Researchers at the University of York conducting a randomised trial of 755 patients, have found that acupuncture plus usual care is significantly more effective for depression, compared with usual care alone.
Patients were recruited from 27 North of England GP practices, all having consulted their GP for moderate-to-severe depression in the preceding five years. They were randomised to receive up to 12 weekly sessions of acupuncture plus usual care (302 patients), up to 12 weekly sessions of counselling plus usual care (302 patients), or usual care alone (151 patients). Usual care, including anti-depressants, was available according to need, and monitored in all three groups; at the outset, 69% of patients were taking anti-depressants, and nearly half were taking painkillers.
Compared to usual care alone, there was a significant improvement in symptoms at both 3 and 6 months for both the acupuncture and counselling interventions. Painkiller use by the acupuncture group showed a particularly marked decrease during the trial, but this was not sustained at follow-up.
(Acupuncture and Counselling for Depression in Primary Care: A Randomised Controlled Trial. PLOS Medicine, September 2013. http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001518)
A randomized, controlled trial carried out by Chinese researchers, suggests acupuncture can both speed up response to selective serotonin reuptake inhibitors (SSRIs), and prevent symptom aggravation, in patients with major depressive disorder. Examples of SSRIs include citalopram, fluoxetine, prozac and sertraline.
In the six week study plus four week follow-up, 160 patients were randomly allocated to receive either paroxetine alone, or paroxetine plus 18 sessions of manual or electro-acupuncture. From weeks one to six, the addition of either form of acupuncture produced significantly greater reductions in depression scores at most time points compared with the drug alone: clinical response rates rose to 70% with acupuncture, versus 42% for paroxetine alone. The proportion of patients requiring an increased drug dose due to symptom aggravation, ranged from 6 to 9% for acupuncture, compared with 23% for paroxetine alone. Four weeks after completion of acupuncture treatment, patients in the electro-acupuncture group continued to exhibit significantly greater clinical improvement, suggesting a long-lasting enhancement of the drug’s effects.
(A 6-Week Randomized Controlled Trial with 4-Week Follow-Up of Acupuncture Combined with Paroxetinein Patients with Major Depressive Disorder. Journal of Psychiatric Research, June 2013)
A pilot study carried out in America looking at acupuncture for depression, has found it to be a safe, well-tolerated and effective treatment for patients with major depressive disorder (MDD).
Thirty outpatients with MDD (73% female and mean age 47), received acupuncture for eight weeks, either once or twice a week depending on their preference. Depression scores decreased from 19.1 to 9.9 in the once-weekly group, and from 21.9 to 14.3 in the twice-weekly group. The researchers say the results suggest acupuncture has good feasibility in outpatient settings, and that a full controlled trial is warranted.
(A Pilot Study of Acupuncture Monotherapy in Patients with Major Depressive Disorder. Journal of Affective Disorders, accepted March 2012.)
American researchers have completed a pilot study suggesting that acupuncture may be a useful adjunct to drug treatment in patients with depression, who are not responding to anti-depressant drugs alone.
Thirty patients (47% female and average age 48) with major depressive disorder, and partial or non-response to drug treatment after eight or more weeks, were given acupuncture for eight weeks, on either a weekly or twice-weekly basis. Twenty patients completed the study, and depression scores in both groups decreased significantly (18.5 to 11.5 on average). Response rates (defined as an improvement of 50% or more in depression score) were 47%. The authors concluded that acupuncture was safe, well-tolerated and effective, and may be useful in out-patient settings.
(A Pilot Study of Acupuncture Augmentation Therapy in Anti-Depressant Partial & Non-Responders with Major Depressive Disorder. Journal of Affect Disorders, April 2011.)
A systematic review and meta-analysis of clinical studies looking at acupuncture and depression, has concluded that it is a safe and effective treatment for some forms of the condition.
A total of 207 studies were examined, and 20 were deemed to be of sufficient quality to be subject to meta-analysis. The results showed that for major depressive disorders, acupuncture on its own is as effective as anti-depressant medication in improving symptom severity. For post-stroke depression, acupuncture was also found to be superior to anti-depressants, in improving response and symptom severity. Notably, the incidence of adverse events in acupuncture treatment, was significantly lower than with anti-depressants.
(The Effectiveness and Safety of Acupuncture Therapy in Depressive Disorders: Systematic Review and Meta-Analysis. Journal of Affective Disorders, 2009.)