Stellate Ganglion Block (SGB) for Depression

Stellate Ganglion Block (SGB) for Depression

Kimberly Mercille • May 27, 2025

Stellate Ganglion Block (SGB) is an emerging mental health treatment that targets key mechanisms linked to depression. In this article, we’ll discuss the science behind SGB and its potential benefits. If you or someone you know is struggling with depression, this information can help you make an informed decision about whether SGB might be the right option.

What is a Stellate Ganglion Block (SGB)?

What is the Stellate Ganglion?

The stellate ganglion is a cluster of sympathetic nerves located on each side of the neck near the first rib. These nerves are part of the autonomic nervous system, which controls automatic body functions like heart rate, blood pressure, and digestion.

The term "stellate" means "star-shaped" because the ganglion often looks like a star under a microscope. It helps regulate the body's stress response by controlling norepinephrine, a chemical that triggers the fight-or-flight reaction.

When this system becomes overactive, it can cause various physical and psychological problems, including depression. Stellate ganglion block (SGB) therapy may help by reducing the activity of the stellate ganglion, calming the fight-or-flight response, and lessening the damaging effects of prolonged nervous system stress.

How Does Stellate Ganglion Block Work?

Stellate Ganglion block (SGB) is when a local anesthetic is injected near the stellate ganglion. These drugs inhibit transmission between nerve cells, dampening activity in the ganglion. They typically include lidocaine, bupivacaine, or mepivacaine, which are sometimes combined with a steroid medication. Patients may also receive another medication to relax them before treatment.

SGB is typically performed using ultrasound guidance. The injection process lasts no more than 10 minutes, but patients will motinoted for another 30-45 minutes after treatment to ensure their safety.

How Does Stellate Ganglion Block Work for Depression?

Chronic stress is a major contributor to depression and is often linked to an overactive sympathetic nervous system. People with depression commonly show high levels of cortisol, a hormone that plays a key role in the body's stress response, in their blood stream. Cortisol is helpful in small doses, but when chronically elevated, it can disrupt neural circuits in the brain.

Excessive cortisol can lead to:

  • Neurotoxicity - Cortisol can be toxic to nerve cells, especially in the hippocampus, which is crucial for memory and emotional regulation.
  • Overinflammation - Cortisol increases the activity of the body’s natural defense system, resulting in the system causing damage to nerve cells.
  • Impaired synaptic plasticity - Cortisol inhibits the capacity for the brain to “re-wire” itself. This makes it harder for people to adapt to stressful situations and learn new patterns of behaviour.  
  • Disrupted sleep - High cortisol can prevent people from sleeping well. During sleep, restorative biological processes occur in the brain, and excess cortisol can prevent these from happening.

SGB decreases sympathetic nervous system activity, which can reduce cortisol levels. This can help restore function in brain areas and pathways associated with positive mood, emotional regulation, and stress resilience.

Evidence Supporting SGB for Depression

To date, there’s very limited evidence supporting the use of SGB for depression. One pilot study found that SGP significantly reduced depression symptoms in people with treatment-resistant depression (TRD) and was well-tolerated. However, there was no significant difference to the placebo group and the sample size was very small.

Nonetheless, multiple lines of research show that SGB can alleviate symptoms of post-traumatic stress disorder (PTSD), which shares similarities with depression. In a trial of SGB for PTSD, participants reported significantly lower scores of depression following treatment.

Who May Benefit from SGB for Depression?

SGB is primarily utilized for treating PTSD, so individuals with PTSD who also experience depression may find SGB beneficial. Additionally, SGB has shown potential in alleviating anxiety symptoms, suggesting it may be advantageous for those dealing with both depression and anxiety.

Because SGB isn’t approved by the FDA, it is typically only used when standard treatments like antidepressants and psychotherapy haven’t worked. SGB is an “off-label” treatment, much like ketamine therapy or brain stimulation therapies.

Importantly, SGB may not be suitable for everyone because of medical reasons. Contraindications include:

  • Recent myocardial infarction
  • Coagulopathy or anticoagulant therapy
  • Glaucoma
  • Pre-existing contralateral phrenic nerve palsy
  • Severe emphysema
  • Cardiac conduction block


Potential Risks and Side Effects of SGB

Common Side Effects

Most side effects of SGB are temporary and resolve as the anesthetic wears off. These may include:

  • Hoarseness or Voice Changes: The proximity of the stellate ganglion to nerves controlling the voice box can lead to temporary hoarseness.
  • Drooping Eyelid (Ptosis): Temporary drooping of the eyelid on the side of the injection may occur.
  • Red or Bloodshot Eyes: Some individuals may notice redness in the eyes following the procedure.
  • Watery Eyes and Nasal Congestion: Increased tearing and nasal stuffiness are possible but typically short-lived.
  • Sensation of a Lump in the Throat and Difficulty Swallowing: Some individuals may experience a sensation of a lump in the throat and have difficulty swallowing after the procedure.
  • Warmth or Tingling in the Arm or Hand: A warm or tingling sensation in the affected limb may be experienced temporarily.

