2023 Nutrients

Vitamin D deficiency could accelerate depressive symptoms and suicide risks, and vitamin D supplementation may mitigate these effects.

The paper examines the links between vitamin D deficiency, depression, and suicide from various studies. It hypothesizes that vitamin D could enhance serotonin synthesis and modulate proinflammatory cytokines, both factors in depression and suicide. The paper reviews this hypothesis in the context of the broader health issue of suicide, which is among the leading causes of death worldwide.

This paper then discusses the potential benefits of vitamin D supplementation. Drawing upon indirect evidence suggesting that vitamin D deficiencies may be a risk factor for depression—one of the most common factors in suicide attempts—the paper postulates that vitamin D supplementation could play a role in helping to reduce the risk of depression and thus suicide. The beneficial mechanisms of vitamin D, such as enhancing serotonin synthesis and modulating proinflammatory cytokines, which are associated with depression and suicide, stand as the central contributing factors in this hypothesis.

Vitamin D in Depression: A Potential Bioactive Agent to Reduce Suicide and Suicide Attempt Risk Somoza-Moncada MM, Turrubiates-Hernández FJ, Muñoz-Valle JF, Gutiérrez-Brito JA, Díaz-Pérez SA, Aguayo-Arelis A, Hernández-Bello J

2023 Sleep Medicine Clinics

Acupuncture may enhance the effectiveness of cognitive-behavioral therapy for people suffering from insomnia and related conditions.

The research methodology used in this paper is mainly a theoretical analysis and discussion of the potential synergistic effects of combining cognitive-behavioral therapy for insomnia (CBT-I) and acupuncture. This involves analysis of the current evidence base for the efficacy of acupuncture in treating insomnia and related conditions, along with examination of the practical, logistical, and regulatory aspects of combining these two treatments.

In the discussion of their results, the researchers found that there is a growing body of evidence that supports the potential benefit of acupuncture in treating insomnia and its comorbidities, enhancing the current standard treatment approach of CBT-I. This appears to be an innovative approach that could potentially enhance the treatment effectiveness and outcomes for those struggling with insomnia, though it concurrently raises complex issues in terms of its practical and regulatory implementation.

Acupuncture as an Adjunct Treatment to Cognitive-Behavioral Therapy for Insomnia Kutana S, Mao JJ, Garland SN

2022 Frontiers in Pharmacology

Chinese herbal medicine was effective in treating coronary heart disease patients with anxiety or depression, particularly in improving angina pectoris, and its active compounds could act on the pathological targets of CHD, anxiety, and depression.

The meta-analysis of 32 studies found that Chinese herbal medicine (CHM) was more effective in treating anxiety and depression in patients with coronary heart disease (CHD) compared to control groups, and the efficacy of CHM was similar to Western medicine. Additionally, CHM was shown to improve angina stability in CHD patients with anxiety or depression better than control and Western medicine groups. The study identified the main underlying mechanisms to involve anti-damage/apoptosis, anti-inflammation, antioxidative stress, and maintaining neurotransmitter homeostasis, with certain herbal compounds being most related to CHD, anxiety, and depression.

Evidence and Characteristics of Traditional Chinese Medicine for Coronary Heart Disease Patients With Anxiety or Depression: A Meta-Analysis and Systematic Review Wang B, Teng Y, Li Y, Lai S, Wu Y, Chen S, Li T, Han X, Zhou H, Wang Y, Lu Z, Li H, Ding Y, Ma L, Zhao M, Wang X

2022 Frontiers in Pharmacology

Chinese herbal medicine was effective in treating coronary heart disease patients with anxiety or depression, particularly in improving angina pectoris, and its active compounds could act on the pathological targets of CHD, anxiety, and depression.

The meta-analysis of 32 studies found that Chinese herbal medicine (CHM) was more effective in treating anxiety and depression in patients with coronary heart disease (CHD) compared to control groups, and the efficacy of CHM was similar to Western medicine. Additionally, CHM was shown to improve angina stability in CHD patients with anxiety or depression better than control and Western medicine groups. The study identified the main underlying mechanisms to involve anti-damage/apoptosis, anti-inflammation, antioxidative stress, and maintaining neurotransmitter homeostasis, with certain herbal compounds being most related to CHD, anxiety, and depression.

Evidence and Characteristics of Traditional Chinese Medicine for Coronary Heart Disease Patients With Anxiety or Depression: A Meta-Analysis and Systematic Review Wang B, Teng Y, Li Y, Lai S, Wu Y, Chen S, Li T, Han X, Zhou H, Wang Y, Lu Z, Li H, Ding Y, Ma L, Zhao M, Wang X

2022 Research in Nursing & Health

Acupuncture, either in isolation or as an adjunct to pharmacological treatment, has clinical benefits and can be considered a safe option for managing depression.

A review of 22 trials involving 2,391 participants found that acupuncture can reduce depression severity. Combining acupuncture with antidepressants was more effective than using antidepressants alone or waitlist. However, acupuncture alone or with antidepressants didn't show significant benefits compared to sham acupuncture. Sham acupuncture might have stronger effects than other placebos. Differences in treatment sessions and cultural backgrounds between China and Western countries affect outcomes. Lack of standardization in acupuncture regimens hinders research. Mild adverse events were reported but need better documentation.

Efficacy and safety of acupuncture for depression: A systematic review and meta‐analysis Chen B, Wang CC, Lee KH, Xia JC, Luo Z

2022 Journal of Acupuncture and Meridian Studies

Acupuncture shows promise in improving psychiatric symptoms, physical symptoms, and quality of life in patients with treatment-resistant mood disorders, highlighting its potential as a complementary therapy for these conditions.

This prospective study explored the effects of acupuncture on physical symptoms and quality of life (QoL) in patients with treatment-resistant major depressive disorder (MDD) and bipolar disorder (BD). After 12 weeks of acupuncture treatment, significant improvements were observed in psychiatric symptoms, physical symptoms, and various aspects of QoL. These findings suggest that acupuncture may be beneficial for both the physical and mental well-being of patients with treatment-resistant mood disorders, although further research is needed to validate these preliminary results.

Effect of Acupuncture on Physical Symptoms and Quality of Life in Treatment-Resistant Major Depressive Disorder and Bipolar Disorder: a Single-Arm Longitudinal Study Matsuura Y, Hongo S, Taniguchi H, Yasuno F, Sakai T

2022 Journal of Acupuncture and Meridian Studies

Acupuncture shows promise in improving psychiatric symptoms, physical symptoms, and quality of life in patients with treatment-resistant mood disorders, highlighting its potential as a complementary therapy for these conditions.

This prospective study explored the effects of acupuncture on physical symptoms and quality of life (QoL) in patients with treatment-resistant major depressive disorder (MDD) and bipolar disorder (BD). After 12 weeks of acupuncture treatment, significant improvements were observed in psychiatric symptoms, physical symptoms, and various aspects of QoL. These findings suggest that acupuncture may be beneficial for both the physical and mental well-being of patients with treatment-resistant mood disorders, although further research is needed to validate these preliminary results.

Effect of Acupuncture on Physical Symptoms and Quality of Life in Treatment-Resistant Major Depressive Disorder and Bipolar Disorder: a Single-Arm Longitudinal Study Matsuura Y, Hongo S, Taniguchi H, Yasuno F, Sakai T

2022 Frontiers in Pharmacology

Xiao Yao San has potential as an effective and safe alternative treatment for depression, offering multiple mechanisms of action for its antidepressant effects.

