A Cochrane review included 30 studies with a total of 2 812 subjects with depression. The acupuncture varied in terms of point selection, frequency of treatments and total number of treatments administered. Nineteen trials used a standardised treatment protocol with a fixed selection of points administered at each acupuncture session. Acupunture was compared with with sham acupuncture, no treatment, pharmacological treatment, psychotherapy or standard care. There was insufficient evidence of a consistent beneficial effect from acupuncture compared with a wait list control or sham acupuncture control. A subgroup of participants with depression as a co-morbidity experienced a reduction in depression with acupuncture compared with SSRIs (RR 1.66, 95%CI 1.03 to 2.68, 3 trials, 94 participants). Two trials where acupuncture was used in combination with standard medication suggest some benefit with reducing symptoms of depression.
Comment: The quality of evidence is downgraded by study quality (inadequate allocation concealment) and inconsistency (heterogeneity in treatments, controls and outcomes).