threatening event, like combat, a natural disaster, a car accident, or sexual assault (1).

At Stella, we replaced “Disorder” with “Injury. “Disorder” connotes a sense of permanence which is misleading because PTS is treatable. Disorder can also lead to the stigma that can prevent those who need help from asking for it. We speak more about this in our post, “What is PTSD?”

The Family Tree of Trauma

PTSI can be categorized under several main types of trauma.

• Acute trauma: A single stressful or dangerous event.
• Chronic trauma: Repeated and prolonged exposure to highly stressful events. 
• Complex trauma: Results from exposure to multiple traumatic events.

PTSI can come after experiencing events like war, sexual assault, adoption, and domestic abuse to name only a few.  It encompasses many different mental health conditions, like suicidal thoughts, depression, and anxiety. But because of the stigmas surrounding PTSI, over a quarter of the American population believe it is untreatable.

Current treatments that exist for people experiencing trauma symptoms can be classified as pharmacological therapies or psychotherapies, including cognitive-behavioral therapy (CBT), cognitive processing therapy (CPT), prolonged exposure, hypnotherapy, and others. Success rates for singular therapies remain inconsistent and, or many, the formula for lasting relief combines biological and psychological interventions. Because of this, clinicians are exploring new options.

The Innovative Options

A study released earlier this year by Stella’s Chief Medical Officer, Dr. Eugene Lipov, Stella’s Chief Psychologist, ​​Dr. Shauna Springer, and other trauma experts concluded the Stellate Ganglion Block is an effective treatment for PTSI symptoms no matter their gender, trauma type, PTS-related drug use, history of suicide attempts, or age.

Out of the 327 patients were included in the final statistical analysis, an overwhelming majority of them experienced relief in PTSI symptoms after the Stellate Ganglion Block treatment. The patient population included 132 civilian females, 13 military females, 85 civilian males, and 97 military males. 

The Results

Dr. Lipov identified 21 types of self-reported trauma leading to PTSI for the individuals involved. Among the 21 types of reported trauma, 19 types reached statistical significance.

The PCL was used, which is a self-report assessment that determines symptoms, screens, and monitors changes before, during, and after PTSI treatment. There was an average decrease in PCL score was 28.59 and 29.2, respectively. The men and women who had a military background had a significantly greater reduction in PCL score than civilians.

Overall, the study concluded that there was a statistically significant improvement in PTSI symptoms independent of the causative trauma type, gender, age greater than 20, previous suicide attempts, or use of prescription medications for PTSI.

While people experience symptoms caused by emotional trauma differently, we all have one thing in common – we are looking for relief. The Stellate Ganglion Block treatment appears to hold promise for both women and men, with both military and non-military traumas.

Post-traumatic stress can be treated as an injury no matter the complexity of the trauma.

Is the Stellate Ganglion Block Right for You?

The Stellate Ganglion Block is a fast, effective, and research-back treatment and when combined with talk therapy, and other mental health solutions recommended by your providers, can be the new standard of care. Stella simplifies the healing journey. Our PMHNP experts will review symptoms and medical histories to determine if the Stellate Ganglion Block (SGB) is the right treatment plan. More than 80% of Stella patients find relief from their PTSI symptoms. If you are interested in learning more, please contact us directly by calling 1-866-497-9248.

1. https://www.ptsd.va.gov/understand/common/common_adults.asp

This article is written by Stella Co-Founder and Chief Strategy Officer, Michael Gershenzon. 

As the Co-Founder of Stella, I’ve got something to say.

The team at Stella is comprised of over 50 full-time employees who come from varying walks of life. Each employee has a unique background and personal story that led us all to where we all are today. They could be doing just about anything with their careers – working at Fortune 100 companies, bolstering their resumes and enjoying luxurious company perks.

But they chose Stella.

They chose a risky, small start-up born during the chaos of COVID-19 attempting to bring to market the first new FDA-approved standards of care for mental trauma sufferers in over 2 decades.

And Stella chose them, along with everyone else who would come under our care. 

The people at Stella are grappling with a conundrum that our clients are also feeling. We’re all asking ourselves:

“Why are these treatments so expensive and why won’t insurance help?”  

Myself, our C-suite and our board have been trying to crack this since inception. As the Co-Founder, I’m going to attempt to very directly answer these “why” questions below.  

The responses are probably unsatisfactory… but true.