The article discusses the use of Xiaoyaosan, a traditional Chinese medicine formulation, in the treatment of depression. It reviews recent evidence from animal and clinical studies, highlighting the pharmacological mechanisms and effective components involved in the antidepressant effects of Xiaoyaosan. The review explores various factors such as neurotransmitters, neuroplasticity, inflammatory response, gut-brain axis, oxidative stress, and autophagy that contribute to its therapeutic effects. The article emphasizes the potential of Xiaoyaosan as an alternative therapy for depression and provides an overview of its mechanisms of action.

Research progress on classical traditional chinese medicine formula xiaoyaosan in the treatment of depression Chen J, Lei C, Li X, Wu Q, Liu C, Ma Q, Chen J.

2022 Medicine

High prevalence of insomnia, anxiety, and depression among perimenopausal women, emphasizing the importance of exploring acupuncture as a potential green therapy for effectively addressing these interconnected issues.

This passage discusses the prevalence of insomnia among perimenopausal women, its association with anxiety and depression, and the potential of acupuncture as a green therapy for treating these issues. The passage outlines the objectives and methods of a systematic review aiming to evaluate the efficacy of acupuncture in improving sleep quality and alleviating anxiety and depression in perimenopausal women, highlighting the need for safer alternatives to conventional medications and the significance of such a study.

Can acupuncture improve sleep quality and anxiety among women during perimenopause? Ping Y, Liang C, Fan X, Zhang L, Ying D, Wang Z

2022 Medicine

High prevalence of insomnia, anxiety, and depression among perimenopausal women, emphasizing the importance of exploring acupuncture as a potential green therapy for effectively addressing these interconnected issues.

This passage discusses the prevalence of insomnia among perimenopausal women, its association with anxiety and depression, and the potential of acupuncture as a green therapy for treating these issues. The passage outlines the objectives and methods of a systematic review aiming to evaluate the efficacy of acupuncture in improving sleep quality and alleviating anxiety and depression in perimenopausal women, highlighting the need for safer alternatives to conventional medications and the significance of such a study.

Can acupuncture improve sleep quality and anxiety among women during perimenopause? Ping Y, Liang C, Fan X, Zhang L, Ying D, Wang Z

2022 Evidence-Based Complementary and Alternative Medicine

Xiao Yao San, alone or combined with anxiolytics, assists in better improvement and safety in treating anxiety disorders compared to anxiolytics alone.

The methodology involved a systematic search on PubMed, Cochrane Library, EMBASE, Web of Science, and several Chinese databases for all randomized control trials (RCTs) that have evaluated the use of XYS for treating anxiety disorders until November 2021. The studies were independently screened, and data were extracted by two investigators who also assessed the risk of bias in the selected trials using RevMan5.3 software.

The meta-analysis result shows that the use of XYS, either on its own or together with anxiolytics, showed better improvements in anxiety-related symptoms and fewer adverse drug reactions compared to treatment with anxiolytics only. This suggests that XYS, whether used alone or in conjunction with anxiolytic agents, appears to offer a more effective and safer treatment option for anxiety disorders.

Evaluation of the Safety and Efficacy of Xiao Yao San as a Treatment for Anxiety: A Systematic Review and Meta-Analysis Lin J, Ji Y, Si J, Wang G, Li X, Shen L

2022 Annals of Medicine

The Gui Zhi-Shao Yao herb pair in traditional Chinese medicine potentially treats chronic pain, anxiety, and depression through interactions with nine key targets.

The methodology in this research utilised network pharmacology to explore the active components of the "Gui Zhi-Shao Yao" herb pair and their possible targets. Initially, 15 active compounds were identified through a series of analysis which revealed about 130 potential targets. By considering the intersections between the targets of the "Gui Zhi-Shao Yao" herb pair and chronic pain, anxiety disorder, and mental depression, nine vital targets were identified and listed in order of importance.

The results discussion revealed that the "Gui Zhi-Shao Yao" herb pairing acted on the nine identified key targets to alleviate chronic pain, anxiety, and depression. Gene ontology and pathway analysis demonstrated that there were 11 primary pathways, including AGE-RAGE signalling pathway, IL-17 signalling pathway, and TNF signalling pathway. These pathways appear to be actively involved in the pathological processes, providing a holistic understanding of how the "Gui Zhi-Shao Yao" herb pair functions therapeutically.

A network pharmacology approach to predict potential targets and mechanisms of “Ramulus Cinnamomi (cassiae) – Paeonia lactiflora” herb pair in the treatment of chronic pain with comorbid anxiety and depression Pan HT, Xi ZQ, Wei XQ, Wang K

2022 Annals of Medicine

The Gui Zhi-Shao Yao herb pair in traditional Chinese medicine potentially treats chronic pain, anxiety, and depression through interactions with nine key targets.

The methodology in this research utilised network pharmacology to explore the active components of the "Gui Zhi-Shao Yao" herb pair and their possible targets. Initially, 15 active compounds were identified through a series of analysis which revealed about 130 potential targets. By considering the intersections between the targets of the "Gui Zhi-Shao Yao" herb pair and chronic pain, anxiety disorder, and mental depression, nine vital targets were identified and listed in order of importance.

The results discussion revealed that the "Gui Zhi-Shao Yao" herb pairing acted on the nine identified key targets to alleviate chronic pain, anxiety, and depression. Gene ontology and pathway analysis demonstrated that there were 11 primary pathways, including AGE-RAGE signalling pathway, IL-17 signalling pathway, and TNF signalling pathway. These pathways appear to be actively involved in the pathological processes, providing a holistic understanding of how the "Gui Zhi-Shao Yao" herb pair functions therapeutically.

A network pharmacology approach to predict potential targets and mechanisms of “Ramulus Cinnamomi (cassiae) – Paeonia lactiflora” herb pair in the treatment of chronic pain with comorbid anxiety and depression Pan HT, Xi ZQ, Wei XQ, Wang K

2022 Natural Product Communications

Combining traditional Chinese medicine may offer potential therapeutic value in treating both Alzheimer's disease and major depressive disorder simultaneously.

Researchers leveraged network pharmacology and molecular docking technology to identify the effect of traditional Chinese medicine and its multitarget components for treating Alzheimer's disease and major depressive disorder. They analyzed 234 TCM prescriptions for major depressive disorder, identifying the top 10 most commonly used herbs, reflecting 198 active ingredients. They then did comparative analysis for prospective ingredient targets related to both disorders. The analysis included exploring common and key targets and representative compounds for effective treatment. The combination of Xiangfu (Cyperi Rhizoma), Gancao (Licorice) and Chaihu (Radix Bupleuri) constituted the major component of representative ingredients that were analyzed.

The results yielded the identification of 30 common targets, 9 key targets, and 7 representative compounds relevant to both disorders. Their findings revealed these common targets were essential to regulate multiple pathways linked to both disorders, emphasizing the potential for a cohesive treatment approach. Furthermore, molecular docking studies unveiled the binding affinity of several natural chemicals, including quercetin, kaempferol, β-sitosterol, stigmasterol, isorhamnetin, naringenin, and 8-isopentenyl-kaempferol, with key prospective targets. This suggests that a TCM combination could provide therapeutic advantages in treating both Alzheimer's disease and major depressive disorder.

Screening Traditional Chinese Medicine Combination for Co-Treatment of Alzheimer's Disease and Major Depressive Disorder by Network Pharmacology Huang Z, Fang Y, Wang X, Wang Q, Wang T

2022 Frontiers in Psychiatry

Acupuncture can be a safe and effective alternative therapy to conventional drugs for improving sleep quality and relieving symptoms in patients with active depression.

