Animal and human studies suggest that the beneficial effects of acupuncture on health, including mental and emotional functioning, are related to different mechanisms of action, including changes in neurotransmitters involved in emotional regulation such as serotonin, modulation of the autonomic nervous system, and changes in immune function. Some researchers have argued that the placebo effect plays a significant role in clinical response to acupuncture; however, sham-controlled studies do not support this hypothesis.
Research findings support acupuncture as a treatment of anxiety.
Acupuncture and acupressure are widely used to treat anxiety in both Asia and Western countries. Extensive case reports from the Chinese medical literature suggest that different acupuncture protocols reduce the severity of generalized anxiety and panic attacks (Lake & Flaws 2001).
In a small double-blind sham-controlled study, 36 mildly depressed or anxious patients were randomized to either an acupuncture protocol traditionally used by Chinese medical practitioners to treat anxiety or to a sham acupuncture protocol (i.e. acupuncture points believed to have no beneficial effects). All patients received three treatments. Heart rate variability (HRV) and mean heart rate were measured at 5 and 15 minutes following treatment. Resting heart rate was significantly lower in the treatment group but not in the sham group, and changes in HRV measures suggested that acupuncture may have changed autonomic activity resulting in a reduction of overall anxiety. The significance of these findings is limited by the absence of measures of baseline anxiety before and after treatment.
In another double-blind study, 55 adults who had not been diagnosed with an anxiety disorder were randomized to either a sham acupuncture point or a bilateral auricular (involving points on the ears) acupuncture protocol called the “shenmen” point. That protocol is believed to be effective against anxiety. In all subjects, acupuncture needles remained in place for 48 hours. The “relaxation” group was significantly less anxious at 30 minutes, 24 hours, and 48 hours compared to the other two groups, however, there were no significant inter-group differences in blood pressure, heart rate, or electrodermal activity (Wang 2001).
Reviews report mainly positive findings.
An early narrative review of controlled studies, outcomes studies, and published case reports on acupuncture as a treatment of anxiety and depressed mood was published by the British Acupuncture Council. Sham-controlled studies yielded consistent improvements in anxiety using both regular (i.e. body) acupuncture and electro-acupuncture. The authors remarked that significant differences existed between protocols used in both regular and electro-acupuncture, suggesting that acupuncture may have general beneficial effects or possibly placebo effects. Although most controlled studies reviewed reported a general anxiety-reducing effect of acupuncture, the reviewers regarded these findings as inconclusive because of study design problems, including the absence of standardized symptom rating scales in most studies, limited follow-up, and poorly defined differences between protocols used in different studies.
A recently published systematic review (Amorim 2018) compared findings of studies on traditional (body) acupuncture, ear acupuncture (ariculotherapy), and electro-therapy in the treatment of anxiety. Some studies included in the review reported that acupuncture enhances response to prescription anti-anxiety medications and may also reduce medication side effects. The authors found good evidence that different styles of acupuncture reduce symptoms of anxiety in general, and recommended additional sham-controlled studies to help determine whether certain protocols are more beneficial than others.
Few mild adverse effects
Uncommon transient adverse effects associated with acupuncture include bruising, fatigue, and nausea. Very rare cases of pneumothorax (i.e. a potentially life-threatening condition caused when an acupuncture needle results in the collapse of a lung) have been reported.
Author:James Lake, MD
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