Health Runs Through Insurance Companies (and The Government)

For better or worse, the US healthcare system revolves around health insurance companies which serve as the arbiters of what care you can receive (and don’t receive).  At the risk of oversimplifying, we need three ingredients for a treatment to be adopted by insurance:

• A government agency (i.e. the FDA) signing off the treatment is safe and effective
• Proof the treatment saves the insurance company money. In many cases this is by offsetting an existing cost elsewhere. The cost of trauma, depression and anxiety are enormous, however they are often indirect (lost productivity, absenteeism, etc..) as opposed to an existing direct insurance cost.
• A bureaucratic process that entails pitching and contracting with each insurance company to convince them to include this as a benefit for their members

The median cost of FDA approval for a new drug is $19 million.  The process from pre-clinical testing to FDA approval takes an average of 12 years for a drug and 7 for a medical device.  While that time passes, people suffer and in some cases die.

Importantly, the absence of FDA approval or insurance coverage does NOT mean a treatment is not effective. There are roughly 10,000 approved therapeutics for roughly 10,000 individual diseases but once a drug is approved for one condition its often not approved for others where it can be beneficial. A few common examples include:

• LASIK for Vision Correction (FDA approved but not covered by insurance)
• Aspirin for Cardiovascular Disease Prevention (not FDA approved for that indication)

Mental Health (Let Alone Interventional Mental Health) Is Way Behind

Despite the jaw dropping impact to the US economy ($210+ billion from depression absenteeism alone, according to the APA), immeasurable personal and familial suffering, and very measurable loss of life (death by suicide is the 10th leading cause of death, according to the CDC), mental health is decades behind other healthcare fields in terms of medical innovation and even willingness to acknowledge the problem. 

As humans, our most important organ, the brain, is one of the least understood. The complexity of the brain and relative astronomical cost of brainscan technology, like fMRI, have put research and innovation in this space on the backburner.

You can see physical symptoms of disease.  You can see a broken bone.  You can see cancer. You can’t readily see mental trauma without a brain scan (see point about its uneconomical cost above).

It’s no wonder why society generally views mental afflictions as “something just in your head that you can tough through.”  

In this context, it may be easier to understand why proven treatments have been forced outside of insurance and FDA adoption.

While the Stellate Ganglion Block (SGB) for trauma and acute anxiety, ketamine infusions for treatment resistant depression, and other modalities have proven their efficacies, they remain FDA approved for other indications, just not for mental health.  

These treatments are administered by the same exact Board-Certified Doctors which may treat people with SGB or Ketamine for pain, but these modalities are forced to wear the “off-label” tag. This off-label tag impacts everyone involved:

• Doctors shoulder materially more liability
• Mental trauma survivors pay out of pocket
• Companies fight an uphill battle of educating clients 

We’re dedicated to providing people with access to treatments that work while proving to the industry that these biological treatments are not “fringe” – they just haven’t made it through the multi-decade process of FDA approval, insurance reimbursement, and medical community adoption. 

Stella Invests In Much More Than “Just The Procedure”

For every mental trauma survivors we treat, Stella loses approximately $2,000. By the way, we’re not alone. Some companies like Field Trip Health, Novamind, Numinus, Ketamine One, Wesana, Revitalist, TrippSitter and others do as well. (They are public companies and so are their numbers, you don’t have to take my word for it). More on this later.

Unfortunately today, there is no singular “mental trauma cure.” Individuals’ paths to healing are customized to each respective person, their circumstance, their biology and their lifestyle.

What we’re building is not just “a procedure” or “an infusion.” It’s a curated whole person care model which encompasses medical, behavioral and social determinants of care (which may involve a procedure or infusion along the way). Stella pairs biological modalities with psychological ones to ensure the most effective, lasting outcomes.

In some ways, you could compare Stella’s approach to mental trauma treatment to tearing an ACL. Treatment for an ACL tear often looks something like this:

• Surgery to repair the torn ligament
• Appointments with qualified doctors to verify all is healing appropriately
• Medications along the way to manage the pain
• Months of physical therapy to relearn to walk
• Crutches to aid your walking while you rebuild strength

We follow a similar blueprint for mental trauma relief.

Stella provides a biological intervention to heal the injury caused by mental trauma, pair it with trauma-informed therapy for reintegration, provide self-help tools to manage the pain along the way, and recommend a support system to ensure you maintain the gains. This is all wrapped up in dedicated compassionate care coordination that guides your journey from beginning to end.