The research methodology involved a systematic review of randomized controlled trials focusing on the effect of acupuncture on depression-related insomnia. These studies were identified from seven different databases, dating up until December 2021. The papers included compared acupuncture to controls (waiting list or placebo/sham acupuncture) and conventional treatments (Western pharmacotherapy and/or cognitive-behavioral therapy) either alone or in combination with acupuncture. The analysis followed Cochrane criteria and encompassed a total of 21 trials, including 1,571 participants.

Regarding results, it was found that acupuncture significantly reduced severity metrics of sleep quality and depression for patients who have active depression, compared with placebo-acupuncture. When contrasted with standard care (antidepressants and/or sleeping aids), acupuncture led to improvements in sleep quality and depressive symptom scores. However, for those suffering from the lingering symptoms of past or partially treated depression, the therapeutic benefits of acupuncture were minor and not statistically noteworthy. Unfortunately, no studies were found to review acupuncture's efficacy compared to cognitive-behavioral therapy or its potential synergistic effect when used concurrently.

The Role of Acupuncture in the Management of Insomnia as a Major or Residual Symptom Among Patients With Active or Previous Depression: A Systematic Review and Meta-Analysis Zhao FY, Kennedy GA, Spencer SJ, Conduit R, Zhang WJ, Fu QQ, Zheng Z

2022 Frontiers in Psychiatry

Acupuncture can be a safe and effective alternative therapy to conventional drugs for improving sleep quality and relieving symptoms in patients with active depression.

The research methodology involved a systematic review of randomized controlled trials focusing on the effect of acupuncture on depression-related insomnia. These studies were identified from seven different databases, dating up until December 2021. The papers included compared acupuncture to controls (waiting list or placebo/sham acupuncture) and conventional treatments (Western pharmacotherapy and/or cognitive-behavioral therapy) either alone or in combination with acupuncture. The analysis followed Cochrane criteria and encompassed a total of 21 trials, including 1,571 participants.

Regarding results, it was found that acupuncture significantly reduced severity metrics of sleep quality and depression for patients who have active depression, compared with placebo-acupuncture. When contrasted with standard care (antidepressants and/or sleeping aids), acupuncture led to improvements in sleep quality and depressive symptom scores. However, for those suffering from the lingering symptoms of past or partially treated depression, the therapeutic benefits of acupuncture were minor and not statistically noteworthy. Unfortunately, no studies were found to review acupuncture's efficacy compared to cognitive-behavioral therapy or its potential synergistic effect when used concurrently.

The Role of Acupuncture in the Management of Insomnia as a Major or Residual Symptom Among Patients With Active or Previous Depression: A Systematic Review and Meta-Analysis Zhao FY, Kennedy GA, Spencer SJ, Conduit R, Zhang WJ, Fu QQ, Zheng Z

2022 Plants

The traditional Chinese medicine Gan Mai Da Zao Tang may lessen depressive behaviors in rats, likely through licorice increasing serotonin transporter and brain-derived neurotrophic factor signals in the hippocampus.

This study experimentally examined the antidepressant impacts of Gan-Mai-Da-Zao (GMDZ), a Chinese traditional medicine that contains blighted wheat, licorice, and jujube. The researchers used an unpredictable chronic mild stress model in rats, some of whom received an injection with p-chlorophenylalanine to generate a chemical model for depression. The investigators employed behavioral tests, including forced swim tests, open field tests, and sucrose preference tests, to evaluate the chronic influence of GMDZ.

The oral application of GMDZ over 21 days considerably eased depressive behaviors in rats induced by either the unpredictable chronic mild stress or p-chlorophenylalanine. The treatment increased the expression of the serotonin transporter and brain-derived neurotrophic factor in the hippocampus in the rats with depression. However, rats provided with a similar herbal mixture that did not include licorice showed a significantly worse response, suggesting that licorice may play an essential role in the efficacy of GMDZ in combatting depression-like behaviors.

Major Plant in Herbal Mixture Gan-Mai-Da-Zao for the Alleviation of Depression in Rat Models Li YX, Cheng KC, Hsu CT, Cheng JT, Yang TT

2022 Frontiers in Neuroscience

Chinese herbal medicine shows promising and safe outcomes in relieving functional dyspepsia symptoms and associated psychological disorders.

The methodology for this research involved a comprehensive search across various libraries and databases, such as PubMed, Embase, Cochrane Library, Web of Science, and various Chinese data sources, seeking randomized controlled trials where functional dyspepsia was treated with Chinese herbal medicine. The aim was to assess the efficacy and safety of this type of treatment for functional dyspepsia. Two researchers independently conducted each stage of the process, from searching the sources, screening the documents, extracting data, and assessing risk biases within the included studies. They used RevMan 5.4 software to do a meta-analysis of the selected research materials.

The discussion of their findings showed that treatment with Chinese herbal medicine significantly alleviated the symptoms of functional dyspepsia, compared to both a placebo group and a group treated with traditional prokinetic agents and flupentixol melitracen. Patients treated with Chinese herbal medicine reported higher total effective rates and lower total symptom scores, along with smaller depression and anxiety scores. The symptoms of functional dyspepsia, in this case, were improved more successfully with Chinese herbal medicine than with other treatment types, without any significant adverse reactions.

Chinese Herbal Medicine for Functional Dyspepsia With Psychological Disorders: A Systematic Review and Meta-Analysis Luo X, Wang L, Fang S, Qing X, Jiang T, Yang Y, Su X, Wei W

2022 Frontiers in Neuroscience

Chinese herbal medicine shows promising and safe outcomes in relieving functional dyspepsia symptoms and associated psychological disorders.

The methodology for this research involved a comprehensive search across various libraries and databases, such as PubMed, Embase, Cochrane Library, Web of Science, and various Chinese data sources, seeking randomized controlled trials where functional dyspepsia was treated with Chinese herbal medicine. The aim was to assess the efficacy and safety of this type of treatment for functional dyspepsia. Two researchers independently conducted each stage of the process, from searching the sources, screening the documents, extracting data, and assessing risk biases within the included studies. They used RevMan 5.4 software to do a meta-analysis of the selected research materials.

The discussion of their findings showed that treatment with Chinese herbal medicine significantly alleviated the symptoms of functional dyspepsia, compared to both a placebo group and a group treated with traditional prokinetic agents and flupentixol melitracen. Patients treated with Chinese herbal medicine reported higher total effective rates and lower total symptom scores, along with smaller depression and anxiety scores. The symptoms of functional dyspepsia, in this case, were improved more successfully with Chinese herbal medicine than with other treatment types, without any significant adverse reactions.

Chinese Herbal Medicine for Functional Dyspepsia With Psychological Disorders: A Systematic Review and Meta-Analysis Luo X, Wang L, Fang S, Qing X, Jiang T, Yang Y, Su X, Wei W

2022 Critical Reviews in Food Science and Nutrition

Vitamin D supplementation, particularly in doses greater than 2,000 IU/day, can help reduce depressive symptoms in adults.

In the methodology, a comprehensive database search (including Medline, PsycINFO, CINAHL and The Cochrane Library) was performed to identify English language articles relating to the impact of Vitamin D on depression in adults, published before April 2022. This meta-analysis considered both general and clinical populations and also included studies of individuals suffering from systemic diseases, but excluded studies involving light therapy, co-supplementation (except calcium), and bipolar disorder. During the assessment of the work, the Cochrane risk-of-bias tool (RoB 2) and GRADE standards were employed to appraise the validity of each study.

The results revealed a positive effect of Vitamin D on alleviating depressive symptoms. Despite the presence of high heterogeneity within included studies and with the majority having concerns related to risk of bias, it was found overall that Vitamin D supplementation, particularly when administered at doses about 2,000 IU/day, could serve as a valuable solution in reducing depressive conditions. This offers an interesting angle for mental health treatment, suggesting the supplement could be a useful addition to standard therapeutic procedures for clinical depression.

