Acupuncture for Depression

The research on acupuncture for depression is promising, but unclear. While there have been several controlled trials of acupuncture for depression, none have had an excellent study design.

Acupuncture has been found to be as effective as medications in treating depression in most trials. However, it does not seem to matter which points in the body receive the acupuncture needles (whether they are acupuncture points associated with depression, acupuncture points not associated with depression or just random points). There is also some evidence that electro-acupuncture might be more effective than traditional acupuncture for depression.

Acupuncture does not yet have solid evidence for depression, but it might be effective and has positive side-effects, including relaxation and strenghtening the immune system.

Research

Röschke, J. The benefit from whole body acupuncture in major depression. Journal of Affective Disorders, Volume 57, Issue 1 - 3, Pages 73 - 81.

In a single-blind placebo-controlled study design we investigated the efficacy of acupuncture additionally applied to drug treatment in major depression. We randomly included 70 inpatients with a major depressive episode in three different treatment groups: verum acupuncture, placebo acupuncture and a control group. All three groups were pharmacologically treated with the antidepressant mianserin. Results: Patients who experienced acupuncture improved slightly more than patients treated with mianserin alone. However, we could not detect any differences between placebo and verum acupuncture.

Allen, J. Schnyer, R. Hitt, S. The Efficacy of Acupuncture in the Treatment of Major Depression in Women. Psychological Science. Volume 9 Issue 5, Pages 397 - 401.

The effectiveness of acupuncture as a treatment for major depression was examined in 38 women, randomly assigned to one of three treatment groups. Specific treatment involved acupuncture treatments for symptoms of depression; nonspecific treatment involved acupuncture for symptoms that were not clearly part of depression; a wait-list condition involved waiting without treatment for 8 weeks. Results from this small sample suggest that acupuncture can provide significant symptom relief in depression, at rates comparable to those of psychotherapy or pharmacotherapy.

Luo H, Clinical research on the therapeutic effect of the electro-acupuncture treatment in patients with depression. Psychiatry Clin Neurosci. 1998 Dec;52 Suppl:S338-40.

Electroacupuncture (EA) stimulation has been found to influence the brain (norepinephrine metabolism in experimental animals). Preliminary clinical research has shown that EA treatment is as effective as amitriptyline for patients with depression. In this study, two consecutive clinical studies on the treatment of depression with EA are conducted. The first study was double blind placebo controlled, in which 29 depressed inpatients were recruited. Patients were randomly divided into three groups: EA + placebo; amitriptyline; and EA + amitriptyline. They received EA and/or amitriptyline treatment for 6 weeks. The Hamilton Rating Scale for Depression, Clinical Global Impression and ASBERG scales for the side effect of antidepressants were used to evaluate the therapeutic efficacy and side effects. Based on the results and research protocol of the first study, a multi-centered collaborative study was conducted, in which 241 inpatients with depression were recruited. Patients were randomly divided into two treatment groups: the EA + placebo and the amitriptyline groups. The results from both studies showed that the therapeutic efficacy of EA was equal to that of amitriptyline for depressive disorders (P > 0.05). Electro-acupuncture had a better therapeutic effect for anxiety somatization and cognitive process disturbance of depressed patients than amitriptyline (P < 0.05). Moreover, the side effects of EA were much less than that of amitriptyline (P < 0.001). The article suggested that EA treatment was an effective therapeutic method for depressive disorders. Particularly, it was a treatment of choice for depressed patients who were unable to comply with the classic tricyclic antidepressants because of their anticholinergic side effects. The possible mechanism of EA treatment is discussed.

Smith CA, Hay PP. Acupuncture for depression. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD004046.

This review examined the efficacy and adverse effects of acupuncture for depression by reviewing studies on six databases. Inclusion criteria included all published and unpublished randomised controlled trials comparing acupuncture with sham acupuncture, no treatment, pharmacological treatment, other structured psychotherapies (cognitive behavioural therapy, psychotherapy or counselling), or standard care. Meta analysis was performed using relative risk for dichotomous outcomes and weighted mean differences for continuous outcomes, with 95% confidence intervals. Primary outcomes were reduction in the severity of depression, measured by self rating scales, or by clinician rated scales; and an improvement in depression defined as remission vs no remission. In seven trials including 517 participants, there was no evidence that medication was better than acupuncture in reducing the severity of depression (WMD 0.53, 95%CI -1.42 to 2.47), or in improving depression, defined as remission versus no remission (RR1.2, 95%CI 0.94 to 1.51). However, scientific study design was poor and the number of people studied was small.

Manber, R. Acupuncture: a promising treatment for depression during pregnancy. Journal of Affective Disorders 83 (2004) 89–95.

Compared active acupuncture to active control acupuncture and massage in depression relief for pregnant women. While the study size was very small, it found active acupunture to decrease depressive symptoms at rates similar to medications and therapy. The researchers call for further investigation since their numbers were small and the blind was inadequate.

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