This may shed light on the earlier point – “how is it possible Stella loses $2,000 per treated patient?”  The simple answer is – we don’t exist to “transact a procedure.” Matter of fact, you may be able to get that cheaper somewhere else. 

We’ve invested in 360 degree care coordination that leads to outcomes previously unfathomed. 

This is all on the bet that one day, this will be a standard of care for mental trauma survivors. That insurance companies will adopt the new age of mental healthcare. That those we serve no longer have to come out of pocket for treatment to which they have a right.

Oh and by the way, if we don’t successfully obtain FDA and insurance adoption, we’ll likely be out of business in the next few years.

In Conclusion

We’re not able to fix the US healthcare system.  I wish we could.  We can’t.

We are able to make innovative treatments accessible to mental trauma survivors nationally (50+ locations in the US) and globally (we have locations in Australia and Israel). 

We are able to wrap these treatments in additional care and not view them as “transactional procedures.”  Mental trauma survivors need care – not procedures. 

We are able to prove to the government regulatory bodies that these treatments are objectively safe and incredibly effective for the right people and when administered by the right teams in the right settings.

We are able to prove to insurance companies that these treatments both save lives and save them money.

Unfortunately, between now and insurance reimbursability, these treatments will cost survivors too much money and force companies like Stella to subsidize losses.

We’re working hard to change that. We chose you.

Since March 2020, there have been 442 million COVID-19 cases worldwide. Over the last two years, we’ve learned a lot about how the virus works and how to protect ourselves against it. We’re also learning what COVID-19’s long-term impact on our mental and physical health will be.

While most people who are infected with COVID-19 recover from their symptoms in within four weeks, studies indicate that about 10% of people experience long Covid symptoms.¹ Long Covid can present itself in many ways but the most common symptoms are:²  

• Fatigue
• Dizziness upon standing
• Elevated resting heart rate
• Shortness of breath
• Brain fog
• Sleep disturbance
• Fevers
• Gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea, cramping, etc.)
• Loss of smell
• Loss of taste
• Anxiety
• Depression

Research on Long Covid

Medical professionals continue to innovate as we learn more about how COVID-19 can impact the body in the long term. While early papers, case studies, and trials have provided helpful information about Long Covid, more research needs to be conducted.

Stella Certified Doctor Dr. Luke D. Liu and Research Coordinator Deborah L. Duricka recently added to this body of knowledge with their independent study conducted earlier this year, Stellate ganglion block reduces symptoms of Long COVID: A case series. This study explains how the Stellate Ganglion Block (SGB) successfully reduced two individuals’ long COVID symptoms.

SGB’s History and How It’s Used Today

SGB is an injection of local anesthetic into the stellate ganglion – a bundle of nerves in the neck – first performed in 1926 to treat chronic back pain. Almost 100 years later, SGB is still a common pain management procedure. 

In 2006, Stella’s Chief Medical Officer Dr. Eugene G. Lipov pioneered the use of SGB to alleviate symptoms of Post Traumatic Stress Disorder (PTSD) – please note that Stella prefers the term Post Traumatic Stress Injury (PTSI). Two years later, a peer-reviewed study on the topic was published.

Dr. Liu’s study offers another possible application of SGB: the treatment of long Covid symptoms.

SGB as a Long Covid Treatment

People with long Covid may develop dysautonomia, or the dysfunction of the parasympathetic nervous system. The parasympathetic nervous system regulates non-voluntary body functions like digestion, blood pressure, sweating, and more. Many with long Covid present with some these symptoms.

During SGB, local anesthetic is injected which temporarily blocks or “turns off” the nerves it’s injected into which can help restore normal biological functions. 

Dr. Liu performed SGB on two women with long Covid symptoms. After the procedure, both women reported improvement, suggesting that SGB may be able to effectively treat long Covid symptoms.

Reviewing the Case Study

Eight months after the onset of the COVID-19 diagnosis, the 42-year-old woman was still experiencing over 7 different long Covid symptoms:

• Debilitating fatigue
• Mental fogginess
• Difficulty concentrating
• Elevated resting heart rate
• Sleep disturbance
• Altered sense of taste and smell
• Lack of appetite and food aversion due to changes in taste and smell

The unpalatability of food led to a 30-pound weight loss that continued to progress. On top of her symptoms, she had been let go from her job and was teaching four-hour CPR courses with difficulty, relying on her teaching manual to recall facts and procedures previously well known to her. 

After receiving SGB on her right side, she had immediate improvement in taste and smell as well as improvement in mental clarity and concentration. Two days later, she received SGB on her left side and immediately experienced more improvement to their taste and smell.

