Acupuncture Continuing Education

Acupuncture Alleviates Depression and Anxiety, Boosts Paxil

Acupuncture is effective for the treatment of depression and generalized anxiety disorder and enhances the effects Paxil.

Researchers from the Beijing University of Chinese Medicine (Wang et al.) find acupuncture effective for the alleviation of both depression and anxiety for patients taking drug therapy. Two types of acupuncture demonstrated proven efficacy. Both manual acupuncture and electroacupuncture increased treatment outcomes for mild to moderate depression patients taking paroxetine (also known by the trade name Paxil). Manual acupuncture and electroacupuncture provided patients with a greater quality of life, as assessed by the World Health Organization's WHOQOL-BREF scale. The assessment technique evaluates the perceived quality of life of each patient, overall health conditions, psychological parameters, physiological changes, and environmental perceptions.

 

Abdominal needle insertion in progress

 

In a related study, Chen et al. demonstrated that patients with generalized anxiety disorder receiving standard acupuncture had an 86.2% improvement rate. After the additional of abdominal acupuncture points, the patient outcome rate increased to 89.6%. It is worth noting that abdominal acupuncture shows slightly preferable results over non-abdominal acupuncture for the treatment of generalized anxiety disorder. 

Paroxetine hydrochloride (Paxil) is widely used as an antidepressant. However, it can produce adverse effects including dizziness, constipation, insomnia, headaches, oral dryness, nausea and diarrhea—all of which impact patients’ quality of life. The research demonstrates that acupuncture enhances drug treatment efficacy, significantly mitigates drug adverse effects, and reduces the chance of relapses.

These modern findings are consistent with the Traditional Chinese Medicine (TCM) view that acupuncture may be applied to benefit mental health. This is expressed in TCM treatment principles including circulating the qi, calming the spirit (shen), stabilizing or descending the uprising yang, and lifting the qi. The efforts by the researchers accomplish two important goals. First, the research demonstrates that acupuncture is safe and effective. Second, the research is an acupuncture continuing education effort to determine optimal protocols for mental health patients. The research tests ancient acupuncture point prescriptions using modern scientific validation techniques. Let’s take a closer look at the investigations.

In the Beijing University of Chinese Medicine study, patients received paroxetine hydrochloride medication combined with conventional manual acupuncture or electroacupuncture and achieved a 100% total treatment effective rate. Those who received solely paroxetine hydrochloride achieved a far lower rate of 87.5%. In addition, the former two patient groups (manual and electroacupuncture) also achieved higher scores in all categories of the WHOQOL-BERF scale than the latter (drugs only), showing that they experienced a higher perceived quality of life.

A total of 72 patients diagnosed with mild to moderate depression were divided into three groups, all of which were given paroxetine hydrochloride (Paxil). Group A, with 23 patients, received electroacupuncture. Group B, with 32 patients, received manual acupuncture. Group C, with 17 patients, was the control group receiving only Paxil. Acupuncture points used in the study for both electroacupuncture and manual acupuncture groups included the following:

  • Baihui (GV20)
  • Yintang (MHN3)
  • Fengfu (GV16)
  • Fengchi (GB20)
  • Dazhui (GV14)
  • Neiguan (PC6)
  • Sanyinjiao (SP6)

One to two additional acupoints were selected on an individual basis dependent upon differential diagnostics. For the electroacupuncture group, the stimulator device was connected to Baihui, Yintang, and Fengchi with a 2 – 15 Hz disperse-dense wave (varying intensity based on patient tolerance levels); however, a slight visible pulsation at the needle site was requisite for a basic minimum level of stimulation. Needles were retained for 30 minutes and each of the acupuncture points that were not connected to the device were manipulated manually for 5 – 15 seconds after 15 minutes of retention and again just prior to removal.

Each 30 minute electroacupuncture session was conducted every other day for six consecutive weeks. The same protocol was followed for Group B, except that no electro-stimulation device was used. In all groups, paroxetine hydrochloride (Paxil) was administered orally after breakfast for six consecutive weeks: 10 mg daily for the first two days followed by 20 mg daily.

The results of this study showed that while Paxil was inarguably effective in treating mild to moderate depression, acupuncture greatly amplified the results and provided greater perceived quality of life scores, according to the WHOQOL-BREF scale. The control group receiving only medications showed an improvement rate of 87.5%; however, both groups receiving acupuncture had an astonishing 100% total treatment effective rate. The addition of acupuncture, whether manual or electrical, helped to mitigate the side effects of the drug, alleviate depression, and enhance the patients’ overall wellbeing.

This is a familiar finding across multiple studies. Depression and anxiety are difficult to treat and a multifaceted approach to patient care is warranted. The findings of Wang et al. confirm that inclusion of acupuncture into standard care increases treatment efficacy.

In a study from the Guangzhou Hospital of Integrated Traditional and Western Medicine (Bai Y.F.), the therapeutic effects of two different acupoint prescriptions were compared. For the treatment of generalized anxiety disorder, acupuncture needles applied to abdominal acupoints were slightly more effective than acupuncture on non-abdominal acupoints. The research indicates that specific locations for acupoint prescriptions, especially abdominal acupoints, greatly enhances mental health.

