
Acupuncture for Mental Health.
Chronic stress, anxiety and depression are the most common and disabling mental health concerns in modern society. They are often experienced as a complex set of emotional, physical and behavioural symptoms.
People with anxiety disorder frequently experience unpleasant feelings of worry or fear accompanied by physical symptoms such as fatigue, headaches, muscle aches, digestive complaints, trembling, irritability, sweating and hot flashes.
Depression is characterised by low energy, mood and low self-esteem, poor concentration, negative thoughts and emotions, and loss of interest in normally enjoyable activities. Appetite, body weight and sleep are also commonly affected.
What Does The Research Say?
The following insights are obtained from systematic reviews and analysis of clinical trials investigating the efficacy of Chinese medicine and acupuncture for mental health.
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.
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
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.
2018 Cochrane Database of Systematic Reviews
Acupuncture may result in a moderate reduction in the severity of depression when compared with treatment as usual or no treatment.
The 64 trials included in this review compared acupuncture alone or in combination with pharmaceutical therapy versus a range of comparator interventions. The reduction in severity of depression at the end of treatment was smaller when acupuncture was compared with control acupuncture than when acupuncture was compared with no treatment control, although we rated both sets of results as providing lowâ€quality evidence. The possible benefit of acupuncture provided alone or in conjunction with pharmaceutical medication such as a selective serotonin reuptake inhibitor (SSRI) compared with pharmaceutical monotherapy is uncertain owing to the very low quality of available evidence. The effect of acupuncture compared with psychological therapy is unclear. The risk of adverse events with acupuncture is also unclear, as most trials did not report these adequately. However, in general, the risk of adverse events associated with acupuncture is low (Melchart 2004;Witt 2009). Few trials reported on dropout, reduced use of medication, and quality of life. Evidence is insufficient to show the optimal type of acupuncture or characteristics of acupuncture dosage. Lack of mediumâ€term and longâ€term followâ€up in clinical trials represents a significant limitation of the evidence base.
Acupuncture for depression Smith CA, Armour M, Lee MS, Wang LQ, Hay PJ
2017 Programme Grants for Applied Research
For patients continuing to experience depression in primary care, there are statistically significant benefits at 3 months associated with both acupuncture and counselling interventions when provided as adjuncts to usual care.
In this report we present what is to our knowledge the first study to rigorously evaluate the clinical and economic impacts of acupuncture and counselling for patients who are representative of those who continue to experience depression in primary care. Our evidence on acupuncture compared with usual care and counselling compared with usual care shows that both treatments are associated with a statistically significant reduction in symptoms of depression in the short to medium term, with no reported serious adverse events related to treatment. Acupuncture is cost-effective compared with counselling or usual care alone, although the ranking of counselling and acupuncture depends on the relative costs of delivering these interventions.
Acupuncture, Counselling or Usual Care for Depression (ACUDep): a randomised controlled trial MacPherson H, Vickers A, Bland M, et al.
2017 Journal of Trauma & Dissociation
There are potential clinical benefits of acupuncture on PTSD symptoms and functional status immediately post-intervention, as well as PTSD and depressive symptoms in the months following completion of acupuncture treatment.
Overall, the results of this systematic review warrant caution in promoting acupuncture as an evidence-based treatment for adult patients with PTSD despite identified positive treatment effects. We have limited confidence in estimates indicating that needle acupuncture reduces PTSD and depressive symptoms at follow-up compared to passive controls, TAU, and active interventions, and we have very limited confidence in the estimates for PTSD symptoms at post-intervention and functional status. Moreover, no significant differences were observed between acupuncture and comparators for other outcomes, including no evidence for post-intervention or longer term improves on important psychological outcomes such as anxiety symptoms and sleep quality. Evidence from RCTs does suggest that acupuncture is relatively safe. Larger trials that minimize participant attrition would improve the quality of and confidence in effect estimates.
Acupuncture for the Treatment of Adults with Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis Grant, S., Colaiaco, B., Motala, A., Shanman, R., Sorbero, M., & Hempel, S.
2015 Explore: The Journal of Science & Healing
Acupuncture seems to be an effective add-on treatment in patients with depression and, to a lesser degree, in patients with schizophrenia.
