Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Jul 31;8(8):1140.
doi: 10.3390/jcm8081140.

Acupuncture for Depression: A Systematic Review and Meta-Analysis

Mike Armour  1   2 , Caroline A Smith  3   4 , Li-Qiong Wang  5 , Dhevaksha Naidoo  3 , Guo-Yan Yang  3 , Hugh MacPherson  6 , Myeong Soo Lee  7 , Phillipa Hay  4   8
Affiliations
Review

Acupuncture for Depression: A Systematic Review and Meta-Analysis

Mike Armour et al. J Clin Med. .

Abstract

Background: Depression is commonly treated with anti-depressant medication and/or psychological interventions. Patients with depression are common users of complementary therapies, such as acupuncture, either as a replacement for, or adjunct to, their conventional treatments. This systematic review and meta-analysis examined the effectiveness of acupuncture in major depressive disorder.

Methods: A search of English (Medline, PsychINFO, Google Scholar, and CINAL), Chinese (China National Knowledge Infrastructure Database (CNKI) and Wanfang Database), and Korean databases was undertaken from 1980 to November 2018 for clinical trials using manual, electro, or laser acupuncture.

Results: Twenty-nine studies including 2268 participants were eligible and included in the meta-analysis. Twenty-two trials were undertaken in China and seven outside of China. Acupuncture showed clinically significant reductions in the severity of depression compared to usual care (Hedges (g) = 0.41, 95% confidence interval (CI) 0.18 to 0.63), sham acupuncture (g = 0.55, 95% CI 0.31 to 0.79), and as an adjunct to anti-depressant medication (g = 0.84, 95% CI 0.61 to 1.07). A significant correlation between an increase in the number of acupuncture treatments delivered and reduction in the severity of depression (p = 0.015) was found.

Limitations: The majority of the included trials were at a high risk of bias for performance blinding. The applicability of findings in Chinese populations to other populations is unclear, due to the use of a higher treatment frequency and number of treatments in China. The majority of trials did not report any post-trial follow-up and safety reporting was poor.

Conclusions: Acupuncture may be a suitable adjunct to usual care and standard anti-depressant medication.

Keywords: acupuncture; depression; dosage; frequency.

PubMed Disclaimer

Conflict of interest statement

M.A., C.A.S., D.N. and G.-Y.Y. As a medical research institute, NICM Health Research Institute receives research grants and donations from foundations, universities, government agencies and industry. Sponsors and donors provide untied and tied funding for work to advance the vision and mission of the Institute. This study was not specifically supported by donor or sponsor funding to NICM. L.-Q.W.: none P.H.: Hay receives/has received sessional fees and lecture fees from the Australian Medical Council, Therapeutic Guidelines publication, and New South Wales Institute of Psychiatry and royalties/honoraria from Hogrefe and Huber, McGraw Hill Education, and Blackwell Scientific Publications, Biomed Central and PlosMedicine and she has received research grants from the NHMRC and ARC. She is Chair of the National Eating Disorders Collaboration Steering Committee in Australia (2019-) and Member of the ICD-11 Working Group for Eating Disorders (2012-) and was Chair Clinical Practice Guidelines Project Working Group (Eating Disorders) of RANZCP (2012–2015). She has prepared a report under contract and conducted education for Psychiatrists funded by Shire Pharmaceuticals (2017–2018). All views in this paper are her own. H.M.: MacPherson is an Emeritus Professor of Acupuncture Research, Department of Health Sciences, University of York, UK, Chair of Trustees of the Northern College of Acupuncture, York, UK, and Clinical Director of the York Clinic for Integrated Healthcare, York, UIK. M.S.L.: Korea Instutute of Oriental Medicine is a Korean government funded institute for researching Korean Medicine (KIOM).

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Risk-of-bias. Green, low risk of bias; yellow, unclear risk of bias; red, high risk of bias.
Figure 3
Figure 3
Acupuncture versus sham control on the severity of depression.
Figure 4
Figure 4
Acupuncture plus SSRI/SNRI versus SSRI/SNRI alone on the severity of depression.
Figure 5
Figure 5
The effect of acupuncture on the severity of depression by study location.
Figure 6
Figure 6
Meta-regression of total number of treatments on the severity of depression.
See this image and copyright information in PMC

References

    1. Hasin D.S., Sarvet A.L., Meyers J.L., Saha T.D., Ruan W.J., Stohl M., Grant B.F. Epidemiology of adult DSM-5 major depressive disorder and its specifiers in the United States. JAMA Psychiatry. 2018;75:336–346. doi: 10.1001/jamapsychiatry.2017.4602. - DOI - PMC - PubMed
    1. Malhi G.S., Bassett D., Boyce P., Bryant R., Fitzgerald P.B., Fritz K., Hopwood M., Lyndon B., Mulder R., Murray G., et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Aust. N. Z. J. Psychiatry. 2015;49:1087–1206. doi: 10.1177/0004867415617657. - DOI - PubMed
    1. National Institute for Health and Care Excellence . Depression in Adults: Recognition and Management (NICE Clinical Guideline 30) NICE; London, UK: 2009. - PubMed
    1. Kessler R.C., Soukup J., Davis R.B., Foster D.F., Wilkey S.A., Van Rompay M.I., Eisenberg D.M. The use of complementary and alternative therapies to treat anxiety and depression in the United States. Am. J. Psychiatry. 2001;158:289–294. doi: 10.1176/appi.ajp.158.2.289. - DOI - PubMed
    1. Hansen A.H., Kristoffersen A.E. The use of CAM providers and psychiatric outpatient services in people with anxiety/depression: A cross-sectional survey. BMC Complement. Altern. Med. 2016;16:461. doi: 10.1186/s12906-016-1446-9. - DOI - PMC - PubMed