The effectiveness and safety of acupuncture therapy in depressive disorders: systematic review and meta-analysis.
BACKGROUND
Although acupuncture has been used as an alternative treatment for depressive disorders, its effectiveness and safety are not well defined. The purpose of this systematic review with meta-analysis was to evaluate the effectiveness of acupuncture as monotherapy and as an additional therapy in treating various depressive conditions, particularly major depressive disorder (MDD) and post-stroke depression (PSD).


METHODS
Following systematic review, meta-analysis was conducted on high-quality randomized controlled trials (RCTs).


RESULTS
Of 207 clinical studies of acupuncture for various depression retrieved, 113 (54.6%) were on MDD and 76 (36.7%) on PSD. Twenty RCTs of MDD (n=1998) and 15 of PSD (n=1680) identified for high-quality protocol (Jadad score >or=3) were included for meta-analysis. The efficacy of acupuncture as monotherapy was comparable to antidepressants alone in improving clinical response and alleviating symptom severity of MDD, but not different from sham acupuncture. No sufficient evidence favored the expectation that acupuncture combined with antidepressants could yield better outcomes than antidepressants alone in treating MDD. Acupuncture was superior to antidepressants and waitlist controls in improving both response and symptom severity of PSD. The incidence of adverse events in acupuncture intervention was significantly lower than antidepressants.


CONCLUSIONS
Acupuncture therapy is safe and effective in treating MDD and PSD, and could be considered an alternative option for the two disorders. The efficacy in other forms of depression remains to be further determined.
Zhang
Zhang-Jin
ZJ
School of Chinese Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong, China. zhangzj@hkucc.hku.hk
Chen
Hai-Yong
HY
Yip
Ka-chee
KC
Ng
Roger
R
Wong
Vivian Taam
VT
D015670:Acupuncture Therapy / Q000009:adverse effects; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000150:complications / Q000523:psychology / Q000628:therapy; D016896:Treatment Outcome
D000928:Antidepressive Agents