Acupuncture for posttraumatic stress disorder: a systematic review of randomized controlled trials and prospective clinical trials

Young-Dae Kim, In Heo, Byung-Cheul Shin, Cindy Crawford, Hyung-Won Kang, Jung-Hwa Lim, Young-Dae Kim, In Heo, Byung-Cheul Shin, Cindy Crawford, Hyung-Won Kang, Jung-Hwa Lim

Abstract

To evaluate the current evidence for effectiveness of acupuncture for posttraumatic stress disorder (PTSD) in the form of a systematic review, a systematic literature search was conducted in 23 electronic databases. Grey literature was also searched. The key search terms were "acupuncture" and "PTSD." No language restrictions were imposed. We included all randomized or prospective clinical trials that evaluated acupuncture and its variants against a waitlist, sham acupuncture, conventional therapy control for PTSD, or without control. Four randomized controlled trials (RCTs) and 2 uncontrolled clinical trials (UCTs) out of 136 articles in total were systematically reviewed. One high-quality RCT reported that acupuncture was superior to waitlist control and therapeutic effects of acupuncture and cognitive-behavioral therapy (CBT) were similar based on the effect sizes. One RCT showed no statistical difference between acupuncture and selective serotonin reuptake inhibitors (SSRIs). One RCT reported a favorable effect of acupoint stimulation plus CBT against CBT alone. A meta-analysis of acupuncture plus moxibustion versus SSRI favored acupuncture plus moxibustion in three outcomes. This systematic review and meta-analysis suggest that the evidence of effectiveness of acupuncture for PTSD is encouraging but not cogent. Further qualified trials are needed to confirm whether acupuncture is effective for PTSD.

Figures

Figure 1
Figure 1
Flow chart of the trial selection process. PTSD: posttraumatic stress disorder; RCT: randomized controlled trial; UCT: uncontrolled clinical trial; AT: acupuncture.

