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Acupuncture treatment for mental illness


Acupuncture for psychiatric illness: a literature review

Review

. 2008 Summer;34(2):55-64.

doi: 10.3200/BMED.34.2.55-64.

Noah Samuels  1 , Cornelius Gropp, Shepherd Roee Singer, Menachem Oberbaum

Affiliations

Affiliation

  • 1 The Center for Integrative Complementary Medicine, Jerusalem, Israel. [email protected]
  • PMID: 18682338
  • DOI: 10.3200/BMED.34.2.55-64

Review

Noah Samuels et al. Behav Med. 2008 Summer.

. 2008 Summer;34(2):55-64.

doi: 10.3200/BMED.34.2.55-64.

Authors

Noah Samuels  1 , Cornelius Gropp, Shepherd Roee Singer, Menachem Oberbaum

Affiliation

  • 1 The Center for Integrative Complementary Medicine, Jerusalem, Israel. [email protected]
  • PMID: 18682338
  • DOI: 10.3200/BMED.34.2.55-64

Abstract

The use of complementary and alternative medicine (CAM) is on the rise, especially among psychiatric patients. Acupuncture is considered a safe and effective treatment modality, and traditional Chinese medicine teaches that acupuncture harmonizes the body's energies. Scientific research has found that acupuncture increases a number of central nervous system hormones (ACTH, beta-endorphins, serotonin, and noradrenaline) and urinary levels of MHPG-sulfate, an adrenergic metabolite inversely related to the severity of illness in schizophrenics. Acupuncture can have positive effects on depression and anxiety, although evidence is still lacking as to its true efficacy for these conditions. To the authors' knowledge, no trials have been conducted for schizophrenia, and researchers evaluating acupuncture in cases of substance abuse have found conflicting results. Further research is warranted.

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EVIDENCE MAP OF ACUPUNCTURE FOR MENTAL HEALTH - Evidence Map of Acupuncture

The results for mental health indications are presented in the bubble plot and text summary below. The bubble plot represents 17 systematic reviews summarizing evidence for 9 clinical indications relevant to mental health [search date: March 2013].

Legend: The bubble plot shows an estimate of the evidence base for mental health-related indications judging from systematic reviews and recent large trials. The plot depicts the estimated size of the literature (y-axis, number of RCTs included in largest review), the estimated effect (x-axis), and the confidence in the estimate (bubble size).

The figure provides a broad visual overview of the evidence base of acupuncture for mental health. The bubble plot depicts the estimated research volume based on the number of acupuncture RCTs included in the largest review for each of the 10 depicted clinical indications, the estimated treatment effect of acupuncture compared to passive control, and the confidence in the effect estimate, judging from published systematic reviews. Effect sizes based on specific individual reviews, as well as reason for classifying the evidence bases as inconclusive, are reported in the narrative synthesis. The evidence map used the clinical topics as addressed in existing reviews and individual research studies may have contributed to a number of included reviews and clinical indications. All 3 depicted dimensions (literature size, effect, and confidence) are estimates and can only provide a broad overview of the evidence base.

As shown in the bubble plot, acupuncture for the treatment of depression has been evaluated in a large number of studies; a 2010 systematic review on acupuncture therapy in depressive disorders included 35 RCTs meeting an initial quality threshold.103 Across studies and across the most recent of the 5 identified systematic reviews positive effects were shown. However, effects depend on the comparator – a 2010 Cochrane review reported that acupuncture may have an additive benefit when combined with medication compared with medication alone but noted inconsistent effects from acupuncture compared with a waitlist control or sham acupuncture control. The review also noted a high risk of bias in the majority of included trials and concluded that evidence to recommend the use of acupuncture for people with depression is insufficient.96 Schizophrenia has also been addressed in a number of studies; a 2009 systematic review included 13 RCTs.101 A Cochrane review with literature searches up to April 2005 reported that Brief Psychiatric Rating Scale (BPRS) data favored a combined acupuncture and antipsychotic group (WMD -4.3, 95% CI: -7.0, -1.6). However data for global state outcomes, leaving the study early, and dichotomized BPRS data (improved versus not improved) were equivocal and the review concluded that there is insufficient evidence to recommend the use of acupuncture for people with schizophrenia.164 A review on acupuncture for anxiety and anxiety disorders included 10 RCTs.147 The review reported that all studies indicated positive findings; however, the review also pointed out that studies lacked many basic methodological details and concluded that there is insufficient research evidence for firm conclusions.