The effect of vitamin D supplementation on depressive symptoms in adults: A systematic review and meta‐analysis of randomized controlled trials Mikola T, Marx W, Lane MM, Hockey M, Loughman A, Rajapolvi S, Rocks T, O’Neil A, Mischoulon D, Valkonen-Korhonen M, Lehto SM, Ruusunen A

2022 Frontiers in Pharmacology

Modified Xiao Chai Hu Decoction combined with mirtazapine shows superior effectiveness in treating persistent depressive disorder compared to traditional Chinese medicine alone.

For the study, patients from the Naval General Hospital diagnosed with persistent depressive disorder were selected and divided into two groups. One group received modified Xiaochaihu Decoction only, while the other group was treated with a combination of modified Xiaochaihu Decoction and mirtazapine. To track progress, measurements were taken using the self-rating depression scale and the traditional Chinese medicine scale at the beginning of treatment, and again after a period of 12 weeks. Moreover, an account of any adverse reactions was also kept.

The study results indicate the total effective rate was significantly higher in the combined group compared to the control group. It was also found that while post-treatment scores of the depression scales were lower in both groups, the difference between the groups was not statistically significant. However, the combined group reported higher improvement rates for symptoms like insomnia, bitter taste, languid, and belching/anorexia. An increased frequency of adverse events was also noted in the combined group.

Modified Xiaochaihu Decoction Combined with Mirtazapine in the Treatment of Persistent Depression: A Pilot Randomized Controlled Trial Xin Li, Xiuyu Li, Man Gong, Chaoqun Li, Jing Li, Chao Zhou, Tingting He

2022 Journal of Diabetes Research

Vitamin D supplementation effectively improves depressive symptoms in women with type 2 diabetes and low vitamin D levels, regardless of the dose administered.

In the study, a double-blind randomized active comparator-controlled trial was performed. Female participants with significant depressive symptoms, as indicated by the Center for Epidemiologic Studies Depression scale, received weekly oral vitamin D supplements: a group received a higher dose (50,000 IU), while the control group received a lower dose (5,000 IU). These doses were taken over the course of 6 months, and participants' vitamin D and depression levels were evaluated at baseline, at the 3-month point, and at the end of the study.

The improvement in depressive symptoms over the course of the study was significant, irrespective of the supplement dose given. There was no discernible difference between the depression scores of those who received the higher dose compared to those who received the lower dose. This remained true when considering women with moderate baseline depressive symptoms. However, among women with severe depressive symptoms at the outset, both groups showed similar improvements in their follow-up depression scores. The dose administered did not affect the significant time-related decrease in depressive symptoms.

Vitamin D Supplementation for the Treatment of Depressive Symptoms in Women with Type 2 Diabetes: A Randomized Clinical Trial Penckofer S, Ridosh M, Adams W, Grzesiak M, Woo J, Byrn M, Kouba J, Sheean P, Kordish C, Durazo-Arvizu R, Wallis D, Emanuele MA, Halaris A

2022 Journal of Ethnopharmacology

Xiang Fu, a traditional Chinese herbal medicine, shows significant antidepressant effects.

The study reviewed the major antidepressant mechanisms and clinical applications of Cyperi Rhizoma, known as CR. It aimed to evaluate the pharmacological effects and the chemical compositions associated with these effects. The authors underwent an extensive literature search using "Cyperus rotundus L." as the search term across multiple electronic databases including Web of Science, ScienceDirect, and PubMed.

In discussing the results, the researchers found that CR has broad application in alleviating symptoms related to stagnation of Qi, such as issues with the liver, stomach, and bowels, common in different countries. They identified the effective constituents of CR, including Aqueous extract, EtOH extract, essential oil, total oligomeric flavonoids, and five other extracts. These exhibited various pharmacological activities, such as antibacterial, antioxidant, neuroprotective, antihemolytic, and anti-inflammatory effects. Notably, specific components like α-cyperone and nootkatone showed antidepressant effects. Through synthesizing this scientific information, they concluded that CR holds potential as a herbal medicine to develop antidepressant drugs with fewer side effects.

The association study of chemical compositions and their pharmacological effects of Cyperi Rhizoma (Xiangfu), a potential traditional Chinese medicine for treating depression Lu J, Li W, Gao T, Wang S, Fu C, Wang S

2021 Annals of General Psychiatry

Acupuncture therapy aimed at reducing anxiety in patients with generalised anxiety disorder has certain beneficial effects compared to controls.

Twenty RCTs were included in this systematic review and meta-analysis. All included studies were designed for patients with generalised anxiety disorder (GAD), and 18 studies were published in Chinese. Egger’s test showed that the asymmetry of the funnel plot in all studies was not significant. The meta-analysis of anxiety symptoms showed that acupuncture was more effective than the control condition, with a standard mean effect size of − 0.41, and that acupuncture intervention showed good tolerance and safety in the treatment of anxiety disorder.

Effectiveness of acupuncture on anxiety disorder: a systematic review and meta-analysis of randomised controlled trials Yang, Xy., Yang, Nb., Huang, Ff. et al.

2021 Evidence-Based Complementary and Alternative Medicine

The comprehensive evaluation results show that scalp acupuncture is effective in treating insomnia.

A total of 21 studies were included in this study, and a total of 1606 cases were included. The comprehensive evaluation results show that scalp acupuncture is effective in treating insomnia. Compared with the control group, scalp acupuncture can significantly improve the effective rate of treating insomnia. The PSQI score subgroup analysis showed that the PSQI score of the head was significantly better than that of the drug and blank group, but there was no significant difference from other acupuncture methods. Sensitivity analysis showed that scalp acupuncture ameliorates the PSQI score better, but excluding any item had high heterogeneity. Meta regression analysis of PSQI score according to different intervention measures in the control group showed that the difference of intervention measures in the control group was the source of heterogeneity. In terms of adverse events, the scalp acupuncture group had no adverse events, which was significantly better than the control group. Based on this study, we found that scalp acupuncture is effective and safe in the treatment of insomnia.

Efficacy and Safety of Scalp Acupuncture for Insomnia: A Systematic Review and Meta-Analysis Fu-gui Liu, Ai-hua Tan, Chao-qun Peng, Yun-xia Tan, Ming-chao Yao

2021 Frontiers in Aging Neuroscience

Stroke patients who received acupuncture had a lesser risk of insomnia across various demographic and medical variables.

The study data was derived from the case database of a Chinese hospital, featuring stroke patients diagnosed between 2010 and 2019. These patients were sorted into two groups: one which received acupuncture and one which did not. The sorting was performed using a propensity score matching technique. Comparisons were made between the two groups using the incidence of insomnia as the primary indicator, with Cox regression analysis and the Kaplan-Meier method serving as the main analytical tools.

The results indicated that stroke patients who underwent acupuncture treatments were less susceptible to insomnia as compared to counterparts who didn't receive acupuncture treatment. This decrease in the incidence of insomnia was observed across various categories such as genders, age groups, stroke types and stroke locations, with the acupuncture group displaying a significantly lesser cumulative incidence of insomnia.

Acupuncture Reduced the Risk for Insomnia in Stroke Patients: A Propensity-Score Matched Cohort Study Qiu X, Han NS, Yao JX, Yu FR, Lin YY, Zhuang X

2021 Journal of Trauma Nursing

Auricular acupressure may be a safe and effective technique for reducing burnout and secondary traumatic stress in healthcare workers.