Soon after, she was able to drive home without conscious effort to recall the route, demonstrating noticeable improvement in memory. On top of that, she was able to teach a nine-hour course for CPR instructors without relying on written material, demonstrating a drastic improvement in recall. 

Two weeks later, she reported durable restoration of taste and smell and refreshing sleep resembling her pre-COVID-19 baseline.

COVID Symptoms Before and After SGB Treatment

Seven months after her COVID-19 diagnosis, the 44-year-old woman entered Dr. Liu’s office. 

Initially, her COVID-19 symptoms were loss of smell and taste, mental fogginess, headache, and shortness of breath. 

One week after the onset of acute symptoms, her headache worsened, prompting evaluation in the ER. Her headache symptoms dissipated over the following two weeks but she still experienced a multitude of symptoms:

• Declining cognitive function
• Developement of stuttering speech
• Significant cognitive impairment
• Right-sided paresis (muscular weakness)

Her symptom of paresis prompting hospitalization and evaluation. Her MRI results demonstrated inflammation and did not show signs of neither a stroke nor viral infection of the brain. 

After being discharge with ‘sequelae of COVID-19-induced ventriculitis’ as a leading consideration, she was prescribed intense occupational, physical, and speech therapy for profound memory deficits, speech impediment, impaired coordination, inability to concentrate, and debilitating fatigue. Yet, despite these therapies, she could not continue her work as a special education teacher.

Now seven months later, she had returned to work with limited duties and shortened hours with while still experiencing Long Covid symptoms: 

• Debilitating fatigue and speech impediment.
• Altered taste that led to food aversion and significant unintentional weight loss.
• Severe generalized body pain described as dull with pins and needles that occasionally kept her bedbound. 
• The acute stress and mental or physical exertion exacerbated her right-sided motor deficits, fatigue, and cognitive issues. 
• Intermittent headaches described as “crawling pain in my brain.”

Within minutes of receiving SGB treatment on her right and left side, her taste and smell drastically improved. Three days later, her physical and mental stamina had improved significantly, allowing her to perform routine household activities without debilitating lapses in memory. 

One week after treatment, she began a new job as a high-school teacher and was able to teach a full day of classes, which she states would have been impossible prior to treatment. Two weeks later, she reported durable resolution of stuttering and 75% improvement in all other symptoms. 

At 60-day follow-up, she reported normal levels of fatigue and cognitive function, durable restoration of smell and taste, and absence of post-exertional malaise.

COVID Symptoms Before and After SGB Treatment

A Promising Future

While this has not been through any clinical studies and the only data are investigative case studies at this point, its application in treating long Covid/PASC is novel but promising. 

The lack of effective treatments for long Covid/PASC makes the SGB an attractive therapeutic modality that deserves further investigation.

Read the full study here.

1. https://health.ucdavis.edu/coronavirus/covid-19-information/covid-19-long-haulers#:~:text=This%20condition%20can%20affect%20anyone,will%20experience%20long%2Dhaul%20symptoms.

2. Soriano J.B., Allan M., Alsokhn C., Alwan N.A., Askie L., Davis H.E., Diaz J.V., Dua T., de Groote W., Jakob R., Lado M., Marshall J., Murthy S., Preller J., Relan P., Schiess N., Seahwag A. World Health Organization; 6 October 2021. A Clinical Case Definition of Post COVID-19 Condition by a Delphi Consensus.

Stella co-founder and leading trauma expert Dr. Shauna Springer spoke with Mission 22 to discuss the power of Stellate Ganglion Block (SGB). Mission 22 is a national community supporting active service members, Veterans, and family members through three key areas of focus:

• Support and Treatment Programs— addressing Post-Traumatic Stress, Traumatic Brain Injury, suicide risk and other challenges.
• Social Impact— uniting civilians and the military community to raise awareness of issues active service members, Veterans, and their family members face.
• Memorials— remembering and honoring service members and Veterans through large scale installations and digital initiatives, while raising awareness for issues faced on home soil.

Stella believes that when biological interventions – like the Stellate Ganglion Block (SGB) and ketamine infusion therapy – are paired with psychological interventions, like Mission 22’s Recovery and Resilience Program, the result can be life-changing.

In recent years, the 17 most common symptoms following trauma have been identified. On this list includes suicidal thoughts or attempts.

