10. October 2017 · Comments Off · Categories: Acupuncture, Depression, Insomnia

Acupuncture could be a viable alternative to medication for treating depression-related insomnia, report the authors of a meta-analysis from China. Eighteen randomised-controlled clinical trials with 1678 participants were analysed. The results showed that acupuncture treatment led to significant improvements in sleep scores compared with western medicine. Acupuncture combined with western medicine produced a better effect on sleep quality compared with western medicine alone. Acupuncture and western medicine improved depression scores by an equal amount, and acupuncture combined with western medicine was more effective than western medicine alone.
The Efficacy of Acupuncture for Treating Depression-Related Insomnia Compared with a Control Group: A Systematic Review and Meta-Analysis. Biomed Res Int. 2017;2017:9614810.

25. May 2017 · Comments Off · Categories: Acupuncture, Antidepressants, Depression

Acupuncture may enhance the effect of antidepressant drugs by improving connectivity in brain networks involved in emotional processing and stress. In a Chinese/Korean/American research collaboration, 46 depressed female patients were randomised into either a verum acupuncture plus fluoxetine group, or a sham acupuncture plus fluoxetine group, for eight weeks. The abdominal acupuncture protocol used was: Zhongwan REN-12, Xiawan REN-10, Qihai REN-6, Guanyuan REN-4, Shangqu KID-17 (bilateral), Huaroumen ST-24 (bilateral), and Qipang M-CA-23 (bottom two points only), once a day for the first three days and then once every three days for the remainder of the eight-week trial. Sham treatment consisted of guide tubes without needles being tapped against the same points. Resting-state fMRI data were collected before the first and last treatments. Results showed that, compared with those in the sham acupuncture group, verum acupuncture patients showed greater clinical improvement. Increased resting state functional connectivity between the amygdala and the anterior cingulate cortex was positively associated with clinical improvement in the verum group.
Repeated acupuncture treatments modulate amygdala resting state functional connectivity of depressive patients. Neuroimage Clin. 2016 Jul 27;12:746-752.
The researchers also found that acupuncture had a positive effect on the brain’s motivation/reward circuitry in the same patient group. Previous studies have shown that this corticostriatal reward circuitry is associated with the pathophysiology of major depressive disorder. Increased resting state functional connectivity between the striatum and medial prefrontal cortex following verum acupuncture was significantly positively associated with decreased clinical depression scores.
Acupuncture treatment modulates the corticostriatal reward circuitry in major depressive disorder. J Psychiatr Res. 2017 Jan;84:18-26.

Auricular acupuncture (AA) is as effective as progressive muscle relaxation (PMR) in treating anxiety and depression, according to German research. One hundred and sixty two patients with a primary diagnosis of anxiety disorder or major depressive disorder were allowed to choose between treatment with AA (National Acupuncture Detoxification Association protocol) or treatment with PMR, a standardised and accepted relaxation method. Each group had treatments twice a week for four weeks. The results showed that treatment with AA significantly decreased tension, anxiety and anger/aggression throughout the four weeks, but did not elevate mood. No statistically significant differences were found between the two treatments at any time point.
Auricular Acupuncture Versus Progressive Muscle Relaxation in Patients with Anxiety Disorders or Major Depressive Disorder: A Prospective Parallel Group Clinical Trial. J Acupunct Meridian Stud. 2016 Aug;9(4):191-9.

03. March 2016 · Comments Off · Categories: Acupuncture, Depression

A pilot study from Japan shows that acupuncture can significantly improve depression and autonomic function in patients with medication-resistant depression. Thirty in-patients received either press-needle (PN) acupuncture or sham PN acupuncture (with a blunt press-needle) at eight acupoints for three days. The points used were bilateral Ximen P-4, Shousanli L.I.-10, Yinlingquan SP-9 and Sanyinjiao SP-6. Following PN acupuncture, participants showed significant improvement in depression scores, blood pressure and measures of vagal function, compared to sham PN. The authors suggest that improvement in vagal nerve function by acupuncture may be associated with its therapeutic mechanism in depression.
Acupuncture-induced changes of vagal function in patients with depression: A preliminary sham-controlled study with press needles. Complement Ther Clin Pract. 2015 Aug;21(3):193-200.

23. April 2015 · Comments Off · Categories: Acupuncture, Depression

Acupuncture is cost-effective compared with counselling or usual care alone for patients with depression, according to analysis of the results of a major UK trial. Cost-effectiveness analyses were based on the results of the Acupuncture, Counselling or Usual care for Depression (ACUDep) trial. Statistical analyses demonstrated a difference in mean quality adjusted life years (QALYs) and suggested differences in mean costs which were mainly due to the cost of delivering the interventions. Acupuncture and counselling were found to have higher mean QALYs and higher costs than usual care. Acupuncture was shown to have an incremental cost-effectiveness ratio (ICER) of £4,560 per additional QALY and was shown to be cost-effective with a probability of 0.62, at a cost-effectiveness threshold of £20,000 per QALY. Compared with acupuncture counselling is more effective and more costly with an ICER of £71,757 and a probability of being cost-effective of 0.36. (Cost-Effectiveness Analysis of Acupuncture, Counselling and Usual Care in Treating Patients with Depression: The Results of the ACUDep Trial. PLoS One. 2014 Nov 26;9(11):e113726).

