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 low‐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 medium‐term and long‐term follow‐up in clinical trials represents a significant limitation of the evidence base.
