title: The benefit of combined acupuncture and antidepressant medication for depression: A systematic review and meta-analysis.
abstract: Acupuncture, one of the most popular complementary therapies, is best known for its ability to provide pain relief. Accumulating evidence suggests that acupuncture may also be beneficial in depression, although its effectiveness remains uncertain in this condition. We conducted a meta-analysis of randomized trials in which the effects of acupuncture combined with antidepressant medications were compared with those of antidepressant medications alone in adults with a diagnosed depressive disorder. Thirteen randomized controlled trials involving 1046 subjects were included in the meta-analysis. Our results confirmed that the pooled standardized mean difference of the 'endpoint scores of the 17-item Hamilton rating scale for depression' was -3.74 (95% CI, -4.77 to -2.70, p<0.001) in week 1 and -2.52 (95% CI, -4.12 to -0.92; p<0.01) in week 6, indicating a significant difference in favor of acupuncture combined with selective serotonin reuptake inhibitors (SSRIs). Moreover, therapeutic response rates were statistically significantly different between the two groups (risk ratio [RR], 1.23; 95% CI, 1.10 to 1.39; p<0.001; I(2)=68%) in favor of the combined treatment group. This systematic review and meta-analysis suggest that acupuncture combined with antidepressant medication is effective, has an early onset of action, safe and well-tolerated over the first 6-week treatment period. Moreover, this treatment combination appears to result in greater therapeutic efficacy than SSRI therapy alone. More high-quality randomized clinical trials are needed to evaluate the clinical benefit and long-term effectiveness of acupuncture in the treatment of depression.
authors.affiliation: Department of Psychiatry, Taoyuan Armed Forces Hospital, Taoyuan, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Yuan-Yu
authors.initials: YY
authors.lastname: Chan
authors.affiliation: Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan; Department of Life Science, National Chung Hsing University, Taichung, Taiwan.
authors.forename: Wan-Yu
authors.initials: WY
authors.lastname: Lo
authors.affiliation: Department of Psychiatry, Taoyuan Armed Forces Hospital, Taoyuan, Taiwan; Graduate Institute of Health and Welfare Policy, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Szu-Nian
authors.initials: SN
authors.lastname: Yang
authors.affiliation: Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan; Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan. Electronic address: yihungchen@mail.cmu.edu.tw.
authors.forename: Yi-Hung
authors.initials: YH
authors.lastname: Chen
authors.affiliation: Research Center for Chinese Medicine & Acupuncture, China Medical University, Taichung, Taiwan; School of Chinese Medicine, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, Asia University, Taichung, Taiwan. Electronic address: jglin@mail.cmu.edu.tw.
authors.forename: Jaung-Geng
authors.initials: JG
authors.lastname: Lin
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D003863:Depression / Q000188:drug therapy / Q000628:therapy*; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D006801:Humans
chemical_list: D000928:Antidepressive Agents
keywords: Acupuncture; Antidepressant; Depression; Meta-analysis; Systematic review