The overall clinical results on using acupuncture to treat depression are promising, but only limited evidence for its effectiveness in treating schizophrenia was found. Acupuncture improves the quality of life, particularly that of sleep, in psychiatric patients. Brain research has revealed that acupuncture has a modulating and normalizing effect on the limbic–paralimbic–neocortical network (LPNN), including the default mode network. Because the LPNN is related to sleep and emotions, this might explain the improved qualities of life and sleep after acupuncture.
Schizophrenia and Depression: A systematic Review of the Effectiveness and the Working Mechanisms Behind Acupuncture Bosch P, van den Noort M, Staudte H, Lim S.
2015 Acupuncture in Medicine
Acupressure seems to be effective in providing immediate relief of pretreatment anxiety among adults, and has a medium effect size.
Of 39 potentially relevant studies, seven RCTs met the inclusion criteria for review while five studies met the criteria for meta-analysis. All studies reported the positive effect of acupressure on relieving anxiety from the anticipation of surgery or treatment. EX-HN3 (Yintang), HT7 (Shenmen) were the commonest points selected and two studies used bilateral points. The acupressure procedure was generally well reported and studies had a low risk of bias. The combined results of the five trials showed a greater overall reduction in anxiety in the acupressure group than in the sham controls.
Effects of Acupressure on Anxiety: A Systematic Review and Meta-Analysis Au DWH, Tsang HWH, Ling PPM, Leung CHT, Ip PK, Cheung WM
2014 Medical Care
Improvement in post traumatic stress disorder severity was significantly greater among those receiving acupuncture than in those receiving usual PTSD care.
Mean improvement in PTSD severity was significantly greater among those receiving acupuncture than in those receiving usual PTSD care (PCLΔ=19.8±13.3 vs. 9.7±12.9, P<0.001; CAPSΔ=35.0±20.26 vs. 10.9±20.8, P<0.0001). Acupuncture was also associated with significantly greater improvements in depression, pain, and physical and mental health functioning. Pre-post effect-sizes for these outcomes were large and robust.
Acupuncture was effective for reducing PTSD symptoms. Limitations included small sample size and inability to parse specific treatment mechanisms. Larger multisite trials with longer follow-up, comparisons to standard PTSD treatments, and assessments of treatment acceptability are needed. Acupuncture is a novel therapeutic option that may help to improve population reach of PTSD treatment.
Randomized effectiveness trial of a brief course of acupuncture for posttraumatic stress disorder Engel CC, Cordova EH, Benedek DM, Liu X, Gore KL, Goertz C, et al.
2014 PLOS One
Acupuncture is cost-effective compared with counselling or usual care alone in treating patients with depression.
The results of this analysis suggest acupuncture is cost-effective compared with counselling or usual care alone. This result is strongly influenced by the cost of acupuncture which only remains cost-effective when the cost of providing the intervention is lower than that of counselling. For patients in whom acupuncture is unavailable and perhaps inappropriate, counselling has an ICER less than a range of estimates of NICE’s cost-effective threshold. However, further research is needed to determine the most cost-effective treatment pathways for depressed patients when the full range of available interventions is considered.
Cost-effectiveness analysis of acupuncture, counselling and usual care in treating patients with depression: the results of the ACUDep trial Spackman, E., Richmond, S., Sculpher, M., Bland, M., Brealey, S., Gabe, R., Hopton, A., Keding, A., Lansdown, H., Perren, S., Torgerson, D., Watt, I., & MacPherson, H.
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 European Journal of Integrative Medicine
Current evidence from this meta-analysis of randomized trials shows that acupuncture is effective in reducing severity of depression.
Four systematic reviews and 26 RCTs on acupuncture for treatment of depression were identified and included in this review. The methodological quality of the trial reports was generally low in terms of generation of the allocation sequence, allocation concealment, blinding and intention to treat. A significant beneficial effect was found for acupuncture in improvement of depression compared to pooled control measured by Hamilton Rating Scale for Depression. Subgroup analysis suggested that electro-acupuncture and TCM acupuncture, were not statistically different from medication. Acupuncture was regarded as generally safe in the clinical trials included in this review.
Acupuncture treatment for depression—A systematic review and meta-analysis Trine Stub, Terje Alræk, Jianping Liu
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, selfâ€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, selfâ€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, nonâ€verbal communication and matching, and language and social interaction.
Acupuncture for autism spectrum disorders (ASD) Cheuk DKL, Wong V, Chen WX
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Although well-conducted clinical research can help members of the public to make better-informed decisions about their healthcare, we do not make any claims that any particular treatment may be efficacious for any individual person.
When you consult with our Chinese medicine practitioners, you'll receive personalised advice and treatment based on your symptoms and Chinese medicine diagnosis.
Scientific References
Browse our collection of scientific clinical research on acupuncture for mental health.
It includes recent and reputable papers published by peer-reviewed journals within the last 10 years.

