title: Rapid Onset of the Effects of Combined Selective Serotonin Reuptake Inhibitors and Electroacupuncture on Primary Depression: A Meta-Analysis.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of combined selective serotonin reuptake inhibitors (SSRIs) and electroacupuncture therapies for the early treatment of primary depression.
  
  
  METHODS
  Randomized controlled trials (RCTs) were analyzed to compare therapy combining SSRIs and electroacupuncture to SSRI therapy alone. The RCTs were identified by searching, among others, PubMed, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Chongqing VIP database for Chinese Technical Periodicals, WANFANG DATA, and the Chinese Biological Medical Literature Database. Scores from Self-Rated Depression Scale (SDS), the Hamilton Depression Scale (HAMD), the Side Effect Rating Scale (SERS), and the Treatment Emergent Symptom Scale (TESS) were analyzed and coded by two independent investigators and used to evaluate the safety and efficacy of treatment. Statistical analyses were performed using RevMan 5.2 software.
  
  
  RESULTS
  Six RCTs were analyzed. The meta-analysis revealed that the combined therapy of SSRIs and electroacupuncture were associated with superior scores on the HAMD, SDS, and SERS measures compared with SSRIs alone after 1-4 weeks of treatment: HAMD scores, mean difference (MD)(1 week), 2.32 (95% confidence interval [CI](1 week), 1.47-3.16, p(1 week)<0.00001); MD(2 weeks), 2.65 (95% CI(2 weeks), 1.81- 3.50, p(2 weeks)<0.00001); MD(4 weeks), 2.70 (95% CI(4 weeks), 1.90-3.51, p(4 weeks)<0.00001); SDS scores: MD(1 week), 3.13 (95% CI(1 week), 1.22-5.03, p(1 week) = 0.001); MD(2 weeks), 4.05 (95% CI(2 weeks), 0.22-7.87, p(2 weeks) = 0.04); MD(4 weeks), 5.02 (95% CI(4 weeks), 1.61-8.43, p(4 weeks) = 0.004); SERS scores: MD(2 weeks), 2.20 (95% CI(2 weeks), 1.43-2.96, p(2 weeks)<0.00001); MD(4 weeks), 2.12 (95% CI(4 weeks), 1.42-2.83, p(4 weeks)<0.00001). However, two of the aforementioned outcomes were rated as medium quality because of heterogeneity, as assessed using the Grading of Recommendations Assessment, Development and Evaluation system.
  
  
  CONCLUSIONS
  The available evidence suggests that the early treatment of primary depression using both SSRI and electroacupuncture therapies is more efficient than treatments with SSRIs alone and leads to a better and earlier control of depressive symptoms.
authors.affiliation: 1 Department of Clinical Medicine, First Clinical College, Southern Medical University , Guangzhou, Guangdong, People's Republic of China .
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: 2 College of Traditional Chinese Medicine, Southern Medical University , Guangzhou, Guangdong, People's Republic of China .
authors.forename: Shan-shan
authors.initials: SS
authors.lastname: Qu
authors.affiliation: 2 College of Traditional Chinese Medicine, Southern Medical University , Guangzhou, Guangdong, People's Republic of China .
authors.forename: Ji-ping
authors.initials: JP
authors.lastname: Zhang
authors.affiliation: 1 Department of Clinical Medicine, First Clinical College, Southern Medical University , Guangzhou, Guangdong, People's Republic of China .
authors.forename: Ya-ling
authors.initials: YL
authors.lastname: Sun
authors.affiliation: 1 Department of Clinical Medicine, First Clinical College, Southern Medical University , Guangzhou, Guangdong, People's Republic of China .
authors.forename: Wei-lu
authors.initials: WL
authors.lastname: Liu
authors.affiliation: 1 Department of Clinical Medicine, First Clinical College, Southern Medical University , Guangzhou, Guangdong, People's Republic of China .
authors.forename: Ling
authors.initials: L
authors.lastname: Xie
authors.affiliation: 2 College of Traditional Chinese Medicine, Southern Medical University , Guangzhou, Guangdong, People's Republic of China .
authors.forename: Yong
authors.initials: Y
authors.lastname: Huang
authors.affiliation: 3 Department of Rehabilitation Medicine, Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong, People's Republic of China .
authors.forename: Jun-qi
authors.initials: JQ
authors.lastname: Chen
mesh_terms: D003863:Depression / Q000628:therapy*; D015671:Electroacupuncture; D006801:Humans; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors