Acupuncture Continuing Education

Acupuncture Prevents Depression After Antidepressant Cessation

Acupuncture prevents depression relapses for patients completing progressive antidepressant medication cessation.

Researchers find acupuncture effective in both the short and long-term for improving positive patient outcomes for patients ceasing antidepressant medication intake. The total effective rate, short-term withdrawal syndrome rate, and long-term relapse rates improve significantly with the implementation of acupuncture into patient management.

 

Ear ShenmenAuricular Acupoint 

Acupuncture alleviates depression and prevents relapses for patients withdrawing from antidepressant drug use. Research conducted at the Anhui University of Chinese Medicine demonstrates that acupuncture minimizes risks associated with cessation of antidepressant drug use. The findings were published in the Shanghai Journal of Acupuncture and Moxibustion.

Two groups of patients underwent identical progressive medication reduction protocols. One group received acupuncture in addition to medication reduction. Results were tabulated based on the Hamilton Depression Scale (HAMD), measured at three time points: before treatment, one week after completion of medication cessation, one year after medication cessation. Let’s look at short and long-term results and then go over how the researchers achieved clinical successes. 

Acupuncture produced a 50% improvement in short-term withdrawal syndrome outcomes. The withdrawal syndrome occurrence rate measured one week after cessation of medication use was 3.3% for patients receiving acupuncture and 53.3% for patients that did not receive acupuncture. Acupuncture produced additional short-term benefits. A total of 93.3% of patients receiving acupuncture successfully completed medication cessation measured at the one week time point. For patients that did not receive acupuncture, that number drops to 73.3%.

Long-term results are significant. At the one year time point, the relapse rate for patients receiving acupuncture treatments during progressive medication withdrawal was 13.3%. The relapse rate jumps to 40.0% for patients that did not receive acupuncture during progressive medication reduction.

Antidepressant medication dose reductions were adjusted every two weeks for all patients in the study. The initial reduction involved cutting medication dosage by 50%. After two weeks, the reduction was 25% of the original dose. After another two weeks, the dosage was adjusted to 12.5% of the original amount. In the final stage, medication was completely eliminated from patient care.

Acupuncture was applied to the following acupoints for all patients in the treatment group:

  • Baihui, DU20
  • Yintang, extra
  • Shenting, DU24
  • Shuigou, DU26
  • Neiguan, PC6
  • Jianshi, PC5
  • Shanzhong, CV17
  • Hegu, LI4
  • Zusanli, ST36
  • Sanyinjiao, SP6

Supplementary acupoints were added for specific differential diagnostic considerations within the Traditional Chinese Medicine (TCM) system:

  • Heart and liver fire excess: Zhongchong (PC9), Taichong (LV3)
  • Liver qi stagnation with spleen deficiency: Taichong (LV3), Zhongwan (CV12)
  • Heart and stomach deficiency: Shenmen (HT7), Qiuxu (GB40)
  • Hot phlegm misting heart orifice mania: Neiguan (PC6), Fenglong (ST40)
  • Heart and spleen deficiency: Shenmen (HT7), Zusanli (ST36)

Manual acupuncture techniques were applied to elicit deqi at the acupoints. Electroacupuncture was applied to DU20 and Yintang with a continuous wave. Auricular acupuncture was added to ear Shenmen. Total needle retention time was thirty minutes. Acupuncture was administered once per day for the first two weeks followed by once every other day for an additional two weeks. Next, acupuncture was administered for another two weeks a rate of once every third day.

 

PC6

 

The study demonstrates that acupuncture reduces risks associated with antidepressant medication cessation. In the short-term, withdrawal syndrome rates decrease markedly. In the long-term, relapse rates drop sharply with acupuncture. Importantly, the total success rate for patients achieving medication cessation increases significantly with the addition of acupuncture to the regimen of healthcare.

Lab Findings
Related laboratory studies support these findings. Researchers document that acupuncture regulates neural progenitor cells (NPs), which are hippocampal brain cells. They add that acupuncture increases hippocampal neurogenesis, the process wherein neurons are generated.

The findings demonstrate that electroacupuncture at acupoints DU20 and GB34 (Yanglingquan) on stress induced rats regulates two major subclasses of NPs. Stress caused cell death and “impaired the proliferation” of the NP subclasses (QNPs, ANPs). The researchers note that electroacupuncture “alleviated depressive-like and anxiety-like behaviors in the rat” group, restored proliferation of ANPs, and limited cell death of QNPs in the hippocampus.

The researchers conclude that electroacupuncture is “beneficial to the division of hippocampal NPs. . . . The present study revealed that chronic EA (electro-acupuncture) treatment exerted significant antidepressant effects in a rat model of depression. Further, the mechanisms underlying antidepressant effects of EA were associated with preserving the QNPs from apoptosis and ameliorating the impaired ANPs proliferation in hippocampus.” The researchers add that this is an “underlying mechanism of antidepressant-like effects of EA (electro-acupuncture).”


References:
He YR, Li SJ, Chen XS. (2014). Application of Acupuncture to the Clinically-recovered Depression Patients during Withdrawal of Medication. Shanghai Journal of Acupuncture and Moxibustion. 33(11).

Geddes JR, Carney SM, Davies C (2003). Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. 9358.

Du YH, Li GP, Yan H et al. (2004). Clinical and fundamental research of acupuncture treatment on depression (weekly paper) - Tian Jin Chinese Traditional Medicine.

Yang, Liu, Na Yue, Xiaocang Zhua, Qiuqin Hana, Bin Lia, Qiong Liu, Gencheng Wu, and Jin Yu. "Electroacupuncture promotes proliferation of amplifying neural progenitors and preserves quiescent neural progenitors from apoptosis to alleviate depressive-like and anxiety-like behaviours.”

 

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