Acupuncture for Depression: A Randomized Controlled Trial

John J. B. Allen, Ph.D.; Rosa N. Schnyer, L.Ac.; Andrea S. Chambers, M.A.; Sabrina K. Hitt, Ph.D.; Francisco A. Moreno, M.D.; and Rachel Manber, Ph.D.

Objective: To assess the efficacy of acupuncture as an intervention for major depressive disorder (MDD).

Method: Acupuncture was examined in 151 patients with MDD (DSM-IV) who were randomly assigned to 1 of 3 groups in a double-blind randomized controlled trial. The specific intervention involved Traditional Chinese Medicine (TCM)-style acupuncture with manual stimulation for depression; the control conditions consisted of (1) a nonspecific intervention using a comparable number of legitimate acupuncture points not specifically targeted to depressive symptoms and (2) a waitlist condition, which involved waiting without intervention for 8 weeks. After 8 weeks, all patients received the depression-specific acupuncture. Each 8-week intervention regimen consisted of 12 acupuncture sessions delivered in an acupuncturist's office in the community. The primary outcome measure was the 17-item Hamilton Rating Scale for Depression. The study was conducted from February 1998 to April 2002.

Results: Twenty patients terminated treatment before the completion of the 8-week intervention (13%) but not differentially by study group. Random regression models of the intent-to-treat sample revealed that although patients receiving acupuncture improved more than those awaiting intervention, no evidence of differential efficacy of the depression-specific over nonspecific intervention was found. Response rates in acupuncture-treated patients were relatively low after 8 weeks (22% and 39% for specific and nonspecific intervention groups, respectively), with the response rate after the entire 16-week trial reaching 50%.

Conclusion: Although TCM manual acupuncture is a well-tolerated intervention, results fail to support its efficacy as a monotherapy for MDD. It can't be ruled out that factors unique to the implementation of acupuncture in this research study may have limited the efficacy of interventions compared to those provided in naturalistic settings.

Clinical Trials Registration: ClinicalTrials.gov identifier NCT00010517.

(J Clin Psychiatry 2006;67:1665-1673)

Received Feb. 23, 2006; accepted May 10, 2006. From the Departments of Psychology (Drs. Allen and Hitt and Mss. Schnyer and Chambers) and Psychiatry (Dr. Moreno), University of Arizona, Tucson; Stanford University, Stanford, Calif. (Dr. Manber); and the Osher Institute, Harvard Medical School, Boston, Mass. (Ms. Schnyer).

This research was supported, in part, by grants from the National Institutes of Health (R21 RR09492, R01 MH56965, and R01 AT00001).

Dr. Moreno is a consultant for and has received grant/research support from Cyberonics and Forest and has received honoraria from and is a member of the speakers/advisory boards for Cyberonics, Forest, and Wyeth-Ayerst. Drs. Allen, Hitt, and Manber and Mss. Schnyer and Chambers report no additional financial or other relationships relevant to the subject of this article.

Acknowledgments are listed at the end of this article.

Corresponding author and reprints: John J. B. Allen, Ph.D., Department of Psychology, University of Arizona, P.O. Box 210068, Tucson, AZ 85721-0068 (e-mail: jallen@u.arizona.edu).