Generalized anxiety disorder is one of the most common mental disorders. In recent years, the rapid growth of industrialized societies has been correlated with increased stress levels from everyday life, work, and study. This disorder has received much international attention for its rising occurrence. It is essentially an anxiety syndrome in which patients experience inexplicable fear, nervousness, and restlessness. Patients may experience other symptoms such as autonomic nervous system disorders and muscular tension during sports.

Diazepam (also known by the trade name Valium) is commonly used as a medication for the treatment of generalized anxiety disorder. It can relieve somatic symptoms, eliminate general nervousness, and improve sleep quality. However, there are limits to its effectiveness and safety. Further, the biggest drawback of diazepam is drug reliance, limiting patients’ diazepam course to a maximum of 3 weeks in many cases. Many other medications for generalized anxiety disorder present similar obstacles regarding long-term use.

In Traditional Chinese medicine, the benefits of acupuncture for the treatment of mental disorders has been established (Chen et al., 2013). In Bai’s study (conducted at the Guangzhou Hospital of Integrated Traditional and Western Medicine), it was discovered that several key abdominal acupuncture points improve mental health including the following:

  • Zhongwan (CV12)
  • Xiawan (CV10)
  • Qihai (CV6)
  • Guanyuan (CV4)
  • Qixue (KD13)
  • Qipang (navel triangle points, 0.5 cun lateral to CV6)

According to TCM principles, these acupuncture points benefit the internal organs, restore physiological function, promote qi circulation, and balance yin and yang. The acupuncture points on the kidney channel (KD13 and Qipang) improve brain function and have a tranquilizing effect, thereby mitigating anxiety. The abdominal acupuncture produced an 89.6% total treatment effective rate and patients receiving acupuncture absent abdominal acupoints achieved an 86.2% total treatment effective rate. Let’s take a closer look at the study.

A total of 58 patients with generalized anxiety disorder participated in the study at the Acupuncture Division of the 2nd Affiliated Hospital of Guangzhou TCM University. They were randomly divided into 2 equal groups of 29 patients: the treatment group and the control group. Treatment group patients received acupuncture on abdominal acupoints and the control group patients received acupuncture on non-abdominal acupoints.

For the abdominal acupuncture group, 0.22 mm x 30 – 40 mm filiform acupuncture needles were inserted into each acupoint. A deep insertion depth was applied to Zhongwan, Xiawan, Qihai and Guanyuan. Qixue and Qipang were pierced with a medium insertion depth. The needles were retained for 30 minutes. One 30 minute acupuncture session was conducted twice per week, for a total of 8 consecutive weeks.

The non-abdominal acupuncture group received an entirely different approach to patient care. The primary acupoints selected for the control group were the following:

  • Baihui (GV20)
  • Yintang (MHN3)
  • Lieque (LU7)
  • Zhaohai (KD6)

Upon disinfection, 0.35 mm x 25 mm filiform acupuncture needles were inserted into each acupoint with qi regulating techniques. The needles were retained for 30 minutes. One 30 minute acupuncture session was conducted twice per week for a total of 8 consecutive weeks. The study demonstrates the specificity of effective action for abdominal acupuncture points when used for the treatment of generalized anxiety disorder.

The selection of LU7 and KD6 for the control group may have been influenced by the groundbreaking research of Lin et al., whose research demonstrates that Lieque (LU7) and Zhaohai (KD6) are effective for the treatment of generalized anxiety disorder. Lin et al. note that “a number of meta analyses and system evaluations point out that acupuncture treatment has more advantages than drugs in the treatment of anxiety disorders.” The researchers note that acupuncture has a fast effective action, high compliance rate, and is a safe treatment modality.

Given the severity and prevalence of depression and anxiety in modern society, it is evident that improved treatment protocols and access to mental healthcare is of great import. Research now confirms that acupuncture has an important role in the mental healthcare system. The aforementioned research examines and evaluates several approaches to care with TCM and finds both manual acupuncture and electroacupuncture safe and effective. This continuing effort to examine the efficacy of specific acupuncture protocols promotes the optimization of patient outcomes. The effort is welcomed in the ongoing struggle to provide quality mental healthcare for large scale populations.

 


References:
Wang SH, Wang YZ, Ma XH, Guo Zhuo, Yang XJ, Zhang WY & Guo TW. (2014). Study on alleviating side effect of paroxetine and improving quality of life using acupuncture in treatment of mild or moderate depression. Chinese Journal of Behavioral Medicine and Brain Science. 23(3).

Lv M, Wang LL, Liu LY et al. (2004). Acupuncture combined with medication intreating depression. Journal of Nanjing University of Traditional Chinese Medicine. 20(3): 149-151.

Bai YF. (2014). Therapeutic Observation of Abdominal Acupuncture for Generalized Anxiety Disorder.
Shanghai J Acu-mox. 33(1).

Chen XL, Xu K, Luo RH et al. (2013). Electroacupuncture in treating depression: a randomized controlled study. J Acupuncture Tuina Sci. 11(1): 42-45.

Lin, Chuhua; Zhao, Xiaoyan; Liu, Xing; Fu, Wenbin. Observation on the mechanism of acupuncture treatment for generalized anxiety disorder using Lieque (LU7), Zhaohai (KI6) as the main acupoints. Bioinformatics and Biomedicine (BIBM), 2013 IEEE International Conference on. 18-21, 12-2-13.

 


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