AUTHOR=Zhao Fei-Yi , Fu Qiang-Qiang , Kennedy Gerard A. , Conduit Russell , Zhang Wen-Jing , Zheng Zhen 

TITLE=Acupuncture as an Independent or Adjuvant Management to Standard Care for Perimenopausal Depression: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Psychiatry

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.666988

DOI=10.3389/fpsyt.2021.666988

ISSN=1664-0640

ABSTRACT=Background
Many women with perimenopausal depression (PMD) have sought alternative therapies such as acupuncture because of concerns about risks associated with antidepressant and hormone replacement therapy (HRT). This systematic review aimed to clarify if acupuncture is effective for PMD compared with waitlist control or placebo-/sham-acupuncture, and if acupuncture alone or combined with standard care (antidepressant and/or HRT) is more effective in ameliorating PMD in comparison to standard care alone.
Methods
Randomized controlled trials (RCTs) of PMD treatment via acupuncture Vs. waitlist-control or placebo-/sham-acupuncture, and RCTs of PMD treatment via acupuncture alone or combined with Western pharmacotherapy Vs. Western pharmacotherapy were searched for from seven databases from inception to December 2020. Cochrane criteria were followed.
Results
Twenty five studies involving 2213 women were analyzed. Meta-analyses indicated that acupuncture significantly reduced the global scores of Hamilton Depression Scale (HAMD) [SMD= -0.54, 95%CI (-0.91, -0.16), p< 0.01], compared with standard care. The therapeutic effect of acupuncture maintained at 2-week, 4-week and 12-week follow-ups. Acupuncture combined with standard care was more effective than standard care alone in decreasing HAMD scores [SMD= -0.82, 95%CI (-1.07, -0.58), p< 0.01]. Too few RCTs were available to assess the clinical efficacy differences between acupuncture and placebo-/sham-acupuncture or HRT alone. Acupuncture also showed better effects in decreasing Kupperman Index (KI) scores, whether compared with antidepressant alone [MD= -4.55, 95%CI (-8.46, -0.65), p= 0.02] or antidepressant combined with HRT [MD= -0.89, 95%CI (-1.34, -0.43), p< 0.01].
Conclusions
In comparison to standard care, acupuncture alone or combined with standard care was associated with significant improvements in PMD, and reductions of other menopausal symptoms. This finding suggests that acupuncture may be a useful addition to treatment for PMD.