We can be so overwhelmed by our symptoms that we sometimes consider harming ourselves or suicide. When we’re experiencing trauma symptoms, we can also experience depression, panic attacks, anxiety, and substance abuse and are at higher risk for suicide. In fact, people diagnosed with trauma symptoms are 9.8 times more likely to die by suicide.¹ 

SGB has emerged as a promising treatment option for symptoms of trauma. Stella founders Dr. Eugene Lipov and Dr. Shauna Springer recently published a study with other trauma experts that indicates that the SGB is an effective treatment for trauma symptoms regardless of gender, trauma type, PTSD-related medication use, history of suicide attempt, or age.² 

Dr. Springer sat down with Mission 22 to discuss how SGB has a direct link to decreasing suicide and review the six key symptoms of hyper-reactivity that SGB targets.

• Sleep Difficulties
• Chronic Hypervigilance
• Startle Response
• Difficulties Concentrating
• Floods of Anxiety
• Irritability or Anger/Rage

Dr. Springer also explores a couple common misconceptions about SGB.

The first misconception is that SGB “blocks you.” This misconception is tied to the assumption that SGB is a nerve blocker, which it is not. If you’re asking yourself, “What Is SGB?” you can learn more about how it works here.

The next misconception discussed is the assumption that SGB “takes your edge away.” On the contrary, people who have received SGB by Stella have come back and reported that SGB had improved reaction time.

Listen to the full piece here:

If you are thinking about suicide or need emotional support, please text “HOME” to 741741 for free, 24/7 crisis counseling from Crisis Text Line. We want you to know that you are not alone and that there is hope. 

1. National Center for PTSD. PTSD and Death from Suicide. Retrieved 9/28/21 from https://www.ptsd.va.gov/publications/rq_docs/V28N4.pdf 
2. Lipov, E. G., Jacobs, R., Springer, S., Candido, K. D., & Knezevic, N. N. (2022). Utility of Cervical Sympathetic Block in Treating Post-Traumatic Stress Disorder in Multiple Cohorts: A Retrospective Analysis. Pain Physician, 25(1), 77-85. Available from: https://www.painphysicianjournal.com/current/pdf?article=NzM5Nw%3D%3D

The following article refers to PTSD (Post-Traumatic Stress Disorder), whereas at Stella, we use the term PTSI (Post-Traumatic Stress Injury). We encourage you to adopt this language to break the stigma against Post-Traumatic Stress.  Read more about the shift from PTSD to PSTI here.

Individuals seeking relief from symptoms of post-traumatic stress, anxiety, and/or depression have many treatment options: pharmaceutical drugs, exposure therapy, EMDR, insight-oriented therapy, RTM, yoga, mindfulness-based stress reduction… The list goes on.

For many, the formula for lasting relief combines biological and psychological interventions. Think ketamine intravenous infusions plus group therapy or EMDR plus daily meditation.

The idea of researching all available treatments can be daunting. And deciding where to start our healing journey – or what to add to it – takes time and serious consideration. That’s where Stella comes in.

In this article, we explain the Stellate Ganglion Block by Stella and how it can treat symptoms of post-traumatic stress, anxiety, and/or depression. We’ll also describe how our Psychiatric Mental Health Nurse Practitioners create a custom care plan for each person they help.

What Is The Stellate Ganglion Block?  

When someone experiences a traumatic or highly stressful event, their body’s fight-or-flight response turns on, and sometimes it stays on long after the traumatic event. The over-activation of the fight-or-flight response can create extra nerve fibers in the brain, producing norepinephrine, a hormone responsible for increased heart rate and alertness, affecting sleep, mood, and memory. This culmination of events can lead to post-traumatic stress and its symptoms. Brain imagery data suggests that trauma causes a change that is visible in the brain, namely nerve growth around the amygdala.¹

The Stellate Ganglion Block (SGB) is an injection of local anesthetic into the stellate ganglion – a bundle of nerves in the neck – that helps restore normal biological function and has the potential to relieve even the most severe symptoms of trauma. This can stop the nerve growth that is occurring and eliminate or prune the extra nerve fibers that have been created, thereby resetting the amygdala to its pre-trauma state.²

Stella’s Chief Medical Officer Dr. Eugene Lipov published the first case report that explores the use of SGB to proactively address trauma symptoms. He suggests that the local anesthetic temporarily “turns off” the stellate ganglion, which has been sending signals via nerve pathways to the amygdala, causing nerve growth.²

Stella is committed to driving quality research on SGB. Dr. Lipov created the industry-leading method for administering SGB effectively and published the first unified theory of how SGB works. Our network of providers follows strict SGB safety and emergency protocols, developed by Dr. Lipov.

