Study confirms benefits of auricular acupuncture in treating depression

Julia Moiori Gencia FAPESP – Auricular acupuncture, recommended by the World Health Organization (WHO) and offered as an integrative practice by the Brazilian National Health Service SUS (Sistema Única de Saúde) since 2006, is safe and safe for patients with depression. , effectively reduce symptoms of depression. According to a study conducted by researchers from the University of São Paulo (USP) and the University of Southern Santa Catarina (UNISUL).

The research results are reported in the article published in a diary JAMA network open. They confirm the effectiveness of auricular acupuncture as an alternative treatment for depression, a mood disorder for which an increasing number of people are seeking treatment from SUS, judging from data provided by the Ministry of Health.

According to the WHO, depression is one of the leading causes of disability worldwide. The lifetime prevalence of depression in Brazil is 15.5%, one of the highest in the world, and the lifetime prevalence of depression in Brazil is one of the highest in the world, compared to YLL (years of life lost), a measure of premature mortality calculated by subtracting the age at death from the maximum life expectancy. Depressive disorders accounted for 10.3%. Expectations for people of that age.

Yet less than half of those affected worldwide receive treatment considered appropriate, including psychotherapy and medication. In some countries, the percentage is less than 10%. This is due to the high cost of antidepressants and their side effects, such as stomach discomfort and decreased sex drive. As a result, there is increasing interest in non-pharmacological and more affordable options. For example, in the United States, one third of the population prefers alternative treatments for depression.

One such alternative is auricular acupuncture. This is an ancient Chinese technique in which a thin needle is inserted into a point in the outer ear for the purpose of stimulating various organs, including the brain and vagus nerve. Needles are cheap. A pack of 50 (enough for 10 sessions) costs less than R$10.00 (currently about $2.00 USD). This technique is simple and quick (sessions can be completed in 5 to 15 minutes), does not require extensive training, and can be provided by a nurse or physical therapist, unlike whole body acupuncture, which can only be provided by a qualified practitioner. Can be applied. The disadvantage is that its efficacy and safety in treating depression have not yet been fully established.

Researchers sought this kind of evidence in their study. Funded by FAPESP The study was conducted from March to July 2023 and included 74 patients with Patient Health Questionnaire 9 (PHQ9) scores indicating moderate or moderately severe depression. Prospective participants were not included if they had previously undergone auricular acupuncture or if they were severely depressed and at risk of suicide. They were given 12 sessions of 15 minutes each over a 6-week period.

The average age of participants was 29 years, and most (84%) were female. They were divided into two groups of 37 people. One group received special auricular acupuncture (SA) to treat depression according to traditional Chinese medicine, stimulating six points in the outer ear that correspond to symptoms. Shenmen (mental), subcortical, heart, lungs, liver, kidneys. The other received nonspecific treatment (NSA) using astigmatism or auricular points (four points on the pinna, cheek, face, and spiral) not associated with symptoms of mental illness. For ethical reasons, all participants continued their usual treatment. The efficacy and safety of acupuncture treatment were evaluated after 4 weeks, 6 weeks, and 3 months.

At the end of the follow-up period, 58% of patients in the SA group were found to have improved their PHQ9 scores by at least 50%. The rate for the NSA group was 43%. This difference was not considered statistically significant. Nevertheless, the authors note that some results are promising. For example, the proportion of patients who recovered from depression and were in remission was higher in the SA group after 4 weeks, and a statistically significant difference in remission was observed in favor of the SA group. 3 months later.

“Our results showed that almost 60% recovered from depression thanks to specific auricular acupuncture treatment. This is in line with other published studies on the subject, compared to the recovery of treatment with drugs. ”, said Daniel Mauricio de Oliveira Rodríguez, lead author of the paper and professor of natural sciences at UNISUL. “Furthermore, 46% of these participants reported cessation of symptoms, compared to 13% in the NSA group. By comparison, that rate is about 35% for patients receiving drug treatment.”

Another promising result was that there were no serious side effects and no significant differences between the groups. The majority of participants (94% in the SA group and 91% in the NSA group) reported only mild pain at the needle site. “This proves the safety of the intervention over six weeks,” Rodriguez said.

More safety

“We are witnessing a veritable epidemic of mood disorders. I don’t think we’ve ever had this much anxiety and depression since the coronavirus pandemic. Acceptance of the gold standard in treatment is far from ideal.” said. alexandre faisal curie, a researcher at the Department of Preventive Medicine at the Faculty of Medicine of the University of São Paulo (FM-USP). “In clinical practice, we see patients with chronic depression who take medications for long periods of time, with side effects and relapses, so we need complementary options that are proven to be effective.”

Three important lessons can be learned from this study, Faisal added. In the case of SUS, this validates a technology that is already widely used and is, in fact, the most frequently implemented integration method in public systems. For patients, auricular acupuncture has been confirmed as a safe option in the treatment of mental illness. And for health care professionals, it stigmatizes non-allopathic treatments.

Despite the promising results, the researchers say the study has notable limitations and that longer-term studies with more participants are needed to more deeply explore the effectiveness of this treatment. he pointed out. “I believe that the more people who participate, the more favorable the outcome will be for the intervention,” Faisal said.

The article “Efficacy and safety of auricular acupuncture for depression: a randomized clinical trial” can be found at: jamanetwork.com/journals/jamanetworkopen/fullarticle/2812388.