References

    1. Reed RV, Fazel M, Goldring L. Post-traumatic stress disorder. British Medical Journal. 2012;344e3790
    1. Shalev AY. What is posttraumatic stress disorder? Journal of Clinical Psychiatry. 2001;62(supplement 17):4–10.
    1. Bryant RA. Acute stress disorder as a predictor of posttraumatic stress disorder: a systematic review. Journal of Clinical Psychiatry. 2011;72(2):233–239.
    1. National Collaborating Centre for Mental Health (UK) Post-Traumatic Stress Disorder: The Management of PTSD in Adults and Children in Primary and Secondary Care. Gaskell and British Psychological Society; 2005.
    1. Australian Centre for Posttraumatic Mental Health. Australian Guidelines for the Treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder. Australian Centre for Posttraumatic Mental Health; 2007. Evidence review and treatment recommendations for adults with PTSD; pp. 33–101.
    1. Strauss JL, Coeytaux R, McDuffie J, Nagi A, Williams J. Efficacy of Complementary and Alternative Medicine Therapies for Posttraumatic Stress Disorder. Washington, DC, USA: VA Evidence-based Synthesis Program Reports; 2011.
    1. Unutzer J, Klap R, Sturm R, et al. Mental disorders and the use of alternative medicine: results from a national survey. American Journal of Psychiatry. 2000;157(11):1851–1857.
    1. Nasir LS. Acupuncture. Primary Care. 2002;29(2):393–405.
    1. Conboy L, St John M, Schnyer R. The effectiveness of acupuncture in the treatment of Gulf War Illness. Contemporary Clinical Trials. 2012;33:557–562.
    1. Pilkington K, Kirkwood G, Rampes H, Cummings M, Richardson J. Acupuncture for anxiety and anxiety disorders—a systematic literature review. Acupuncture in Medicine. 2007;25(1-2):1–10.
    1. Lee MS, Shin BC, Ernst E. Acupuncture for Alzheimer's disease: a systematic review. International Journal of Clinical Practice. 2009;63(6):874–879.
    1. Fogarty S, Harris D, Zaslawski C, McAinch AJ, Stojanovska L. Acupuncture as an adjunct therapy in the treatment of eating disorders: a randomised cross-over pilot study. Complementary Therapies in Medicine. 2010;18(6):233–240.
    1. Ronan P, Robinson N, Harbinson D, MacInnes D. A case study exploration of the value of acupuncture as an adjunct treatment for patients diagnosed with schizophrenia: results and future study design. Journal of Chinese Integrative Medicine. 2011;9(5):503–514.
    1. Becker-Carus C, Heyden T, Kelle A. Effectiveness of acupuncture and attitude-relaxation training for treatment of primary sleep disorders. Zeitschrift fur Klinische Psychologie, Psychopathologie und Psychotherapie. 1985;33(2):161–172.
    1. Lin J-G, Chan Y-Y, Chen Y-H. Acupuncture for the treatment of opiate addiction. Evidence-Based Complementary and Alternative Medicine. 2012;2012:10 pages.739045
    1. Yang CH, Lee BH, Sohn SH. A possible mechanism underlying the effectiveness of acupuncture in the treatment of drug addiction. Evidence-based Complementary and Alternative Medicine. 2008;5(3):257–266.
    1. Eshkevari L, Egan R, Phillips D, et al. Acupuncture at ST36 prevents chronic stress-induced increases in neuropeptide Y in rat. Experimental Biology and Medicine. 2012;237:18–23.
    1. Hollifield M, Sinclair-Lian N, Warner TD, Hammerschlag R. Acupuncture for posttraumatic stress disorder: a randomized controlled pilot trial. Journal of Nervous and Mental Disease. 2007;195(6):504–513.
    1. Feinstein D. Rapid treatment of PTSD: why psychological exposure with acupoint tapping may be effective. Psychotherapy. 2010;47(3):385–402.
    1. Hollifield M. Acupuncture for posttraumatic stress disorder: conceptual, clinical, and biological data support further research. CNS Neuroscience and Therapeutics. 2011;17:769–779.
    1. Bidwell S, Jensen M. Etext on Health Technology Assessment (HTA) Information Resources. Chapter 3. Using a search protocol to identify sources of information: the COSI Model. .
    1. Higgins J, Green S. Cochrane Handbook for Systematic Reviews of Interventions. Version 5. 1. 0. 2011.
    1. Moher D, Hopewell S, Schulz KF, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. Journal of Clinical Epidemiology. 2010;63(8):e1–e37.
    1. MacPherson H, Altman DG, Hammerschlag R, et al. Revised standards for reporting interventions in clinical trials of acupuncture (STRICTA): extending the consort statement. Acupuncture in Medicine. 2010;28(2):83–93.
    1. Zhang H, Yuan C, Ran L, et al. RCT research of different acupuncture therapies in treating Posttraumatic stress disorder after Wenchuan "5.12" earthquake. China Journal of Traditional Chinese Medicine and Pharmacy. 2010;25:1505–1510.
    1. Zhang H, Ran L, Yuan X, Wang K, Hu Z, Yang J. Clinical observation on acupuncture and moxibustion in treating post traumatic stress disorder after 5.12 earthquake. Journal of Chengdu University of TCM. 2010;33, article 4
    1. Zhang Y, Feng B, Xie JP, Xu FZ, Chen J. Clinical study on treatment of the earthquake-caused post-traumatic stress disorder by cognitive-behavior therapy and acupoint stimulation. Journal of Traditional Chinese Medicine. 2011;31(1):60–63.