What Makes SGB by Stella Different?

Historically, SGB has been used for pain management. For this indication, SGB consists of a single injection on the right side of the neck.

After researching and testing many ways of administering SGB, Dr. Lipov found that two injections – known as the “Dual Sympathetic Reset” – yield the best results. The injections are made at vertebrae C6 and C4 (or C3) on the right side of the neck.

The Benefits of SGB by Stella

We do not require trauma histories.

To determine if someone is a good candidate for Treatment by Stella, they’ll schedule an initial consultation with a licensed Psychiatric Mental Health Nurse Practitioner (PMHNP). Stella’s PMHNP will review an individual’s symptoms and health history to create a custom care plan.

During this process, the PMHNP will never ask the individual to disclose anything about the trauma(s) they’ve experienced. The PMHNP simply needs to understand if the individual is experiencing symptoms that indicate the need for Stella’s biological interventions – like SGB or Ketamine Infusion Therapy.

SGB can accelerate the positive impact of existing treatments.

It can be difficult to attend therapy or make continual progress when symptoms of post-traumatic stress, anxiety, and/or depression are in control. After SGB, Stella’s patients report a sense of calm that allows them to be more present during therapy in ways that felt impossible before.

SGB can happen at any point on a healing journey.

Whether trauma was experienced months or decades ago, SGB may be a good treatment option.

Many of our patients are encouraged to learn that SGB is an effective treatment option regardless of gender, trauma type, age, PTSD-related medication use, or history of suicide attempts.⁴

SGB takes less than 20 minutes. 

The injection itself takes less than 20 minutes.

On the day of the procedure, individuals can expect to spend several hours at the treatment location to allow time to check in, twilight sedation (if available), SGB, and follow-up observations.

SGB is safe.

Who performs the Stellate Ganglion Block? Every Stella doctor is Board Certified and personally trained by Dr. Lipov in our proprietary methodology. We also require our doctors to use image guidance for correct needle placement.

What medication is used in a Stellate Ganglion Block? The local anesthetics Stella uses are Bupivacaine or Ropivacaine, both of which are FDA-approved.

Serious side effects are extremely rare.

Stella’s Clinical Approach

Stella takes a trauma-informed approach to treatment and communication. We recognize that everyone experiences and processes their symptoms of post-traumatic stress, anxiety, and/or depression differently. Our Care Team meets our patients exactly where they are. After an initial consultation with a Psychiatric Mental Health Nurse Practitioner (PMHNP) and the support of Stella’s Care Team, our patients can make an informed decision about the next step on their healing journey.

We respect our patients’ relationships with other mental health care providers, doctors, and healers. Our PMHNPs will work with each patient’s healthcare team to help them find lasting relief from symptoms of post-traumatic stress, anxiety, and depression.

PTSD Medications & SGB

Before determining if SGB is right for an individual, a PMHNP will review the individual’s list of current medications. Most prescription and over-the-counter medications do not interact with either of the local anesthetics – Bupivacaine or Ropivacaine – that Stella doctors use for SGB.

Like many other medical procedures and surgeries, Stella requires that blood thinners be stopped a few days before the SGB procedure, as they can cause problems.

SGB & Other Therapies

The Stellate Ganglion Block (SGB) is just one part of the healing journey. When someone feels out of control in their body or alone in a room full of people, SGB has the potential to restore the sense of calm and clarity they crave. And when paired with skilled therapy, SGB can be life-changing.

Mental health care providers can help maximize and maintain SGB’s positive impacts. For example, when someone isn’t distracted by their symptoms, it becomes easier to be fully present during therapy sessions and thus integrate takeaways into everyday life.

We think that those who received SGB by Stella put it best:

“I’m not as fearful or panicked as I was, but I’m still working through my anxiety with my therapist. She has hope for me and feels like I have made a good leap in my process.” 

“I feel like [SGB] has been a HUGE turning point in my healing. It’s allowed me to start a spiritual 12-step program that requires intense vulnerability in a group setting. I can feel appropriate emotions but not get triggered by others’ trauma. This is a first.”

If you’re a mental healthcare provider looking to join Stella’s mission to end the needless suffering caused by emotional trauma, please find more information about how to collaborate with Stella here.

How To Learn More

You can read up on this breakthrough treatment on the How SGB Works page of our website.