Regarding topics with fewer primary research studies and positive results, a review on posttraumatic stress disorder (PTSD) was identified that included 4 RCTs. The review found that acupuncture was superior to waitlist control (posttraumatic symptom scale-self report effect size [ES] -0.98, p=0.001) and cognitive behavioral therapy alone (Revised Impact on Event Scale ES -1.56, p<0.001) based on one RCT each.31

The role of acupuncture for opiate addiction has been addressed in a substantial number of studies; a 2009 systematic review included 21 RCTs of acupuncture therapy combined with opioid receptor agonists for heroin detoxification,188 but the evidence base regarding the effectiveness of acupuncture is unclear. The largest review reported no effects on relapse rate after 6 months and the methodology of some included trials was poor; however, positive effects for withdrawal symptoms, side effects, and medication dosage were shown. A competing review concluded that the review results cannot be used to establish the efficacy of acupuncture in the treatment of opiate addiction because the majority of included studies were classified as having low quality.58 A review on auricular acupuncture for not further specified drug addiction and a review on acupuncture for chronic fatigue syndrome (CFS) showed conflicting results across included studies and did neither pool the data nor report sufficient detail for a reanalysis. The reviews included 10 or fewer studies.

Three recent reviews on cocaine addiction, including a Cochrane review last updated in 2006,162 did not support the use of acupuncture for the treatment of cocaine dependence; the largest review included 9 RCTs. A single review on alcohol dependence was identified reviewing 11 RCTs; it did not report favorable results and concluded that the existing studies do not allow any conclusion about acupuncture treatment efficacy.

In addition, 2 reviews were identified that could not be incorporated into the bubble plot. One review concluded that acupuncture was no more effective than other treatments in treating opiate addiction. 159 A review comparing acupuncture and Western medicine for post-stroke depression190 found mixed results depending on the selected patient outcome.

Acupuncture for the treatment of neurosis and depression

With neurotic disorders, Western medicine operates with pills - tranquilizers, antidepressants. But these are symptomatic remedies, but the problem can be eliminated in essence.

Tibetan doctors consider neuroses, depression, and other disorders of the nervous system and psyche to be the result of an imbalance in the regulating basis Wind (Rlung). And if the cause is known, then there are ways to eliminate it.

The usual cause of nervous disorders is the energy depletion of the body. This is due, firstly, to the innate characteristics of metabolism.


Most often, people of the constitutional type Wind suffer from neuroses and depression - impressionable, emotional, restless, mobile. They are not at all prone to excess weight, they are lean, tall or, on the contrary, miniature.

The metabolism of such people is very fast, so the energy does not have time to spend rationally and most of it is wasted - on emotional outbursts, violent and fruitless impulses, insomnia, constant anxiety.

The result is an exhaustion of the nervous system, or the basis of Wind. This base is of a cold nature, so its depletion is often accompanied by coldness of the hands, feet, and a sensation of chilliness.

No pills can restore the energy balance. Only proper nutrition, herbal medicine can increase the level of heat. For these methods to work optimally, it is necessary that the energy move freely in the body along the meridians.

But with neurosis of anxiety, fear or other disorders of the nervous system in the body, as a rule, there are muscle spasms, blood circulation is disturbed. If the normal circulation of energy is not restored, it is almost impossible to increase the level of body heat.

And then acupuncture comes to the rescue. With the help of acupuncture, the Tibet clinic doctor restores the normal movement of energy along the meridians of the body and puts the energy balance of the body in order.

Thus, acupuncture eliminates the cause of nervous disorders - energy depletion. No pills can help with this, but acupuncture sessions help.

The success of acupuncture in the treatment of neuroses, depression and other nervous diseases is so obvious that modern medicine tries to explain them scientifically. Her explanation consists of three points.

1. Acupuncture somehow stimulates the production of dopamine and serotonin.

Indeed, the introduction of needles into bioactive points according to certain patterns stimulates the production of the "hormone of pleasure" - dopamine and the "hormone of happiness" - serotonin.

Serotonin is a hormone that is produced when exposed to sunlight. The lack of sun in the northern climate is one of the main causes of depression and suicidality.

An example is Finland. This country has one of the highest living standards, but also one of the highest suicide rates. The reason is the shortage of the sun, a small number of sunny days, that is, a purely climatic, and not an economic factor.

Russia is also among the country-record holders in the number of suicides, and the climate factor plays a significant role in this.

