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Acupuncture for Depression
Scientific research suggests that acupuncture may have a clinically relevant effect on individuals with depression. Various systematic reviews and meta-analyses indicate that acupuncture can contribute to the reduction of depressive symptoms and that the treatment is well tolerated by patients [1,2,3]. While a large portion of the research originates from China, an increasing number of studies from Europe and other Western healthcare systems have emerged in recent years. These studies contribute to a better understanding of the applicability of acupuncture within the conventional healthcare context.
Research
An important systematic review by the Cochrane Collaboration concludes that acupuncture may be effective for depression, both as a monotherapy and in combination with antidepressants, although it is emphasized that the quality of the evidence varies [1].
More recent systematic reviews and meta-analyses confirm this view. Analyses show that acupuncture can be statistically significantly more effective than usual care or placebo acupuncture in treating depressive complaints [2,3]. Additionally, it appears that the combination of acupuncture with antidepressants, particularly SSRIs, may be more effective than medication alone [4].
A large pragmatic study from the United Kingdom, conducted in primary care, demonstrated that patients with depressive complaints who received a series of acupuncture treatments reported greater symptom improvement than patients who only received usual care [5]. The average treatment series consisted of about ten sessions, and the effect lasted up to twelve months after treatment.
In clinical practice, it typically becomes clear within a few treatment sessions whether a patient benefits from acupuncture. The treatment plan is individually tailored to the complaints and overall health status of the patient.
Side Effects and Safety
Acupuncture generally has few side effects. When side effects do occur, they are usually mild and short-lived reactions such as a small bruise, slight post-treatment soreness, or temporary fatigue.
In comparison to pharmacological treatment, acupuncture typically reports fewer side effects. This can make the treatment an attractive complementary option for some patients, especially when medication is poorly tolerated [2].
Medical Guidelines
International guidelines present a varied picture of the role of acupuncture in depression. The Canadian CANMAT guideline mentions acupuncture as a possible second-line treatment option for depression [6].
In the United Kingdom, acupuncture is currently not included as a standard intervention in the Multidisciplinary Guideline for Depression (2024). Reasons cited include methodological questions surrounding placebo acupuncture, potential bias in some of the research, and limited integration of acupuncture within conventional care pathways [7]. The same is true for the Netherlands.
Acupuncture in Integrative Care
Within international developments in the field of integrative care, there is a growing interest in collaboration between conventional healthcare providers and complementary practitioners. In various projects in the United Kingdom, for example, acupuncture is offered within primary care networks for patients with anxiety and mood disorders.
These initiatives demonstrate that the integration of acupuncture into multidisciplinary care is possible and is often positively experienced by patients. Further study into effectiveness, cost-effectiveness, and implementation in Western healthcare systems can contribute to a clearer role for acupuncture in the treatment of depression.
References – Depression
1.Smith, C.A., et al. (2018). Acupuncture for depression. Cochrane Database of Systematic Reviews. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004046.pub4/related-content
2.Armour, M., et al. (2019). Acupuncture for depression: A systematic review and meta-analysis. Journal of Clinical Medicine.
https://pubmed.ncbi.nlm.nih.gov/31370200/
3.Hu, Z., et al. (2021). Effectiveness and safety of acupuncture in treating major depressive disorder: A network meta-analysis. Scientific Reports. https://www.nature.com/articles/s41598-021-88263-y
4.Tan, Y., et al. (2024). Efficacy of acupuncture for depression: A systematic review and meta-analysis. Frontiers in Neuroscience.
https://pubmed.ncbi.nlm.nih.gov/38745939/
5.MacPherson, H., et al. (2013). Acupuncture and counselling for depression in primary care: A randomised controlled trial. PLoS Medicine.
https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001518
6.Kennedy, S.H., et al. (2016). CANMAT Clinical Guidelines for the Management of Major Depressive Disorder. https://pmc.ncbi.nlm.nih.gov/a... Institute for Health and Care Excellence (NICE). (2022). Depression in adults: treatment and management (NG222). https://www.nice.org.uk/guidan...