Call our Care Advocates at (908) 928-4086 to schedule your initial consultation with a Psychiatric Mental Health Nurse Practitioner. You’ll work together to determine if SGB is the next right step in your healing journey.

1. Alkire, M.T., Hollifield, M., Khoshsar, R., Nguyen, L., Alley, S. R., and Reist, C. (2015). Neuroimaging suggests that stellate ganglion block improves post-traumatic stress disorder (PTSD) through an amygdala mediated mechanism. Presented at the Anesthesiology Annual Meeting, October 24, 2015.
2. Eugene G.LipovaJaydeep R.JoshiaSarahSandersaKonstantin V.Slavinb A unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD) https://www.sciencedirect.com/science/article/abs/pii/S0306987709000413
3. U.S. Department of Veterans Affairs. (2018, September 13). How Common is PTSD in Adults? U.S. Department of Veterans Affairs. Retrieved February 2, 2022, from https://www.ptsd.va.gov/understand/common/common_adults.asp 
4. Lipov, E. G., Jacobs, R., Springer, S., Candido, K. D., & Knezevic, N. N. (2022). Utility of Cervical Sympathetic Block in Treating Post-Traumatic Stress Disorder in Multiple Cohorts: A Retrospective Analysis. Pain Physician, 25(1), 77-85. Available from: https://www.painphysicianjournal.com/current/pdf?article=NzM5Nw%3D%3D 

The following article refers to PTSD (Post-Traumatic Stress Disorder), whereas at Stella, we use the term PTSI (Post-Traumatic Stress Injury). We encourage you to adopt this language to break the stigma against Post-Traumatic Stress.  Read more about the shift from PTSD to PSTI here.

At Stella, we continue to innovate in trauma treatments like our lives depend on it – because they do.

Before the COVID-19 pandemic, it was estimated that 6% of the U.S. adult population would struggle with symptoms following trauma exposure at some point in their lives, with 15 million suffering from trauma symptoms each year.¹ At Stella, we believe the additional burden of psychological trauma beginning in 2020 is hard to calculate. 

In addition to this unprecedented health crisis, other factors –  a fight against systemic racism, intense political division, growing concerns about climate change, and economic uncertainty – created additional traumas and highly stressful experiences, which we know can cause PTSD (which Stella refers to as PTSI), anxiety, and depression.

Those seeking relief from trauma symptoms, anxiety, and depression deserve cutting-edge care. We believe in treatment plans that are practical, informed by modern neuroscience, and, most of all, effective.

To help the people we treat achieve the best possible outcomes, we listen to each individual’s needs and collaborate with their support system of skilled mental health care providers, attentive doctors, empathetic healers, and compassionate family and friends. 

Treatment by Stella is just one aspect of the healing journey. We believe that when our biological interventions – like the Stellate Ganglion Block (SGB) and ketamine infusion therapy – are paired with psychological interventions, the result can be life-changing. This is the new model of trauma treatment. And it’s what people in need of relief deserve. 

Stella is ushering in breakthrough treatments for trauma symptoms, anxiety, and depression. Our treatments are fast, effective, and research-backed. If you’re considering SGB or ketamine infusion therapy by Stella, here are some advantages.

1. Breaking Down The Barriers To Seek Treatment

One of the primary barriers to seeking trauma treatment is overcoming its stigma. Stigma is often used in mental health conversations;  we feel it is important to define it for the purposes of this article.

Shame, disgrace, and dishonor also capture the idea of the stigma around mental health. 

The truth is that it’s ok to need help and to ask for it. This is why Stella exists. We’re relentlessly committed to the care of those experiencing trauma symptoms. We’ll listen to you to understand what you’re going through and learn how we may be able to help. We’ll never judge or make assumptions about you or your experiences.

So why is there a stigma associated with trauma, anxiety, and depression? Historically, experiencing these conditions – let alone seeking relief from them – was considered taboo. For this reason, we may have avoided or waited to seek treatment because we were worried about being treated differently or unfairly. 

Stigma is driven by a lack of information, myths, and fear. Misrepresentations of people diagnosed with trauma symptoms, anxiety, and depression add fuel to the fire. 

In addition to stigma, we may avoid seeking treatment because we think that it requires us to relive their trauma. At Stella, we’ll never ask about personal trauma histories. 

To determine who may be a good candidate for treatment, we need to know which symptoms are being experienced to understand the severity, and we’ll complete a health review. We can collect this information through online forms or over the phone. This helps us confirm that SGB and/or ketamine infusion therapy is right for each unique individual.