2021, Jan 30
Effectiveness of acupuncture on anxiety disorder: a systematic review and meta-analysis of randomised controlled trials
Annals of General Psychiatry International Society of Neurobiology and Psychopharmacology
The study suggest that acupuncture therapy showed beneficial effects in reducing anxiety in patients with anxiety disorder. It indicated that acupuncture is more effective than western medicine. It also further suggests that acupuncture works better in earlier stages.
Yang, Xy., Yang, Nb., Huang, Ff. et al. Full Article

2020, Dec
Long-Term Beneficial Effects of Acupuncture with Reduced Risk of Depression Development Following Trigeminal Neuralgia: A Nationwide Population-Based Cohort Study
Neuropsychiatric Disease and Treatment
The systematic review and meta-analysis also concluded that the therapeutic efficacy of acupuncture is highly effective alone and combined with antidepressant medication.
Liao CC, Lin CL, Liao KR, Li JM Full Article

2019, Jun 17
Effectiveness of Acupuncture for Alzheimer’s Disease: An Updated Systematic Review and Meta-analysis
Current Medical Science Huazhong University of Science and Technology
In most of the studies assessed in the current meta-analysis, acupuncture alone was better than conventional western medicines for the treatment of AD.
Huang, Q., Luo, D., Chen, L. et al. Full Article

2019, Feb 12
The Effects of Acupuncture on Glutamatergic Neurotransmission in Depression, Anxiety, Schizophrenia, and Alzheimer's Disease: A Review of the Literature
Frontiers in Psychiatry
We conclude that the treatment effects of acupuncture may be 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.
Tu CH, MacDonald I, Chen YH Full Article

2018, Mar 04
Acupuncture for depression
Cochrane Database of Systematic Reviews Cochrane
We found low-quality evidence suggesting that acupuncture (manual and electro-) may moderately reduce the severity of depression by end of treatment. Acupuncture may be associated with a small reduction in the severity of depression of 1.69 points on the Hamilton Depression Rating Scale (HAMD) by end of treatment.
Smith CA, Armour M, Lee MS, Wang LQ, Hay PJ Full Article

2017, Mar 9
Acupuncture for the Treatment of Adults with Posttraumatic Stress Disorder: A Systematic Review and Meta-Analysis
Journal of Trauma & Dissociation International Society for the Study of Trauma and Dissociation
The included low-quality studies suggest that acupuncture effectively treats PTSD symptoms post-intervention, especially with longer follow-up (up to 6months) and no significant evidence on depressive symptoms, anxiety symptoms, and sleep quality.
Grant, S., Colaiaco, B., Motala, A., Shanman, R., Sorbero, M., & Hempel, S. Full Article

2017, Jan
Acupuncture, Counselling or Usual Care for Depression (ACUDep): a randomised controlled trial
Programme Grants for Applied Research NHS National Institutes for Health Research
Our evidence on acupuncture compared with usual care and counselling compared with usual care shows that both treatments are associated with a statistically significant reduction in symptoms of depression in the short to medium term, with no reported serious adverse events related to treatment. Acupuncture is cost-effective compared with counselling or usual care alone, although the ranking of counselling and acupuncture depends on the relative costs of delivering these interventions.
MacPherson H, Vickers A, Bland M, et al. Full Article

2016, Jun
Effects from acupuncture in treating anxiety: integrative review
The Brazilian Journal of Nursing Brazilian Nursing Association
Acupuncture seems to be a promising treatment for anxiety; however, there is a need for improving the methodological quality of the research on this field.
Goyata SL, Avelino CC, Santos SV, Souza Junior DI, Gurgel MD, Terra FS Full Article