In this prospective randomized trial with an open, parallel-group design, participants were randomized to receive one of three interventions: auricular acupuncture, auricular seed acupressure, or auricular massage. Interventions took place over a period of 3 weeks at a 334-bed Level II pediatric trauma center. Using a pre-/posttest design, the researchers analyzed self-reported scores from the State-Trait Anxiety Inventory, the Professional Quality of Life scale, and the Caring Ability Inventory.

The study found that auricular seed acupressure was associated with a reduction in burnout and secondary traumatic stress. Importantly, this effect remained even after adjusting for individual pretest scores. Attempts at achieving significant effects on anxiety levels, professional quality of life, and caring ability, however, did not yield any significant improvement. Overall, the data suggest that auricular acupressure is a very effective strategy for reducing work-related stress among health care staff.

Effects of Acupuncture and Acupressure on Burnout in Health Care Workers: A Randomized Trial Afrasiabi J, McCarty R, Hayakawa J, Barrows J, Lee K, Plouffe N, Schomberg J

2020 Annals of Palliative Medicine

Acupuncture treatment of insomnia is efficacious, not because of its placebo effect.

Acupuncture is a common alternative therapy for clinical treatment of insomnia. As the underlying mechanism is yet unclear, its efficacy is often considered as placebo effect. To clarify whether acupuncture treatment of insomnia is only due to its placebo effect, a systematic review and a meta-analysis were designed based on the comparison between acupuncture and sham acupuncture.

Compared to the sham groups, acupuncture significantly decreased the PSQI score (P<0.0001). A subgroup analysis showed that the selection of sham acupuncture methods did not affect the results of PSQI. A subgroup of two trials with a total of 141 participants with major depressive disorder did not show any significant reductions in total PSQI scores (P=0.11). In addition, a significant difference was detected in the change of Insomnia Severity Index (ISI) scores (362 adult patients, 4 trials) between acupuncture and sham acupuncture (P<0.0001). The PSG and actigraphy data from acupuncture and the sham did not reveal any significant differences in the sleep structure changes.

For the selection of sham acupuncture, both methods performed similarly in a clinical setting. Moreover, insomnia patients with major depression disorder were not recommended to use only acupuncture treatment.

Placebo effect of acupuncture on insomnia: a systematic review and meta-analysis Liu C, Xi H, Wu W, Wang X, Qin S, Zhao Y, Zheng S, Wan Q, Xu L.

2020 Nature and Science of Sleep

Ten sessions of electroacupuncture can improve the sleep quality of patients with insomnia without serious adverse effects.

Results of the current trial provide supportive evidence that electroacupuncture can be an effective, safe, and well-tolerated non-pharmacological intervention for insomnia, using validated placebo control and validated subjective questionnaires. Further long-term studies with objective sleep measures are needed for a more definitive conclusion.

Efficacy and Safety of Electroacupuncture for Insomnia Disorder: A Multicenter, Randomized, Assessor-Blinded, Controlled Trial Lee B, Kim BK, Kim HJ, Jung IC, Kim AR, Park HJ, Kwon OJ, Lee JH, Kim JH.

2020 Neuropsychiatric Disease and Treatment

Acupuncture is associated with a reduction in the risk of depression during long-term follow-up in patients with trigeminal neuralgia.

In total, 776 patients with newly diagnosed trigeminal neuralgia in each cohort with similar baseline characteristics were enrolled in the study. The acupuncture cohort had a reduced risk of depression compared to the non-acupuncture cohort. Kaplan–Meier analysis also revealed that the cumulative incidence of depression was significantly lower in the acupuncture cohort during the 13-year follow-up period. In particular, the beneficial effect of acupuncture was a decrease in the risk of depression among TN patients aged 50– 69 years who had also used carbamazepine.

Long-Term Beneficial Effects of Acupuncture with Reduced Risk of Depression Development Following Trigeminal Neuralgia: A Nationwide Population-Based Cohort Study Liao CC, Lin CL, Liao KR, Li JM

2020 Neuropsychiatric Disease and Treatment

Acupuncture is associated with a reduction in the risk of depression during long-term follow-up in patients with trigeminal neuralgia.

In total, 776 patients with newly diagnosed trigeminal neuralgia in each cohort with similar baseline characteristics were enrolled in the study. The acupuncture cohort had a reduced risk of depression compared to the non-acupuncture cohort. Kaplan–Meier analysis also revealed that the cumulative incidence of depression was significantly lower in the acupuncture cohort during the 13-year follow-up period. In particular, the beneficial effect of acupuncture was a decrease in the risk of depression among TN patients aged 50– 69 years who had also used carbamazepine.

Long-Term Beneficial Effects of Acupuncture with Reduced Risk of Depression Development Following Trigeminal Neuralgia: A Nationwide Population-Based Cohort Study Liao CC, Lin CL, Liao KR, Li JM

2020 Evidence-Based Complementary and Alternative Medicine

In the treatment of chronic pain with depression, acupuncture could not only achieve better clinical efficacy, but also have higher safety compared with conventional mediation therapy.

Acupuncture has a promising application prospect due to its unique advantages for the treatment of chronic pain with depression comorbidity, which can be used in patients suffering from some certain chronic pain with depression comorbidity with poorer response to the conventional medication or suffering from serious side effects.

Effect of Acupuncture on Chronic Pain with Depression: A Systematic Review Yan B, Zhu S, Wang Y, Da G, Tian G

2020 Frontiers in Aging Neuroscience

Acupuncture appears to be a promising complementary treatment for Alzheimer's disease, according to findings from systematic reviews and meta-analyses.

The study analysed the role of acupuncture as a complementary treatment for Alzheimer's disease by perusing systematic reviews and meta-analyses using data from eight electronic databases. The researchers employed a variety of tools such as the Assessing the Methodological Quality of Systematic Reviews 2, Risk of Bias in Systematic Reviews tool, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, and the Grading of Recommendations, Assessment, Development, and Evaluation to determine the quality of methodology, risk of potential bias, and quality of the evidence.

A total of eleven systematic reviews and meta-analyses met the necessary criteria for inclusion in this study. The results, despite indicating that acupuncture may show promise as a complementary treatment for Alzheimer's disease, all rated critically low in quality when assessed with the tools employed. Some methodological weaknesses remained, particularly pertaining to the protocol and registration, search strategy, risk of bias, additional analyses, and funding. Only a small portion of the reviews exhibited a low risk of bias. There was no high-quality evidence found, but moderate-quality evidence was provided for seven outcomes. The risk of bias in the original trials seemed more prevalent than inconsistency, imprecision, and publication bias.

Acupuncture for the Treatment of Alzheimer's Disease: An Overview of Systematic Reviews Huang J, Shen M, Qin X, Wu M, Liang S, Huang Y

2020 Frontiers in Pharmacology

Jujube seed extract has been found to primarily reduce anxiety by regulating the GABAergic and serotonergic synapse pathways, specifically modulating GABRA1, HTR1A, and HTR2A.

The research relied on a system biology method supported by Ultra Performance Liquid Chromatography Quadrupole Time of Flight Mass Spectrometry (UPLC-Q-TOF/MS) and Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR). Initially, 35 phytochemicals were identified from the Jujube seed extract, which related to 71 anxiolytic targets. Further investigations, including protein-protein interaction, gene cluster, Gene Ontology, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways analyses, were conducted to identify the anxiolytic mechanisms of the extract.