 

A pragmatic randomised controlled trial from the UK has found that acupuncture combined with a selective serotonin reuptake inhibitor (SSRI) provides significant benefits for patients with depression. Seventy-six patients with depression were randomly divided into two groups. Patients in the treatment group (TG) underwent acupuncture and received an SSRI, while the 26 patients in the control group (CG) received an SSRI only. Mean baseline depression scores were 22.2 and 22.1 in the TG and CG, respectively, but after the first week of treatment, the depression score for the TG had reduced to 15.6, significantly better than the score of 18.3 for the CG. This significant difference was maintained to the end of the six-week treatment period, when depression scores had fallen to 6.3 and 8.2 for the TG and CG. (Acupuncture combined with an antidepressant for patients with depression in hospital: a pragmatic randomised controlled trial. Acupunct Med. 2014 May 7. [Epub ahead of print]). http: / /www.ncbi.nlm.nih.gov/ pubmed/24781054

 

Acupuncture has been found to outperform counselling and usual care for patients suffering from depression complicated by pain. A secondary analysis of data from 755 patients in a UK-based pragmatic randomised controlled trial found that patients with moderate-to­extreme pain did better at three months if they received acupuncture compared to those who received counselling or usual care. Reductions in both depression and pain were most marked in the acupuncture group, followed by the counselling group and then the usual care group. (Acupuncture, counselling or usual care for depression and comorbid pain: secondary analysis of a randomised controlled trial. BMJ Open. 2014 May 2;4(5):e004964). http:/ /www.ncbi.nlm.nih.gov/ pubmed /24793257

 

Adding either acupuncture or counselling to usual care can hasten improvement in patients with persistent depression according to a large UK-based study. In a multi-centre randomised controlled trial, 755 patients presenting with depression after having consulted their general practitioner in primary care were randomised to one of three trial arms: acupuncture, counselling, or usual care alone. Patients attended a mean of ten acupuncture sessions and nine counselling sessions over a three-month period. Acupuncture treatment consisted of a standardised protocol developed by a consensus method, while counselling used a manualised humanistic approach. Patients were followed up over 12 months. Compared to usual care, there was a statistically significant reduction in depression scores at three and 12 months, for both acupuncture and counselling. Differences between acupuncture and counselling were not found to be significant. (Acupuncture and counselling for depression in primary care: a randomised controlled trial. PLoS Med. 2013;10(9):e1001518).

Qigong can reduce symptoms of fatigue and depression in patients with chronic fatigue syndrome (CFS)-like illness, a Hong Kong study has found. One hundred and thirty-seven participants who met the diagnostic criteria for CFS-like illness were randomly assigned to either an intervention group or a waitlist control group.  Participants in the intervention group received 10 sessions of qigong training twice a week for five consecutive weeks, followed by home-based practice for 12 weeks. At the end of the training period, the results showed that total fatigue score, physical fatigue score and depression score were significantly improved and mental fatigue score was marginally significantly improved in the qigong group compared to controls. Anxiety score was not significantly improved in the qigong group. (Effects of qigong exercise on fatigue, anxiety, and depressive symptoms of patients with chronic fatigue syndrome-like illness: a randomized controlled trial. Evid Based Complement Alternat Med. 2013;2013:485341).

A novel acupuncture treatment strategy called dense cranial electro-acupuncture stimulation (DCEAS) has been shown to enhance anti-depressant efficacy in the early phase of selective serotonin reuptake inhibitor (SSRI) treatment for major depressive disorder (MDD). DCEAS involves the electrical stimulation of acupuncture points on the head (including Baihui DU-20, Yintang M-HN3, Sishencong M-HN-1, Toulinqi GB-15, Taiyang M-HN-9, Shuaigu GB-8 and Touwei ST-8), with the rationale that this may stimulate the release of serotonin (5-HT) and other neurochemicals in the brain. In a single-blind, randomised controlled study carried out in Hong Kong, 73 patients were randomly assigned to DCEAS or a control non-invasive electro-acupuncture (n-EA) procedure, in combination with the drug fluoxetine (FLX, Prozac) for three weeks. Patients treated with DCEAS displayed a significantly greater reduction in depression scores at days three and 21 compared with patients receiving n-EA.  (Dense cranial electroacupuncture stimulation for major depressive disorder-a single-blind, randomized, controlled study. PLoS One. 2012;7(1):e29651).