Although uncommon, some individuals may experience more serious complications, such as nerve damage, seizures, and allergic reactions.

Given the potential risks, patients interested in SGB at the Albany Clinic will have an in-depth consultation with one of our qualified healthcare professionals before undergoing treatment. They can assess your medical history, current health status, and the potential benefits and risks of the procedure in your specific case.


SGB for Depression in Illinois

If you're in the Carbondale area and interested in the potential benefits of SGB for depression, the Albany Clinic is here to help. We specialize in innovative mental health treatments, including SGB, which has been shown to provide rapid relief from mental health symptoms, with effects lasting several weeks. Our experienced team offers personalized support, guiding you through every step—from determining if SGB is the right option for you to exploring alternative treatments and financial considerations. Contact us today to learn more about how we can support your mental health journey.

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SGB for Long COVID: Can a Nerve Block Help Ease Symptoms?

By Matt Rodriguez • May 7, 2025
Long COVID is a condition in which symptoms–such as brain fog, fatigue, and shortness of breath—persist for months after a COVID-19 infection. Researchers are still working to understand why this happens and how to treat it. One potential therapy being explored is the stellate ganglion block (SGB) , a procedure that numbs a cluster of nerves in the neck. In the article, we’ll explore the science behind SGB and long COVID and the evidence supporting its use.