The results highlighted that the main anxiolytic mechanisms of the Jujube seed extract were linked to the regulation of serotonergic and GABAergic synapse pathways. The extract's impact on the mRNA expressions of multiple gamma-aminobutyric acid type A (GABA) and serotonin (5-HT) receptors subtypes was verified in human neuroblastoma cells. Surprisingly, the extract (250 μg/mL) not only amplified the mRNA level of GABRA1 and GABRA3 alongside HTR1A, HTR2A, and HTR2B in untreated cells but also suppressed the overexpressed mRNA of GABRA1, GABRA2, HTR1A, and HTR2A in stress-induced cells.

Regulation of GABAA and 5-HT Receptors Involved in Anxiolytic Mechanisms of Jujube Seed: A System Biology Study Assisted by UPLC-Q-TOF/MS and RT-qPCR Method Chen L, Zhang X, Hu C, Zhang Y, Zhang L, Kan J, Li B, Du J

2020 Frontiers in Aging Neuroscience

Depressed patients who received acupuncture treatment showed a significantly lower risk of developing Parkinson's disease.

The study was retrospective in nature and was based on data sourced from Taiwan's National Health Insurance Research Database. An equal number of patients (9,189), with and without acupuncture treatment, were selected from the total 48,981 patients newly diagnosed with depression between 2000 and 2012. These study participants were matched 1:1 using the propensity score method. The incidence of Parkinson's disease in these two groups was compared using the Kaplan-Meier method and the difference was examined with a log-rank test. The severity of depression and specific acupoints used were not indicated.

The results indicated a significantly lower risk of developing Parkinson's disease in patients who had undergone acupuncture treatment. Differences in age, sex, insurance amount, geographic region, urbanization levels, comorbidities, and drugs were taken into account. The cumulative effect was such that the incidence was significantly lower in the acupuncture cohort as compared to the non-acupuncture cohort.

Acupuncture Treatment Reduces Incidence of Parkinson's Disease in Patients With Depression: A Population-Based Retrospective Cohort Study in Taiwan Huang CH, Lin MC, Hsieh CL

2020 Integrative Cancer Therapies

Tian Wang Bu Xin Dan can potentially alleviate symptoms of cancer-related insomnia similarly to cognitive-behavioral therapy.

In this study, 22 participants were divided equally between a group given Cheonwangbosimdan and a control group who received cognitive-behavioral therapy for insomnia. Participants in the Cheonwangbosimdan group were required to consume the herbal liquid daily and participate in weekly visits for a period of four weeks. Conversely, the control group underwent behavioral therapy sessions 4 times over the same four-week period.

The outcomes from these interventions were evaluated using key indices that measured participants' insomnia severity, sleep quality, fatigue, anxiety, and overall performance status. With the focus being on changes observed from the inception of the trial to the end, these measurements were taken at the conclusion of the fifth week. While no significant difference was found between the two study groups, both displayed a positive trend towards alleviating the symptoms of cancer-related insomnia, with anxiety levels markedly lower in the treatment group.

Comparative Effectiveness of Cheonwangbosimdan (Tian Wang Bu Xin Dan) Versus Cognitive-Behavioral Therapy for Insomnia in Cancer Patients: A Randomized, Controlled, Open-Label, Parallel-Group, Pilot Trial Moon SY, Jerng UM, Kwon OJ, Jung SY, Lee JY, Yoon SW, Shin WC, Byun JI, Lee JH

2019 Evidence-Based Complementary and Alternative Medicine

Acupuncture therapy is an effective and safe treatment for chronic pain-related insomnia.

In our current study, we pooled the data from nine studies involving 944 patients. Our pooled analysis indicated that acupuncture treatment was significantly better than drugs group in improving effective rate and cure rate and in debasing PSQI score and VAS score. In addition, compared with sham acupuncture, manual acupuncture treatment has an advantage in improving the effective rate and reducing the PSQI score, but the two groups have no statistical significance in improving the cure rate. In this meta-analysis, only four studies reported relevant adverse events. The combined data showed no significant difference in adverse reactions between acupuncture group and control group. Therefore, we can carefully recommend that acupuncture is as safe as control group for CPRI. In addition, adverse events were relatively mild, mainly including bruises, soreness, nausea, dizziness, and other discomforts. These adverse events can be effectively avoided by strengthening the aseptic operation specification, and improving the professional ability of doctors. Based on the findings of our included studies, we propose that acupuncture is an effective and safe therapy for patients with CPRI.

Acupuncture for Chronic Pain-Related Insomnia: A Systematic Review and Meta-Analysis Fushui Liu, Jianyu You, Qi Li, Ting Fang, Mei Chen, Nana Tang, Xiaojun Yan

2019 Frontiers in Psychiatry

Evidence indicates that acupuncture treatment may be of benefit in several neuropsychiatric disorders, including depression, anxiety, schizophrenia, and Alzheimer's Disease.

The pathophysiology of these disorders may be associated with glutamate dysregulation, marked by a high rate of glutamate release and elevated expression of glutamate receptors and glutamate transporters in the CNS. The ability of acupuncture stimulation to modulate glutamate receptor and EAAT expression suggests that the treatment effects of acupuncture are underpinned by its intervention in the dysregulated glutamate system. Further preclinical and clinical studies are needed to clarify the possible mechanisms of acupuncture in these neuropsychiatric disorders and to establish protocols for treatment guidelines.

The Effects of Acupuncture on Glutamatergic Neurotransmission in Depression, Anxiety, Schizophrenia, and Alzheimer's Disease: A Review of the Literature Tu CH, MacDonald I, Chen YH

2019 Frontiers in Psychiatry

Evidence indicates that acupuncture treatment may be of benefit in several neuropsychiatric disorders, including depression, anxiety, schizophrenia, and Alzheimer's Disease.

The pathophysiology of these disorders may be associated with glutamate dysregulation, marked by a high rate of glutamate release and elevated expression of glutamate receptors and glutamate transporters in the CNS. The ability of acupuncture stimulation to modulate glutamate receptor and EAAT expression suggests that the treatment effects of acupuncture are underpinned by its intervention in the dysregulated glutamate system. Further preclinical and clinical studies are needed to clarify the possible mechanisms of acupuncture in these neuropsychiatric disorders and to establish protocols for treatment guidelines.

The Effects of Acupuncture on Glutamatergic Neurotransmission in Depression, Anxiety, Schizophrenia, and Alzheimer's Disease: A Review of the Literature Tu CH, MacDonald I, Chen YH

2019 Frontiers in Psychiatry

Evidence indicates that acupuncture treatment may be of benefit in several neuropsychiatric disorders, including depression, anxiety, schizophrenia, and Alzheimer's Disease.

The pathophysiology of these disorders may be associated with glutamate dysregulation, marked by a high rate of glutamate release and elevated expression of glutamate receptors and glutamate transporters in the CNS. The ability of acupuncture stimulation to modulate glutamate receptor and EAAT expression suggests that the treatment effects of acupuncture are underpinned by its intervention in the dysregulated glutamate system. Further preclinical and clinical studies are needed to clarify the possible mechanisms of acupuncture in these neuropsychiatric disorders and to establish protocols for treatment guidelines.

The Effects of Acupuncture on Glutamatergic Neurotransmission in Depression, Anxiety, Schizophrenia, and Alzheimer's Disease: A Review of the Literature Tu CH, MacDonald I, Chen YH

2019 Frontiers in Psychiatry

Evidence indicates that acupuncture treatment may be of benefit in several neuropsychiatric disorders, including depression, anxiety, schizophrenia, and Alzheimer's Disease.

