Cervical Sympathetic Blockade Produces a Significant Reduction in Suicidal Ideation in a PTSD Cohort: A Case Series of 254 Patients

Background: Suicide is estimated to account for 1.4% of deaths worldwide, making it among one the leading causes of premature death. Stellate ganglion block (SGB) has been shown to reduce suicidal ideation in a single case report of a patient with comorbid post-traumatic stress disorder (PTSD) and suicidal ideation. Aims: To report a significant reduction of suicidal ideation using cervical sympathetic block (CSB), a more advanced version of SGB, in a cohort of patients with PTSD. Methods: 254 patients were evaluated for suicidal ideation via pre- and post-suicide risk assessments by using the Depressive Symptom Index - Suicidality Subscale (DSI-SS) as part of a pre- and post-treatment clinical interview. Further included were other psychiatric measures. Patients received CSB as per clinic protocol. Results: Overall, the patients had an average DSI-SS reduction of 43.8%, PCL-5 reduction of 31.7%, GAD-7 reduction of 22.5%, and PHQ-9 reduction of 35.5%, following CSB. Limitations: Lack of control, given this is an open-labeled, case series study. Conclusion: Cervical sympathetic block is a safe and minimally invasive procedure that may provide significant reduction in suicidal ideation as well as symptoms of PTSD.