Pharmaceutical medication is largely unsuitable for depression during pregnancy and therefore any non-pharmaceutical alternative is potentially of great value.
Acupuncture: a promising treatment for depression during pregnancy
Rachel Manbera, Rosa N. Schnyerb, John J.B. Allenb, A. John Rushc, Christine M. Blaseya
Journal of Affective Disorders, 2004, Vol.83 (1): 89-95, 15 November.
In a study carried out at Stanford University, 61 women with major depressive disorder were randomly assigned to receive one of three treatments:1. Individually tailored true acupuncture designed to treat their depression,
2. True acupuncture but with points not chosen to treat the depression, and
3. Massage treatment (included to provide a control for attention, physical contact, relaxation and respite from daily stress).
Acute phase treatment was given for twelve sessions over eight weeks, with continued treatment throughout pregnancy for those who responded. As far as possible the acupuncture treatment was double-blinded, with the treatment to be given by a treating acupuncturist determined by a different (assessing) acupuncturist.
The assessment, treatment design, needle insertion, and needle stimulation were all standardised. Response rates at the end of the acute phase were 68.8% in the depression specific acupuncture, 47.4% in the non depression-specific acupuncture, and 31.6% in the massage group.
The study also showed that successful treatment of depression during pregnancy offers protection from postpartum depression.
Acupuncture for depression during pregnancy: a randomized controlled trial.
Manber R1, Schnyer RN, Lyell D, Chambers AS, Caughey AB, Druzin M, Carlyle E, Celio C, Gress JL, Huang MI, Kalista T, Martin-Okada R, Allen JJ.
Obstet Gynecol. 2010 Mar;115(3):511-20. doi: 10.1097/AOG.0b013e3181cc0816.
To estimate the efficacy of acupuncture for depression during pregnancy in a randomized controlled trial.
A total of 150 pregnant women who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder were randomized to receive either acupuncture specific for depression or one of two active controls: control acupuncture or massage. Treatments lasted 8 weeks (12 sessions). Junior acupuncturists, who were not told about treatment assignment, needled participants at points prescribed by senior acupuncturists. All treatments were standardized. The primary outcome was the Hamilton Rating Scale for Depression, administered by masked raters at baseline and after 4 and 8 weeks of treatment. Continuous data were analyzed using mixed effects models and by intent to treat.
Fifty-two women were randomized to acupuncture specific for depression, 49 to control acupuncture, and 49 to massage. Women who received acupuncture specific for depression experienced a greater rate of decrease in symptom severity (P<.05) compared with the combined controls (Cohen’s d=0.39, 95% confidence interval [CI] 0.01-0.77) or control acupuncture alone (P<.05; Cohen’s d=0.46, 95% CI 0.01-0.92). They also had significantly greater response rate (63.0%) than the combined controls (44.3%; P<.05; number needed to treat, 5.3; 95% CI 2.8-75.0) and control acupuncture alone (37.5%; P<.05: number needed to treat, 3.9; 95% CI 2.2-19.8). Symptom reduction and response rates did not differ significantly between controls (control acupuncture, 37.5%; massage, 50.0%).
The short acupuncture protocol demonstrated symptom reduction and a response rate comparable to those observed in standard depression treatments of similar length and could be a viable treatment option for depression during pregnancy.
CLINICAL TRIAL REGISTRATION:
Clinicaltrials.gov, www.clinicaltrials.gov, NCT00186654.
Schizophrenia and Depression: A systematic Review of the Effectiveness and the Working Mechanisms Behind Acupuncture
Peggy Bosch, Maurits van den Noort, Heike Staudte, Sabina Lim
Explore – the journal of science and healing; July–August, 2015 Volume 11, Issue 4, Pages 281–291
This systematic review assessed clinical evidence for the use of acupuncture as an add-on treatment in patients with depression and schizophrenia and for its underlying working mechanisms.
Four databases (Medline, Scopus, ERIC, and the Cochrane Library) were searched with a cutoff date of March 31, 2014.
Systematic reviews and meta-analyses of acupuncture treatment for depression and schizophrenia were considered for inclusion. The scarcity of acupuncture research involving schizophrenia led to the inclusion of randomized controlled trials and case studies.
The primary and secondary aims of this study were to evaluate the effects of acupuncture in treating patients with depression or schizophrenia and the possible working mechanisms underlying acupuncture through a systematic literature review.
The overall clinical results on using acupuncture to treat depression are promising, but only limited evidence for its effectiveness in treating schizophrenia was found. Acupuncture improves the quality of life, particularly that of sleep, in psychiatric patients. Brain research has revealed that acupuncture has a modulating and normalizing effect on the limbic–paralimbic–neocortical network (LPNN), including the default mode network. Because the LPNN is related to sleep and emotions, this might explain the improved qualities of life and sleep after acupuncture.
From the evidence found in this study, acupuncture seems to be an effective add-on treatment in patients with depression and, to a lesser degree, in patients with schizophrenia, but large well-designed studies are needed to confirm that evidence.
Effects of acupuncture on the symptoms of anxiety and depression caused by premenstrual dysphoric disorder.
Carvalho F, Weires K, Ebling M, Padilha Mde S, Ferrão YA, Vercelino R.
Acupunct Med. 2013 Dec;31(4):358-63. doi: 10.1136/acupmed-2013-010394. Epub 2013 Sep 12.
The objective of this investigation was to evaluate the effects of acupuncture and sham acupuncture on the symptoms of anxiety and depression brought on by premenstrual dysphoric disorder (PMDD).
In a single-blind randomised clinical trial, 30 volunteers with PMDD were assigned alternately to group 1 (acupuncture) or group 2 (sham acupuncture), and completed an evaluation of symptoms of anxiety and depression using the Hamilton Anxiety (HAM-A) and Hamilton Depression (HAM-D) Rating Scales. The procedure was performed twice a week for two menstrual cycles, for a total of 16 attendances for each participant.
Before the intervention the mean HAM-A and HAM-D scores did not differ between groups. Following the intervention symptoms of anxiety and depression were reduced in both groups; however, the improvement was significant in group 1 compared to group 2, as shown by a mean reduction in HAM-A scores of 58.9% in group 1 and 21.2% in group 2 (p<0.001). The reduction in the mean HAM-D scores was 52.0% in group 1 and 19.6% in group 2, resulting in a significant difference (p=0.012).
The results suggest that acupuncture could be another treatment option for PMDD patients.