The pathophysiology of these disorders may be associated with glutamate dysregulation, marked by a high rate of glutamate release and elevated expression of glutamate receptors and glutamate transporters in the CNS. The ability of acupuncture stimulation to modulate glutamate receptor and EAAT expression suggests that the treatment effects of acupuncture are underpinned by its intervention in the dysregulated glutamate system. Further preclinical and clinical studies are needed to clarify the possible mechanisms of acupuncture in these neuropsychiatric disorders and to establish protocols for treatment guidelines.

The Effects of Acupuncture on Glutamatergic Neurotransmission in Depression, Anxiety, Schizophrenia, and Alzheimer's Disease: A Review of the Literature Tu CH, MacDonald I, Chen YH

2019 Current Medical Science

Acupuncture yielded positive results for Alzheimer's Disease as determined via clinical efficacy rate, Mini-Mental State Examination score, Ability of Daily Living Scale score and Alzheimer’s Disease Assessment Scale-Cognition score.

Eight databases were searched for articles published up to and including July 2017, and 13 studies fulfilling the inclusion criteria were identified. The main outcomes assessed were clinical efficacy rate, Mini-Mental State Examination score, Ability of Daily Living Scale score, Alzheimer’s Disease Assessment Scale-Cognition score, Hasegawa’s Dementia Scale (HDS) score, and adverse events. The methodological quality of the articles was assessed using Cochrane’s risk of bias. All the studies compared the efficacy of acupuncture with that of medication, and were published in Chinese journals. Meta-analysis revealed that acupuncture yielded positive results as determined via all the indexes scored except the HDS. Only one of the studies reported adverse events associated with acupuncture and medication. The rate of adverse events in the medication group was 13%. In most of the studies assessed in the current meta-analysis, acupuncture alone was better than conventional western medicines for the treatment of AD.

Effectiveness of Acupuncture for Alzheimer's Disease: An Updated Systematic Review and Meta-analysis Huang, Q., Luo, D., Chen, L. et al.

2019 Acta Obstetricia et Gynecologica Scandinavica

Acupuncture during IVF treatment can possibly lower anxiety at the time of embryo transfer but seems to have no long-term impact on women's quality of life.

A multicenter randomised controlled trial was conducted recruiting women between 18 to 42 years, who were already undergoing a fresh IVF cycle and not using acupuncture. The experiment ran between June 2011 and October 2015 in Australia and New Zealand. Random assignments placed participants in either the acupuncture group or a control group which received sham acupuncture. Three treatments were administered in total - the first between the 6th and 8th day of ovarian stimulation, and the other two on the day of the embryo transfer.

The results of the study highlighted that participants who received acupuncture reported experiencing significantly less anxiety following the embryo transfer. However, no discernible difference was found between the groups in terms of quality of life following the embryo transfer. The apparent benefit of acupuncture on the general health of participants was not sustained 14 weeks after the trial, which indicates that acupuncture might not have a long-term impact on a woman's emotional well-being following an IVF cycle.

The effects of acupuncture on the secondary outcomes of anxiety and quality of life for women undergoing IVF: A randomized controlled trial Smith CA, de Lacey S, Chapman M, Ratcliffe J, Norman RJ, Johnson NP, Fahey P

2019 Frontiers in Neuroscience

Gan Mai Da Zao decoction has shown comparable anxiolytic effects to Diazepam and Buspirone in mice, possibly regulated by serotonin and gamma-aminobutyric acid receptors.

The mice were given the Gan-Mai-Da-Zao (GMDZ) decoction orally at different concentrations for a week, with Diazepam and Buspirone serving as positive controls. Anxiety-level testing was conducted using a combination of the elevated plus-maze, light/dark box, marble burying, open field, and rota-rod tests, providing a comprehensive assessment of the decoction's effects on mice.

Furthermore, the anxiolytic effects that GMDZ induced in the mice were challenged by the application of Flumazenil, a gamma-aminobutyric acid-A receptor antagonist, and WAY-100635, a serotonin-1A receptor antagonist. They found that the effects were successfully inhibited, indicating that the mechanism of action of GMDZ could be linked to both the serotonin and gamma-aminobutyric acid receptors in the nervous system, thereby reducing anxiety-like behavior in mice.

GABA and 5-HT Systems Are Involved in the Anxiolytic Effect of Gan-Mai-Da-Zao Decoction Chen HS, Gu LJ, Yang YX, Guo JY

2018 Medicine

Acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes.

Overactive bladder is stated as the occurrence of urinary urgency which will cause negative impacts and decrease patients’ health-related quality of life. The aim of this systematic review is to assess the efficiency and safety of acupuncture for adults with overactive bladder (OAB) comparing with sham-acupuncture, drugs, and acupuncture plus drugs.

Acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes. However, the evidence is insufficient to show the effect using acupuncture alone or the additional effect to drugs in treating OAB.

Acupuncture for adults with overactive bladder: A systematic review and meta-analysis of randomized controlled trials Zhao Y, Zhou J, Mo Q, Wang Y, Yu J, Liu Z.

2018 Journal of Traditional and Complementary Medicine

Gan Mai Da Zao Tang, a traditional herbal formula, produced substantial antidepressant-like effects in rats by regulating monoamine neurotransmitters.

The researchers studied the antidepressant effects of Gan-Mai-Da-Zao-Tang and its constituent ingredients in rats subjected to the forced swim test. 72 male Nerl: Wistar rats aged 8 weeks were divided into groups receiving either a control solution, licorice, wheat, jujube, Gan-Mai-Da-Zao-Tang in a specific ratio, or Prozac. These substances were administered orally for 21 days. On the final day, the forced swimming test was performed which initially involved a pretest lasting 15 minutes followed by a 5 minute real test. Following this, the rats were euthanized and their brain tissues were collected for analysis of monoamine concentrations.

Discussion on the results revealed that the Gan-Mai-Da-Zao-Tang group exhibited significantly reduced immobility time and certain monoamine turnover rates, and showed an increase in concentration of some neurotransmitters in the brain tissues compared to the control group. This indicates a potent antidepressant-like effect by modulating these monoamines concentrations. In contrast, the licorice, wheat, and jujube groups didn't display significant differences when compared with the control group. Prozac, the positive control, resulted in significant reductions in body weight and appetite.

Antidepressant-like effects of Gan-Mai-Dazao-Tang via monoamine regulatory pathways on forced swimming test in rats Huang HL, Lim SL, Lu KH, Sheen LY

2017 Sleep Medicine Reviews

The severity of primary restless legs syndrome symptoms can be significantly ameliorated by acupuncture.

Complementary and alternative therapies have been found to be effective in both primary and secondary restless legs syndrome (RLS). The severity of primary RLS symptoms can be significantly ameliorated by exercise training, transcutaneous spinal direct current stimulation, pneumatic compression devices, light therapy, repetitive transcranial magnetic stimulation, and acupuncture. Pneumatic compression devices and yoga also improve RLS-related disorders. Exercise training is highly efficacious in the reduction of symptom severity in uremic RLS and related effects such as poor quality of life. Endovenous laser ablation may be a good choice for patients with concurrent RLS and superficial venous insufficiency.

Complementary and alternative therapies for restless legs syndrome: An evidence-based systematic review Xu XM, Liu Y, Jia SY, Dong MX, Cao D, Wei YD.

2017 Mindfulness

iRest Yoga Nidra combined with acupuncture significantly improves psychological health in veterans compared to using acupuncture alone.

The study employed iRest Yoga Nidra, a mindfulness approach that promotes relaxation and focused attention, along with acupuncture. Initially developed for military use, iRest was combined with acupuncture in this exploratory study to determine its effectiveness. Specifically, this was tested on veterans with a view to improving their psychological health. Throughout the study, the participants were exposed to principles such as non-judgment and observation of opposing feelings and emotions, along with the inclusion of these principles into their everyday life.