2015, Jul
Schizophrenia and Depression: A systematic Review of the Effectiveness and the Working Mechanisms Behind Acupuncture
Explore: The Journal of Science & Healing
From the evidence found in this study, acupuncture seems to be an effective add-on treatment in patients with depression and, to a lesser degree, in patients with schizophrenia, but large well-designed studies are needed to confirm that evidence.
Bosch P, van den Noort M, Staudte H, Lim S. Full Article

2014, Dec
Randomized effectiveness trial of a brief course of acupuncture for posttraumatic stress disorder
Medical Care American Public Health Association
Acupuncture was effective for reducing PTSD symptoms. Limitations included small sample size and inability to parse specific treatment mechanisms. Acupuncture is a novel therapeutic option that may help to improve population reach of PTSD treatment.
Engel CC, Cordova EH, Benedek DM, Liu X, Gore KL, Goertz C, et al. Full Article

2014, Nov
Cost-effectiveness analysis of acupuncture, counselling and usual care in treating patients with depression: the results of the ACUDep trial
PLOS One Public Library of Science
The clinical results of the trails demonstrated that acupuncture and counselling significantly reduced depression measures at 3 and 6 months when compared with routine care. It was also reported to have improvement over the 12 month period. It also further showcase that acupuncture is cost-effective (in the UK) compared with counselling or usual care alone.
Spackman, E., Richmond, S., Sculpher, M., Bland, M., Brealey, S., Gabe, R., Hopton, A., Keding, A., Lansdown, H., Perren, S., Torgerson, D., Watt, I., & MacPherson, H. Full Article

2014, Oct
Acupuncture for schizophrenia
Cochrane Database of Systematic Reviews Cochrane
Limited evidence suggests that acupuncture may have some antipsychotic effects as measured on global and mental state with few adverse effects. Better designed large studies are needed to fully and fairly test the effects of acupuncture for people with schizophrenia
Shen X, Xia J, Adams CE. Full Article

2014, Mar 06
Current evidence regarding the management of mood and anxiety disorders using complementary and alternative medicine
Expert Review of Neurotherapeutics
The systematic review showcase the efficacy of acupuncture in improving anxiety, depression and bipolar disorders. Patients reported to have reduced pre-procedure anxiety and anxiety disorders. The treatments were also found to have been beneficial with behavioral desensitization for anxiety neurosis.
Anthony J Bazzan, George Zabrecky, Daniel A Monti & Andrew B Newberg Full Article

2014, Mar
Acupuncture and relaxation response for craving and anxiety reduction among military veterans in recovery from substance use disorder
American Journal On Addictions American Academy of Addiction Psychiatry
The study indicated that acupuncture is highly effective with increasing relaxation response for military veterans. It showed that both craving and anxiety levels continued to drop as study participants seek long term therapy. It also showed the importance for the care of military personnel and for veterans who have recently returned from active duty.
Chang, B. H., & Sommers, E. Full Article

2013, Jul
Acupuncture for Generalized Anxiety Disorder: A Systematic Review
Journal of Psychology & Psychotherapy
This systematic review showcase the efficacy of acupuncture in treating generalized anxiety disorder (GAD). Patients reported to have less or no side effects compared to having pharmaceutical drugs
Rui Ma, Shujun Xu, Xiuyun Wen,Qian Wu,Yanan Wu, Yefei Huang and Wenbin Fu Full Article

2013, Feb
Acupuncture for Posttraumatic Stress Disorder: A Systematic Review of Randomized Controlled Trials and Prospective Clinical Trials
Evidence-Based Complementary and Alternative Medicine
This systematic review indicated the efficacy of acupuncture for PTSD patients. Patients reported to have better outcomes compared to drug therapy in particular selective serotonin reuptake inhibitors (SSRI). There were less side effects for non-SSRI group and considered a safe treatment for long term therapy.
Young-Dae Kim, In Heo, Byung-Cheul Shin, Cindy Crawford, Hyung-Won Kang, Jung-Hwa Lim, Full Article

2011, Dec
Acupuncture treatment for depression—A systematic review and meta-analysis
European Journal of Integrative Medicine
Current evidence from this meta-analysis of randomized trials shows that acupuncture is effective in reducing severity of depression and that TCM- and electro acupuncture may have similar effect as current usual care.
Trine Stub, Terje Alræk, Jianping Liu Full Article
