Depression in Pregnancy, Acupuncture Treatment

This is an important study in that it focuses on a patient population that could benefit greatly from a non-pharmaceutical option for treatment. It is unusual in the study design in that it uses practitioners who were "junior," meaning that they were merely administering the acupuncture so not biased by whether the point selection was appropriate or not. The depression specific acupuncture patients achieved much better results than the acupuncture non-specific patients or the massage treatment patients. This is a positive development in the acupuncture research world since many of the recent studies out of Europe have had a hard time clearly delineating the benefits of condition specific treatment versus non-specific treatment. Of note is that they consider 12 sessions a "short" trial. In day to day practice a short practice would be more around 4 visits...

Obstet Gynecol. 2010 Mar;115(3):511-20.
Acupuncture for depression during pregnancy: a randomized controlled trial.

Manber R, 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.

Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California 94305, USA. rmanber@stanford.edu
Abstract

OBJECTIVE: To estimate the efficacy of acupuncture for depression during pregnancy in a randomized controlled trial. METHODS: 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. RESULTS: 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%). CONCLUSION: 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.