The Effectiveness of Acupuncture for Depression

Depression, which is a leading cause of suicide, accounts for a significant amount of the global disease burden. Depression is defined by experiences of extreme sadness, anxiety, hopelessness, and worthlessness, in addition to normal mood swings. People who are affected lose interest in activities they used to enjoy, and they frequently have physical symptoms such as chronic pain, exhaustion, and insomnia.

Antidepressants are the most common first-line treatment for depression in primary care, although they don't work for more than half of patients. Furthermore, the efficacy of antidepressants for people with mild to moderate depression has been recently questioned. People with depression may consider adopting non-pharmacological therapy options and a growing volume of research has been conducted to investigate the effectiveness of acupuncture for depression.

One study compared the clinical effectiveness of either acupuncture or counselling to standard care in patients with depression.

They recruited 755 patients from 27 different general medicine practices in Yorkshire and north- east England and offered them up to 12 weekly sessions of either acupuncture or counselling.

All the patients scored more than 20 points on the Beck's Depression Inventory (BDI-II) indicating moderate to extreme depression.

The authors of the study used the Patient Health Questionnaire-9 (PHQ-9) to assess the outcomes after the end of the course of 12 treatment sessions which was about 3 months. In this study, patients receiving acupuncture for depression scored an average reduction in depression of -2.46 points compared with usual care. The counselling group had similar outcomes as with acupuncture. When acupuncture or counselling was used as adjuncts to usual care, they discovered statistically significant effects after three months of interventions. From a recent (2018) Cochrane review, the effectiveness of acupuncture for depression is unclear. They performed a meta-analysis of acupuncture for depression that included 7104 participants from 64 studies. They examined the use of acupuncture vs none or other different interventions.

Whereas the Cochrane review concluded that the effect of acupuncture compared with psychological therapy is unclear, the research done by MacPherson, et al. (2018) suggested that their “evidence on acupuncture compared with usual care and counselling compared with usual care shows that both treatments are associated with a statistically significant reduction in symptoms of depression in the short to medium term, with no reported serious adverse events related to treatment.”

Most of the studies from Cochrane review were “at high risk of performance bias, at high or unclear risk of detection bias, and at low or unclear risk of selection bias, attrition bias, reporting bias, and other bias.”

The authors of the Cochrane review found low-quality evidence in the reduction of depression severity with acupuncture treatments when compared to no therapy and similar outcomes were reported when acupuncture was used in conjunction with medication vs medication alone.

References

MacPherson H, Vickers A, Bland M, et al. Acupuncture for chronic pain and depression in primary care: a programme of research. Southampton (UK): NIHR Journals Library; 2017 Jan. (Programme Grants for Applied Research, No. 5.3.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK409491/ doi: 10.3310/pgfar05030

Kirsch I, Deacon BJ, Huedo-Medina TB, Scoboria A, Moore TJ, Johnson BT. Initial severity and antidepressant benefits: a meta-analysis of data submitted to the Food and Drug Administration. PLoS Med. 2008 Feb;5(2):e45. doi: 10.1371/journal.pmed.0050045. PMID: 18303940; PMCID: PMC2253608.

Beck's Depression Inventory (BDI-II) https://www.ismanet.org/doctoryourspirit/pdfs/Beck-Depression-Inventory-BDI.pdf

Smith, C.A., Armour, M., Lee, M.S., Wang, L.Q. and Hay, P.J., 2018. Acupuncture for depression. Cochrane database of systematic reviews, (3).

Article by:

Nazan Garcia (Acupuncturist) Bsc (Hons), Lic Ac, MBAA