The analysis of results showed that the combined therapy using iRest and acupuncture had a marked effect on psychological health. There were significant improvements in areas such as depression, psychological symptom severity, depression or tension as a result of pain, and the emotional interference with activities of daily life. Conversely, the group that had only undergone acupuncture treatment showed no significant benefits in these areas. Also significant was that the comfort shown by the treatment group was a moderate to high degree in contrast to the low comfort experienced by the group receiving only acupuncture. The overall treatment condition demonstrated considerable changes, with veterans reporting substantive decreases in the levels of mild, moderate, and severe depression. Additionally, it was indicated that the benefits of the combined treatment did not differ across factors such as age, gender, or race.

The Effect of Mindfulness and Acupuncture on Psychological Health in Veterans: an Exploratory Study Wheeler MS, Glass CR, Arnkoff DB, Sullivan P, Hull A

2016 BMC Complementary Medicine and Therapies

Our results suggest that acupuncture could be effective for treating insomnia after stroke.

A total of 165 studies were identified; 13 RCTs met our inclusion criteria. Meta-analysis showed that acupuncture appeared to be more effective than drugs for treatment of insomnia after stroke, as assessed by the PSQI and by the efficacy standards of Chinese medicine. Intradermal acupuncture had significant effects compared with sham acupuncture, as assessed by the ISI and the AIS.

Acupuncture for insomnia after stroke: a systematic review and meta-analysis Lee SH, Lim SM

2015 Sleep Medicine

Chinese herbal medicine was superior to placebo and benzodiazepine drugs and was superior to benzodiazepines and psychotherapy alone as an adjunct therapy in terms of subjective sleep quality and quantity and safety.

In this study, we systematically reviewed 79 RCTs investigating a variety of Chinese herbal medicine (CHM) treatments for participants with insomnia. We also performed meta-analyses to estimate the efficacy of CHM on subjective sleep quality assessed by validated instruments, patient-rated sleep parameters, clinician-reported severity, and PSG results, as well as to determine the safety of CHM.

Overall, this systematic review and meta-analysis showed that CHM was superior to placebo and benzodiazepine drugs (BZDs) when used as a monotherapy and was superior to BZDs and psychotherapy alone as an adjunct therapy in terms of subjective sleep quality and quantity and safety. CHM was not associated with more benefit than non-BZDs, although the risks were less. These results suggest that CHM could be a promising alternative therapy with a good benefit–risk ratio.

Updated clinical evidence of Chinese herbal medicine for insomnia: a systematic review and meta-analysis of randomized controlled trials Xiaojia Ni, Johannah Linda Shergis, Xinfeng Guo, Anthony Lin Zhang, Yan Li, Chuanjian Lu, Charlie Changli Xue

2015 Evidence-Based Complementary and Alternative Medicine

TCM pattern-based treatments for depression frequently use Xiao Yao and Chai Hu Shu Gan decoctions, with Bai Shao and Chai Hu herbs common across different TCM patterns.

The methodology incorporated a systematic review of randomized controlled trials from both Chinese and English literatures regarding traditional Chinese medicine (TCM) pattern-based treatments for depression. This encompassed a total of 61 studies and 2504 subjects across 27 TCM patterns. Due to varied TCM patterns among participants, the analysis focused on the four most prevalent ones: liver qi depression, liver depression and spleen deficiency, dual deficiency of the heart and spleen as well as liver depression and qi stagnation.

In the discussion of results, it was found that Xiaoyao decoction was most frequently used for the treatment of liver qi depression and liver depression with spleen deficiency, whereas Chaihu Shugan decoction was typically used for liver depression and qi stagnation. Commonly used herbs regardless of the prescribed Chinese herbal formulas included Bai Shao and Chai Hu. Typically, the individual studies did not provide an underlying rationale for herb selection, limiting the conclusions one could draw regarding the efficacy of certain herbal formulas and the response of specific TCM patterns to these treatments.

Prescription of Chinese Herbal Medicine in Pattern-Based Traditional Chinese Medicine Treatment for Depression: A Systematic Review Yeung WF, Chung KF, Ng KY, Yu YM, Zhang SP, Ng BFL, Ziea ETC

2013 International Review of Neurobiology

The clinical efficacy of acupuncture appeared to be supported by evidence obtained from basic neuroendocrinological studies.

A number of studies have demonstrated that acupuncture may modulate a wide range of neuroendocrinological factors following stimulation of acupoints. Evidence has suggested that the clinical efficacy of acupuncture in treatment of insomnia is potentially mediated by a variety of neurotransmitters including norepinephrine, melatonin, gamma-aminobutyric acid, and β-endorphin. However, due to the complexity, these findings are far from conclusive. More research is necessary. More rigors methodology and integrated approach to evaluate both clinical and basic research evidence are required for future studies.

Acupuncture for the treatment of insomnia Kaicun Zhao

2013 Evidence-Based Complementary and Alternative Medicine

Evidence of effectiveness of acupuncture for PTSD is encouraging but not cogent. Acupuncture may be a relatively safe alternative for PTSD in contrast to SSRI, if long-term therapy is needed for treatment.

This is the first systematic review and meta-analysis of prospective clinical trials on the effectiveness of acupuncture for treatment of PTSD. Only 4 RCTs and 2 UCTs met the inclusion criteria for this review. Our main finding of this review is that acupuncture is effective for PTSD based on one high-quality RCT and a meta-analysis.

Acupuncture has positive effects in PTSD patients, although the evidence is still lacking as to its true efficacy for this condition.

Acupuncture for Posttraumatic Stress Disorder: A Systematic Review of Randomized Controlled Trials and Prospective Clinical Trials Young-Dae Kim, In Heo, Byung-Cheul Shin, Cindy Crawford, Hyung-Won Kang, Jung-Hwa Lim,

2011 Cochrane Database of Systematic Reviews

Acupuncture might result in improvement in some outcomes in children with autism spectrum disorders.

When needle acupuncture plus conventional treatment was compared to sham acupuncture plus conventional treatment, the intervention seemed to result in better language comprehension, cognition, self‐care, social function and a higher likelihood of greater than or equal to 25% improvement in global function.

Compared to conventional treatment alone, needle acupuncture plus conventional treatment might result in an overall improvement in autistic features, speech, cognition, global functioning, self‐care, sensory functioning, imitation, repetitive behaviour, and physical health.

Compared to conventional treatment alone, acupressure plus conventional treatment might result in improvement in overall global functioning, communication attitude, non‐verbal communication and matching, and language and social interaction.

Acupuncture for autism spectrum disorders (ASD) Cheuk DKL, Wong V, Chen WX

2009 The Journal of Alternative and Complementary Medicine

Clinical studies have shown that acupuncture may have a beneficial effect on insomnia compared with Western medication.

Forty-six (46) randomized trials involving 3811 patients were included, and the methodological quality of trials was generally fair in terms of randomization, blinding, and intention-to-treat analysis. Meta-analyses showed a beneficial effect of acupuncture compared with no treatment and real acupressure compared with sham acupressure on total scores of Pittsburgh Sleep Quality Index. Acupuncture was superior to medications regarding the number of patients with total sleep duration increased for >3 hours. However, there was no difference between acupuncture and medications in average sleep duration. Acupuncture plus medications showed better effect than medications alone on total sleep duration. Similarly, acupuncture plus herbs was significantly better than herbs alone on increase of sleep rates. There were no serious adverse effects with related to acupuncture treatment in the included trials.

Acupuncture for Treatment of Insomnia: A Systematic Review of Randomized Controlled Trials Cao H, Pan X, Li H, Liu J.