A new US study suggests that acupuncture specifically designed for depression may reduce symptoms during pregnancy: although the study was small, the
researchers say it is the first of its kind and hope that it raises awareness about depression in pregnancy and helps patients and doctors consider an
alternative to antidepressants.
You can read about the study online in the March issue of the journal Obstetrics & Gynecology. The lead author is Dr Rachel Manber, professor of psychiatry and behavioral sciences at Stanford University School of Medicine, California.
Co-author Dr Deirdre Lyell, assistant professor of obstetrics and gynecology at the School of Medicine, told the media that doctors aren't sure how depression develops in pregnancy, but believe it could be something to do with an influx of hormones, or that some women might feel overwhelmed by the major change in their life, and this could also trigger depression.
"Pregnancy just by its nature can bring out some underlying psychiatric and emotional issues," said Lyell.
"Treatment of depression during pregnancy is critically important so that a woman can maintain her sense of well-being and take good care of herself, her fetus and, someday, her child," she added.
Major depressive disorder is characterized by feelings of hopelessness, gloom and dread, accompanied by a loss of interest in pleasurable activities. The disorder affects up 14 per cent of pregnant women, some of whom start experiencing symptoms in pregnancy, while for others it can be ceasing to take medication during pregnancy that triggers a relapse.
There is evidence, that if lef untreated, depression during pregnancy can lead to poor birth outcomes and postnatal depression. There is also a higher likelihood that the expectant mother may neglect to care for herself and her unborn child, and in extreme cases, engage in self-destructive behavior.
According to a paper published in the American Journal of Obstetrics and Gynecology in 2007, although use of antidepressants in pregnancy doubled between 1999 and 2003, many women don't take them because they are worried about safety.
Manber said they saw evidence of this in their present study: 94 per cent of the participants said they were reluctant to take antidepressants. She said because of this concern among women and their doctors, she and her colleagues thought it was important to explore alternatives to drugs.
150 women, whose pregnancies were between 12 and 30 weeks gestation, and who met the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder, took part in the study.
The researchers randomly assigned them to one of three groups, the active therapy group and two control groups. For the active therapy group, 52 women received acupuncture designed specifically for depression. For the two control groups, 49 women received acupuncture not specific for depression (needles were inserted at points not thought to treat depression), and 49 received massage.
The women had 8 weeks altogether of their particular therapy, and underwent assessment by interview at weeks 4 and 8. The interviewer did not know which women had undergone which form of treatment.
The results showed that:
- The active therapy group (the women who received acupuncture specific for depression) showed a bigger reduction in depression symptoms than the two control groups.
- The response rate (defined as having at least 50 per cent or more reduction in symptoms) was 63 per cent in the active therapy group, compared with 44 per cent in the two control groups combined.
- Symptom reduction and response rates did not differ significantly between the two control groups.
"The short acupuncture protocol demonstrated symptom reduction and a response rate comparable to those observed in standard depression treatments of similar length and could be a viable treatment option for depression during pregnancy."
The researchers said they were pleased but not surprised by the findings. An earlier pilot had already shown similar results and other studies involving the general public have also shown acupuncture can relieve depression.
As Lyell explained:
"I don't think that one-size-fits-all treatments are appropriate for everyone, but acupuncture should be considered as an option."
"I hope that people will respect the rigorous methodology used in this blinded, randomized, controlled trial and accept the result: Traditional acupuncture was associated with a significant improvement in depression," she urged.
Manber and Lyell said they will be continuing their research into women's health in pregnancy and after birth.
"Acupuncture for Depression During Pregnancy: A Randomized Controlled Trial."
Manber, Rachel; Schnyer, Rosa N.; Lyell, Deirdre; Chambers, Andrea S.; Caughey, Aaron B.; Druzin, Maurice; Carlyle, Erin; Celio, Christine; Gress, Jenna L.; Huang, Mary I.; Kalista, Tasha; Martin-Okada, Robin; Allen, John J. B.
Obstetrics & Gynecology, March 2010 - Volume 115 - Issue 3 - pp 511-52.
Source: Stanford School of Medicine.
Written by: Catharine Paddock, PhD