Insurance-Backed Options for Depression Treatment in Illinois

By Matt Rodriguez • April 1, 2025
Finding effective depression treatment can be challenging, especially when cost and insurance coverage add to the stress. Fortunately, for individuals in Illinois, several advanced, insurance-backed options are available beyond traditional antidepressants and therapy. This article explores innovative treatments for depression that are available at our Albany Clinic in Carbondale. Addressing the Need for Affordable Depression Relief in Illinois Depression remains a significant public health concern in Illinois. In 2023, data showed that 18.1% of all adults in the state had a doctor's diagnosis of a depressive disorder . Traditional first-line treatments for depression include medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). However, these are not universally effective; approximately one-third of patients are treatment-resistant. Even when these medications do work, they often take a long time to produce noticeable improvements, and unpleasant side effects can deter their use. Talk therapies , such as cognitive behavioral therapy (CBT) and psychodynamic therapy, are also strongly recommended. These treatments can have hugely beneficial effects, but it can require a lot of time commitment for results to show. Moreover, not all therapists accept insurance–especially for those practicing more specialized forms–making the treatment inaccessible for many. Spravato (Esketamine) for Depression What is Spravato, and how does it work? Spravato is an FDA-approved nasal spray that contains esketamine, a derivative of ketamine. Like ketamine, esketamine treats depression by interacting with NMDA receptors , proteins that play a key role in learning and memory. This interaction triggers several neurological processes, including neuroplasticity —the strengthening and forming of connections between nerve cells. Enhanced plasticity may improve the function of nerve circuits responsible for mood regulation, increasing overall well-being. A typical Spravato treatment involves sessions administered under medical supervision, starting with twice-weekly doses and then tapering as appropriate. Whereas antidepressants typically take around four weeks to show an effect, Spravato can have rapid action at alleviating symptoms. A study found that Spravato significantly reduced depression symptoms compared to a placebo drug within just 24 hours of administration. Does Insurance cover Spravato? Due to its FDA approval, Spravato is covered by most major insurance plans in Illinois, including Medicare and Medicaid. However, only patients with a formal diagnosis of treatment-resistant depression (TRD) or major depressive disorder with suicidal ideation (MDSI) are eligible for the treatment. While the medication is usually covered by insurance, patients may still have out-of-pocket costs , including copays , deductibles , and pre-treatment medical evaluations . Your exact expenses will depend on your specific insurance plan. At the Albany Clinic, we’re here to help you understand your costs and maximize your coverage. Transcranial Magnetic Stimulation (TMS) Therapy What is TMS, and how does it work? TMS therapy is a noninvasive procedure that uses magnetic fields to stimulate underactive regions of the brain associated with mood regulation. In depression, TMS targets the dorsolateral prefrontal cortex (DLPFC) , which is often less active in individuals with the condition. TMS therapy works by: Inducing electrical activity in neurons , prompting the release of neurotransmitters involved in mood and motivation. Increasing the activity of neural circuits responsible for mood regulation. Enhancing neuroplasticity , potentially “re-wiring” nerve circuits associated with unhealthy thinking and behavior. The treatment protocol typically consists of daily sessions over several weeks. Each session lasts about 20-40 minutes, during which patients remain awake and alert. Does insurance cover TMS? Since TMS therapy is FDA-approved, some major insurance providers in Illinois cover costs, but unfortunately, the state’s Medicaid does not. If you're considering TMS, check with your insurance provider to see if your plan includes coverage, as eligibility and benefits vary. At the Albany Clinic, we're here to help clarify details and explore options to make treatment more affordable. IV Ketamine Infusion Therapy What is an IV ketamine infusion and how does it work? IV ketamine infusion therapy involves administering ketamine intravenously at sub-anesthetic doses . This approach has shown rapid and robust antidepressant effects, especially in individuals with treatment-resistant depression. IV ketamine shares the same mechanism as Spravato but tends to have more rapid-acting effects. A standard course includes multiple infusions over a set period, with each session lasting approximately one hour. Does insurance cover IV ketamine? Unlike Spravato and TMS, IV ketamine infusion therapy is not FDA-approved for depression treatment and instead is used “ off-label .” This means most insurance plans don’t accept ketamine, and coverage is limited. However, some insurance companies may reimburse some of the treatment costs, such as the evaluation and management part. At the Albany Clinic, we’ll provide you with all the documentation to submit a claim to your insurance provider, but full payment is required before each procedure. Navigating Insurance for Depression Treatment Understanding insurance coverage for depression treatments can be complex. Here are steps to help streamline the process: Verify Coverage : Contact your insurance provider to inquire about treatment coverage specifics. Some insurers require a history of treatment failures with traditional antidepressants before approving coverage for these advanced therapies. Obtain Pre-Authorization : Many insurers require pre-authorization for certain treatments. Ensure all necessary approvals are secured before initiating therapy. The Albany Clinic's administrative team can assist in submitting pre-authorization requests. Understand Financial Responsibilities : Clarify any co-pays, deductibles, or out-of-pocket expenses associated with your treatment plan. Consult Our Team : The Albany Clinic's administrative staff is experienced in navigating insurance processes and can assist you in understanding and managing the financial aspects of your treatment. We also provide financial counseling to help patients explore payment plans and reimbursement options. Going Forward Navigating insurance for depression treatment can be complex, but you don’t have to do it alone. At The Albany Clinic , we’re dedicated to helping patients access effective, insurance-backed treatments while minimizing out-of-pocket costs. Contact us today to learn more about your options and take the next step toward relief.

Creating a Social Anxiety Treatment Plan at The Albany Clinic: Steps for Better Mental Health