2. SGB and Ketamine Infusion Therapy by Stella Are Effective 

Advances in neurobiological models of PTSD (which Stella refers to as PTSI) allow Stella to deploy effective treatments. We know that the greatest possible relief occurs when biological and psychological treatments are used together strategically. 

The American Journal of Psychology called ketamine infusion therapy “one of the most important breakthroughs in antidepressant treatment in decades.”² Ketamine infusion therapy caused a paradigm shift in the treatment of major depressive disorder and treatment-resistant depression because it can decrease symptoms within hours instead of weeks or months. This finding is incredibly encouraging because when we’re struggling with depression, we might not be able to wait for relief. 

Research about SGB is equally compelling. Studies consistently indicate that it can reduce symptoms following trauma by 50% and that it’s particularly helpful in improving symptoms of irritability, surges of anger, difficulty concentrating, and trouble falling or staying asleep.³

When we are no longer overwhelmed by symptoms, we are much more willing and able to incorporate new learnings from therapy into our daily lives. We may also discuss topics that before would have been too overwhelming. 

More than 83% of people who receive SGB by Stella experience relief from symptoms of trauma.⁴

3. Stella Customizes Your Treatment Plan

Stella will meet your needs before, during, and after treatment. 

Before Treatment

Our Patient Care Team will review symptoms and medical history to determine who is a good candidate for treatment. From there, we will customize a treatment plan. Depending on the symptoms, they may recommend SGB, ketamine infusion therapy, or both. 

On Treatment Day

Stella is committed to the principle of trauma-informed care with the goal of making the people in our care feel safe. We take common triggers and preferences into account so others don’t have to. 

After Treatment 

Stella provides the people we work with concierge-level access to a network of mental healthcare professionals which allows for further healing after SGB and/or ketamine infusion therapy. 

Our Patient Care Team will check in to measure symptoms and ensure we are providing proper follow care and resource.

After being treated by Stella, some schedule a follow-up SGB or additional ketamine infusion therapy sessions. Our Patient Care Team will thoroughly explain all options so an informed decision can be made. 

More on Ketamine Infusion Therapy by Stella 

Ketamine infusion therapy by Stella is administered by trained personnel under the direction of a Board Certified Doctor who carefully monitors dosing and makes real-time adjustments as needed. Unlike other ketamine providers, we do not ask those in our care to participate in talk therapy during the infusion session. 

Most treatment locations allow people to bring their own music and a family member or friend. This allows them to set the tone of their infusion session. 

More on SGB by Stella 

In our article How the Stellate Ganglion Block (SGB) Can Augment Treatment Plans we explain what SGB is, highlight its benefits, and discuss how it works in combination with therapy and/or medications. 

Ready To Kickstart Lasting Relief? 

A consultation could change everything. Contact our Patient Care Team directly by calling 1-866-497-9248 or emailing care@stellacenter.com

1. U.S. Department of Veterans Affairs. (2018, September 13). How Common is PTSD in Adults? U.S. Department of Veterans Affairs. Retrieved February 2, 2022, from https://www.ptsd.va.gov/understand/common/common_adults.asp 
2. Newport, D. J., Carpenter, L. L., McDonald, W. M., Potash, J. B., Tohen, M., Nemeroff, C. B., & APA Council of Research Task Force on Novel Biomarkers and Treatments. (2015). Ketamine and other NMDA antagonists: early clinical trials and possible mechanisms in depression. American Journal of Psychiatry, 172(10), 950-966. Available from: https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2015.15040465#B1 
3. James H. Lynch. Stellate ganglion block treats posttraumatic stress: An example of precision mental health. 28 August 2020. From https://onlinelibrary.wiley.com/doi/10.1002/brb3.1807
4. Lipov, E., Ritchie, E.C. A Review of the Use of Stellate Ganglion Block in the Treatment of PTSD. Curr Psychiatry Rep 17, 63 (2015). https://doi.org/10.1007/s11920-015-0599-4. Available from: https://link.springer.com/article/10.1007/s11920-015-0599-4; Navaie, M., Keefe, M.S., Hickey, A.H., Mclay, R.N., Ritchie, E.C., & Abdi, S. (2014). Use of stellate ganglion block for refractory post-traumatic stress disorder: A review of published cases. Journal of Anesthesia and Clinical Research, 5(4), [1000403]. https://doi.org/10.4172/2155-6148.1000403