How does PTSD involve the nervous system?
Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after living through or witnessing a traumatic event, such as combat, violence or a disaster. Alongside the memories, it often shows up in the body.
Being easily startled, feeling tense or on edge and having trouble sleeping are among its common arousal symptoms. These are signs of a fight-or-flight response that keeps firing after the threat is over.
Where does the stellate ganglion come in?
The stellate ganglion is a cluster of sympathetic nerves in the neck, part of the body's fight-or-flight pathway. There is one on each side.
A stellate ganglion block places a local anesthetic beside it to quiet that signal for a time. A dual stellate ganglion block (DSGB) treats both sides.
Two consecutive days with Dr. Meighen
The Reboot Protocol™ is an ultrasound-guided dual stellate ganglion block given over two consecutive days. The right side is done on day one and the left side on day two. Dr. Michael Meighen does the day-one consultation and nervous system evaluation himself and performs both injections.
After each injection, the team monitors you for 30 to 45 minutes. Patients are able to drive themselves home afterward, and where there is a concern, the clinic arranges a driver. Dr. Meighen walks you through what happens on each day of the block before you begin.
What does the research show?
The largest trial so far, published in JAMA Psychiatry in 2020, enrolled 113 active-duty service members at three Army sites. Two right-side blocks, two weeks apart, improved PTSD symptoms more than a sham injection over 8 weeks.
The authors note the short follow-up and mostly mild to moderate symptoms. The VA's patient guide says the evidence is inconclusive and the long-term effects are unknown, and Cleveland Clinic describes the evidence as mixed.
That trial blocked the right side only. The two-sided approach has less published evidence, and using a stellate ganglion block for PTSD is off-label.
Does it replace trauma-focused therapy?
No. The VA lists trauma-focused psychotherapy and medication as the established treatments for PTSD. It says a stellate ganglion block may help when combined with therapy such as prolonged exposure, cognitive processing therapy or EMDR.
Reboot Vitality does not provide talk therapy or psychiatry. The protocol sits beside the work you do with your therapist or doctor, and you keep taking any medication as prescribed. Your evaluation decides whether it fits, as part of how the clinic evaluates and treats PTSD.
Who may it not suit, and what are the side effects?
A block may be the wrong choice if you take a blood thinner, have a bleeding problem or have an infection where the injection goes. The same applies if you have reacted to a local anesthetic, are pregnant or have a heart or lung condition. A very slow heartbeat or severe lung disease such as COPD needs a check first.
Recent thoughts of suicide mean crisis care comes first.
Common effects usually pass within a few hours: a droopy eyelid or smaller pupil, a red or watery eye, a stuffy nose, a hoarse voice or some trouble swallowing. The arm on that side can feel warm, heavy or numb. Serious complications such as infection, bleeding, nerve injury, a collapsed lung or an allergic reaction are rare.
Trouble breathing, chest pain or swelling in the neck afterward needs care now: call 911.
Where does it sit in the four phases?
The protocol belongs to the first of four phases, which calms the stress response first. Later phases look for other factors through testing and targeted therapies, if your evaluation calls for them.
BrainTap, a headset that uses binaural beats with light and guided audio, also sits in the first phase, Reset. Dr. Meighen decides with you what fits.
What if you are in crisis right now?
Call or text 988, the Suicide and Crisis Lifeline, any time. Veterans press 1 for the Veterans Crisis Line. In an emergency, call 911. Reboot Vitality does not provide emergency or crisis care.
Common questions
How many injections does the Reboot Protocol™ involve?
Two. One stellate ganglion block on each side, right side first and left side the next day, each placed under real-time ultrasound and followed by monitoring.
Is a stellate ganglion block for PTSD off-label?
Yes. Using a stellate ganglion block for PTSD is off-label. Dr. Meighen explains what that means for you, and what the research does and does not show, before anything is scheduled.
Do I have to stop therapy or medication?
No. Keep seeing your therapist, and keep taking any medication as prescribed. Never stop a medication without talking to the doctor who prescribed it. The protocol is used alongside the care you already have.
Who performs the injections?
Dr. Michael Meighen performs both injections himself, each under real-time ultrasound. He also does your consultation and nervous system evaluation on day one, before anything is scheduled.