By Matt Rodriguez • March 3, 2025
Struggling with a social anxiety disorder (SAD) can feel isolating and overwhelming, especially when other medications haven’t proved effective. However, ketamine therapy offers a promising path forward, showing fast and significant relief from SAD symptoms. At The Albany Clinic in Albany, New York, we provide customized ketamine treatment plans designed to empower patients to overcome the challenges of SAD. Read on to explore the science and benefits of this transformative approach. Understanding Social Anxiety Disorder Social Anxiety Disorder (SAD), often referred to as social phobia, is a chronic mental health condition characterized by extreme fear and discomfort in social situations. While occasional nervousness in social settings is normal, social anxiety disorder is more persistent and can significantly disrupt daily life, relationships, and career opportunities. According to the National Institute of Mental Health (NIMH) , 7.1% of the U.S. population experiences social anxiety disorder annually. Recognizing the Symptoms of SAD The symptoms of social anxiety disorder can be grouped into three categories: emotional, behavioral, and physical. Emotional Symptoms: Intense fear of social interactions, particularly with strangers. Persistent worry about being judged or negatively evaluated. Excessive anxiety about upcoming social events, often for weeks in advance. Overwhelming self-consciousness in social environments. Behavioral Symptoms: Avoidance of social situations. Skipping school, work, or events to avoid social interaction. Relying on alcohol or other substances to ease anxiety in social settings. Physical Symptoms: Sweating, trembling, dry mouth, or muscle tension. Panic attacks in extreme cases. At The Albany Clinic, we understand the debilitating impact of these symptoms and offer ketamine therapy as a groundbreaking approach to address SAD. Our compassionate team is dedicated to creating personalized treatment plans tailored to each patient’s unique needs. How Ketamine Therapy Helps Treat Social Anxiety Ketamine has emerged as a promising treatment for social anxiety disorder due to its unique mechanism of action. Unlike traditional treatments, ketamine interacts with NMDA receptors in the brain, enhancing neuroplasticity —the brain’s ability to form new neural connections. This process can help improve brain function in areas related to stress and emotional regulation, potentially improving symptoms of SAD. Brain scanning experiments show ketamine alters connectivity in a brain region called the anterior insular cortex , which is thought to play a key role in social emotions. Studies suggest that this region may become dysfunctional in SAD, but ketamine could help restore its normal function and reduce SAD symptoms. Ketamine also lowers the activity of the amygdala , a brain region linked to fear and the body’s stress response. In people with anxiety, the amygdala is often overactive. Ketamine may help by calming this overactivity and reducing feelings of fear. Benefits of Ketamine for SAD Ketamine offers several benefits for treating SAD . One of its most significant advantages is its rapid action , often providing relief within hours, compared to the weeks or months traditional antidepressants can take. Additionally, ketamine has shown sustained effects , with a single dose sometimes improving symptoms for days or even weeks. Whereas common anti-anxiety medications, such as antidepressants, are used every day, ketamine is used more infrequently . A typical dosing regime involves twice-weekly sessions for the first four weeks, with more spaced-out sessions thereafter. This prevents people from developing tolerance to the drug, so they don’t experience withdrawal symptoms once they stop taking medication. However, ketamine does have an abuse potential , and ketamine addiction can lead to severe health consequences. For this reason, it’s essential to use ketamine in carefully controlled clinical environments under medical supervision, such as our clinic in Albany. Typical anti-anxiety medication is also associated with side effects that affect daily function, such as weight gain or sexual dysfunction . Ketamine, on the other hand, has mild side effects that generally wear off once the drug is cleared from the system. These include: Dizziness Decreased heart rate and blood pressure Drowsiness Nausea Research Supporting Ketamine for Social Anxiety A clinical trial from Yale University found ketamine infusions significantly decreased measures of social phobia in anxiety patients, compared to a placebo drug. The difference in improvement was significant from two days post-treatment and lasted up to the two-week follow-up. In another study from the University of Otago, patients with both generalized anxiety disorder (GAD) and SAD had significantly improved symptoms two weeks following ketamine treatment. These patients had been previously non-responsive to other therapies. Is Ketamine Therapy Right for You? Ketamine therapy is not suitable for everyone, but it can be highly effective for those who have not found relief with traditional treatments. You may be a good candidate if: You have been diagnosed with SAD, or another severe form of anxiety Conventional medications or therapies have not provided sufficient relief You are seeking a treatment with faster results However, ketamine therapy may not be recommended if you have: A current or past history of substance abuse You have specific liver or heart conditions You have a history of psychosis At The Albany Clinic, our experienced providers will carefully evaluate your medical history to determine if ketamine therapy is the best option for you. Building a Social Anxiety Treatment Plan at The Albany Clinic Step 1: Initial Consultation Your journey begins with a complimentary consultation to discuss whether ketamine therapy is suitable for you. During this session, our team will answer your questions, assess your mental health history, and develop a personalized treatment plan aligned with your recovery goals. Step 2: Ketamine Infusion Therapy Infusion sessions at The Albany Clinic are conducted in a modern , calming environment designed to put you at ease. Patients are provided with headphones , eye masks , and curated music playlists , though you are welcome to bring your own music if preferred. Each infusion session lasts about 40 minutes , during which time you’ll receive an injection of ketamine directly into the bloodstream through a vein. A dedicated provider will be present throughout your session to monitor your safety and comfort. Step 3: Lifestyle Adjustments and Aftercare Most patients require a series of treatments for optimal results. However, successful management of social anxiety extends beyond therapy sessions. Our team offers tailored aftercare guidance to help you integrate the positive effects of ketamine therapy into your daily life, promoting long-term well-being.  Interested? If you are struggling with social anxiety disorder and looking for an innovative approach to enhance your mental health, The Albany Clinic in Albany, NY, offers expert-led ketamine therapy designed to meet your needs. Our compassionate team is committed to providing evidence-based treatment plans to help you regain control and live a fulfilling life. To find out if ketamine therapy is the right choice for you, schedule a complimentary consultation with one of our specialists today.