Efficacy and safety of acupuncture for depression: A systematic review and meta-analysis.
Binglei Chen, Carol Chunfeng Wang, Khui Hung Lee and 2 others
PMID 36509453WHAT IT FOUND
Acupuncture plus antidepressants reduced depression symptoms more than antidepressants alone.
However, acupuncture did not work better than sham acupuncture. This suggests the benefit may come from the treatment ritual and patient expectation rather than the needles themselves.
Key findings
01Acupuncture combined with antidepressants was more effective than antidepressants alone or waitlist controls in reducing depression severity.
02Acupuncture alone or combined with antidepressants showed no beneficial evidence compared with sham acupuncture.
03Adverse events were generally mild, including headaches, dizziness, fatigue, and nausea, with recovery occurring without further action.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Many included studies had a high risk of bias, particularly regarding blinding of participants and providers, which can overestimate treatment effects. Most studies did not report long-term follow-up outcomes, so it is unclear if benefits persist after treatment ends. There was significant heterogeneity in treatment regimens, including the number of sessions, duration, and acupoints used, making it difficult to define a standard effective dose. The review excluded non-English publications, which may limit the generalizability of the findings to other cultural contexts. The lack of a clear difference between real and sham acupuncture suggests the specific physical intervention may not be the active ingredient.
Declared interests
The authors declare no competing interests. The study was supported by non-US government funding.
The easy way to misread this
Do not interpret the superiority of acupuncture over antidepressants alone as proof that needling has a unique biological effect on mood. The lack of difference between real and sham acupuncture suggests the benefit may be driven by non-specific factors like patient expectation or the therapeutic ritual.