Acupuncture for Depression During Pregnancy: A Randomized Controlled Trial

Manber, Rachel PhD; Schnyer, Rosa N. DAOM, LAc; Lyell, Deirdre MD; Chambers, Andrea S. PhD; Caughey, Aaron B. MD, PhD; Druzin, Maurice MD; Carlyle, Erin MS; Celio, Christine MS; Gress, Jenna L. BA; Huang, Mary I. MS; Kalista, Tasha MA; Martin-Okada, Robin BS; Allen, John J. B. PhD

doi: 10.1097/AOG.0b013e3181cc0816
Original Research

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.

LEVEL OF EVIDENCE: I

Depression during pregnancy is responsive to treatment, and the acupuncture protocol tested in this study could be a viable treatment option for depressed pregnant women.

From the Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California; the University of Texas, Austin, Texas; the University of California, San Francisco, San Francisco, California; and the University of Arizona, Tucson, Arizona.

Supported by Agency for Health Research and Quality Grant award HS09988. The authors received no paid writing assistance. The National Center for Complementary and Alternative Medicine has provided a data safety and monitoring board for this study.

The authors thank the following people for their significant contributions to the implementation of the acupuncture protocols: Jennifer Ashby, MS, LAc, Catherine J. Burns, MS, LAc, Andrew Fitzcharles, MS, LAc, Sharon Hennessey, LAc, and Kathryn Ryan, LAc.

Corresponding author: Rachel Manber, PhD, Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, MC 5723, Stanford, CA 94305; e-mail: rmanber@stanford.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2010 The American College of Obstetricians and Gynecologists