A pilot study of acupuncture augmentation therapy in antidepressant partial and non-responders with major depressive disorder.
BACKGROUND
Acupuncture is widely used for treating major depressive disorder (MDD). There is evidence supporting acupuncture as an antidepressant monotherapy, but its efficacy as augmentation in antidepressant partial and non-responders has not been well-investigated.


METHODS
Thirty subjects (47% female, mean age 48±11 years) with a history of SCID-diagnosed MDD and partial or non-response after ≥8 weeks of antidepressant therapy were assigned 8 weeks of standardized 30-min open acupuncture augmentation sessions on a weekly (n=24) or twice-weekly (n=6) basis. Change in the Hamilton-D-17 score was the primary outcome measure, and response rates (based on HAM-D-17 score improvement of ≥50%) the secondary outcome.


RESULTS
Twenty subjects (40% female; 18 in weekly and 2 in twice-weekly treatment) completed the study. In the intent-to-treat (ITT) sample (N=30), HAM-D-17 scores decreased from 18.5±3.8 to 11.2±5.3 in the weekly group (p<0.001), and from 18.5±3.3 to 11.8±4.8 in the twice-weekly group (p=0.03). Improvement did not differ significantly between treatment arms (p=0.76). Response rates were 47% for all ITT subjects, 50% for the weekly group and 33% for the twice-weekly group (p=0.66). The most common side effects included soreness/pain (n=7), bruising (n=4), and mild bleeding (n=1) at the needle site. One subject discontinued because of side effects (pain).


CONCLUSIONS
Open design, small sample, polypharmacy with antidepressants.


CONCLUSIONS
Once or twice-weekly acupuncture augmentation was safe, well-tolerated and effective in antidepressant partial and non-responders, suggesting good feasibility in outpatient settings. Replication in controlled trials is warranted.
Yeung
Albert S
AS
Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA.
Ameral
Victoria E
VE
Chuzi
Sarah E
SE
Fava
Maurizio
M
Mischoulon
David
D
D015670:Acupuncture Therapy / Q000379:methods / Q000523:psychology; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome
D000928:Antidepressive Agents