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34: Acupuncture for depression during pregnancy

      Objective

      To assess the efficacy of acupuncture for depression during pregnancy in an evaluator-blinded randomized trial.

      Study Design

      150 participants who met DSM-IV criteria for Major Depressive Disorder were randomized to receive either acupuncture specific for depression (SPEC, n=52) or one of two active controls: control acupuncture (CTRL, n=49) or massage (MSSG, n=49). Treatments lasted eight weeks (12 sessions). Junior acupuncturists masked to treatment assignment needled participants at points prescribed by senior acupuncturists. Massage therapists and patients were not blinded. The primary outcome was the Hamilton Rating Scale for Depression, administered by blinded raters at baseline and after four and eight weeks of treatment. Data were analyzed using mixed effects models and by intent-to-treat.

      Results

      Women who received SPEC experienced a significantly greater decrease in depression severity (p<0.05) compared to the combined controls (d=0.39, 95% CI [−1.31, 1.65]) or CTRL acupuncture alone (p<0.05; Cohen′s-d = 0.46, 95% CI [−1.24, 2.31]). They also had a higher response rate (63.0%) than the combined controls (44.3%; p<.05; NNT=5.3, 95% CI [2.8, 75.0]) or CTRL acupuncture alone (37.5%; p<0.05; NNT=3.9, 95% CI [2.2, 19.8]). Symptom reduction and response rates did not differ significantly between controls (CTRL 37.5% and MSSG 50.0%). Mild and transient side effects were reported by 43/150 participants (4 in MSSG; 19 in CTRL, 20 in SPEC). Significantly fewer participants reported side-effects in MSSG than the two acupuncture groups (p<0.01).

      Conclusion

      The benefits observed with eight weeks of SPEC acupuncture are clinically meaningful. The results suggest that the acupuncture protocol we tested could be a viable treatment option for depression during pregnancy.