    1. Wang Y, Hu Y. Acupuncture and moxibustion treatment for 69 cases of posttraumatic stress disorder caused by an earthquake. Henan Traditional Chinese Medicine. 2009;29, article 291
    1. Yuan X, Liu C, Lai R. Acupuncture treatment for 34 cases of posttraumatic stress disorder. Zhongguo Zhen Jiu. 2009;29, article 234
    1. Zhang H, Chen W, Song W, Zhu M, Feng Y. Brain glucose metabolism involved in acupuncture treatment on posttraumatic stress disorder patients. China Journal of Traditional Chinese Medicine and Pharmacy. 2010;25:1882–1884.
    1. Prisco MK. Examining the Effect of Acupuncture on Sleep Difficulties Related to Post Traumatic Stress Disorder. .
    1. Findley TW. Pilot of Acupuncture to Improve Quality of Life in Veterans With Traumatic Brain Injury (TBI) and Post-Traumatic Stress Disorder (PTSD) .
    1. Acupuncture for the Treatment of Post-Traumatic Stress Disorder (PTSD) .
    1. Money N, Fritts M, Miller R, Gore K, Engel C. Integrative Restoration as an Adjunctive Therapy for Post-Traumatic Stress Disorder. Bethesda, MD, USA: The Uniformed Services University of the Health Sciences Research Week; 2009.
    1. Wang Y, Hu Y. Acupuncture, Moxibustion and Tuina. Chengdu, China: Chengdu University of TCM; 2010. Electro-acupuncture on head points in treating posttraumatic stress disorder after "5.12" earthquake: a randomized controlled trial.
    1. Zhang H, Yuan X, Ran L, et al. Electro-acupuncture on head points in treating posttraumatic stress disorder: a randomized controlled trial and PET imaging observation. Proceedings of the 5th Psychosomatic Medicine Symposium of National Integrative Medicine; 2010; Tianjin, China.
    1. Hu Z, Zhang H. Acupuncture, Moxibustion and Tuina. Chengdu, China: Chengdu University of TCM; 2010. Electro-acupuncture on head points and moxibustion in treating posttraumatic stress disorder after Wenchuan "5.12: earthquake: a randomized controlled trial.
    1. Wang K, Zhang H. Acupuncture, Moxibustion and Tuina. Chengdu, China: Chengdu University of TCM; 2010. Electro-acupuncture on head points and auricular acupuncture in treating posttraumatic stress disorder after "5.12" earthquake: a randomized controlled trial.
    1. Wang Y, Hu Y, Wang W, Pang R, Zhang A. Clinical studies on treatment of earthquake-caused posttraumatic stress disorder using electro-acupuncture. Evidence-Based Complementary and Alternative Medicine. 2012;2012:7 pages.431279
    1. Liberati A, Altman DG, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Medicine. 2009;6(7)e1000100
    1. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd edition. New Jersey, NJ, USA: Lawrence Erlbaum Associate; 1988.
    1. Napadow V, Makris N, Liu J, Kettner NW, Kwong KK, Hui KKS. Effects of electroacupuncture versus manual acupuncture on the human brain as measured by fMRI. Human Brain Mapping. 2005;24(3):193–205.
    1. Bisson J, Andrew M. Psychological treatment of posttraumatic stress disorder (PTSD) Cochrane Database of Systematic Reviews. 2005;(2):p. CD003388.
    1. Hsu CH, Hua Y, Jong GP, et al. Shock resuscitation with acupuncture: case report. Emergency Medicine Journal. 2006;23(3):p. e18.
    1. Fleckenstein J, Schottdorf J, Kreimeier U, Irnich D. Acupuncture in emergency medicine: results of a case series. Der Anaesthesist. 2011;60:854–862.
    1. Sniezek DP. Guest editorial: community-based wounded warrior sustainability initiative (CBWSI): an integrative medicine strategy for mitigating the effects of PTSD. Journal of Rehabilitation Research and Development. 2012;49:IX–XIX.
    1. Montejo AI, Llorca G, Izquierdo JA, et al. Sexual dysfunction secondary to SSRIs. A comparative analysis in 308 patients. Actas Luso-Españolas de Neurología, Psiquiatría y Ciencias Afines. 1996;24(6):311–321.
    1. Sussman N, Ginsberg D. Rethinking side effects of the selective serotonin reuptake inhibitors: sexual dysfunction and weight gain. Psychiatric Annals. 1998;28(2):89–97.
    1. White A, Hayhoe S, Hart A, Ernst E. Adverse events following acupuncture: prospective survey of 32 000 consultations with doctors and physiotherapists. British Medical Journal. 2001;323(7311):485–486.
    1. MacPherson H, Thomas K, Walters S, Fitter M. The York acupuncture safety study: prospective survey of 34 000 treatments by traditional acupuncturists. British Medical Journal. 2001;323(7311):486–487.
    1. Park J, White A, Stevinson C, Ernst E, James M. Validating a new non-penetrating sham acupuncture device: two randomised controlled trials. Acupuncture in Medicine. 2002;20(4):168–174.
    1. Watts BV, Landon B, Groft A, Young-Xu Y. A sham controlled study of repetitive transcranial magnetic stimulation for posttraumatic stress disorder. Brain Stimulation. 2012;5:38–43.
    1. Golub RM, Fontanarosa PB. Comparative effectiveness research: relative successes. The Journal of the American Medical Association. 2012;307:1643–1645.

Source: PubMed

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