Acupuncture increases the production of serotonin and thus serves as a cure for depression. As for dopamine, it is not only a “hormone of pleasure”, but also a neurotransmitter.

The conductivity of the "white channels" - the nerves - depends on its concentration. The easier and faster the signals pass through the nerves, the lower the energy costs. Therefore, by facilitating the innervation of the body, acupuncture improves its energy.

2. Acupuncture somehow stimulates the production of endorphins.

Pain-relieving substances that are produced by our brain are similar in their action to morphine. They not only anesthetize, but also improve mood and therefore help with neurosis and depression no worse, but better than antidepressants.

3. Acupuncture relieves muscle spasms and pain.

The introduction of needles into bioactive points relieves muscle tension. Thanks to this, canned nervous stresses are released, mental, nervous tension is relieved.

Acupressure massage also gives a similar effect in the Tibet clinic, during sessions of which patients sometimes begin to cry because the drunken mental load is released and comes out. These are tears and the joy of relief.

Acupuncture in this sense gives less effect than acupressure, but it has an analgesic effect in pain syndromes, which serve as a factor in the development of neurosis, depression, and insomnia.

In general, according to the experience of the doctors of the Tibet clinic, acupuncture is a powerful tool for treating neurosis, depression and other nervous disorders.

In terms of its effectiveness, this method is significantly superior to medications, especially in the long term. After all, acupuncture eliminates not only the symptoms and mechanisms of development of nervous disorders. With its help, it is possible to eliminate the causes of imbalance in the Wind base, which is responsible for the psyche, brain function and nervous system.

With the help of acupuncture, the doctor of the Tibet clinic regulates the energy balance of the body, eliminating the cause of the depletion of the nervous system. At the same time, it acts simultaneously on the signs and causes of a neurotic disorder.

Acupuncture (IRT, acupuncture)

Acupuncture is a section of reflexology, which consists in the impact of various methods (acupuncture (acupuncture), heating (chiu-therapy), auricolotherapy, acupressure) on active vegetative reflexogenic zones.

Acupuncture is a healing method with more than two thousand years of history, originated in China and supplemented with the latest scientific achievements.

How acupuncture works

The method of acupuncture is used in the complex treatment of a variety of diseases, but, first of all, the course of acupuncture (acupuncture) is used to suppress pain of various origins.

According to legend, one of the commanders of Ancient China, who suffered from unbearable back pain, was wounded in battle with an arrow in the Achilles tendon. It was this injury that saved him from back pain. Then the healers had a theory (which later developed into a science called "reflexotherapy") about the relationship of an injection at certain points on the body with the work of certain organs.

Acupuncture stimulates the release of the hormone endorphin in the brain, which leads to a rapid suppression of pain, pain relief. This property has made acupuncture a popular treatment for a variety of conditions that cause acute pain (eg chronic headaches, sciatica and other back pain, joint pain due to arthritis).

The impact of special needles (acupuncture), cauterization and acupressure on biologically active points (located on the meridians, or energy channels associated with one or another internal organ) can activate its own reserve, recovery processes in the body. This method is able to have a powerful effect on the entire body as a whole, normalize the hormonal background, metabolic processes, increase immunity, have a sedative (calming) and relaxing effect, and reverse the course of the disease.

Reflexotherapy is often used in combination with manual therapy, osteopathy and massage, such a course can help even in cases that are “unpromising” from the point of view of traditional medicine (chronic, systemic diseases, etc.). The method does not give complications and has practically no contraindications and, unlike drug therapy, does not cause allergic and other adverse reactions.

Where is acupuncture applied?

The use of acupuncture gives a good effect in the treatment of pain syndromes (headache, pain in various parts of the spine, in the joints), in the complex therapy of diabetes mellitus, bronchial asthma and other serious diseases, it allows to reduce the proportion of medications, affect the psycho-emotional state of the patient.

This method is able to have a powerful effect on the entire body as a whole, launch the protective reserves of a person, normalize hormonal levels, metabolic processes, increase immunity, have a sedative (calming) and relaxing effect.

The course of reflexology is 10-12 (up to 15) sessions, depending on the pathology and condition of the patient. The number of courses is determined by the doctor - acupuncturist based on the dynamics of treatment.

The session may include corporal acupuncture combined with auriculotherapy. In some cases (for example, weight loss, tobacco control), it is possible to place auricular microneedles for a long period (up to several weeks) with periodic correction.

The duration of one session of acupuncture usually ranges from 5-10 to 20-40 minutes. Multiple acupuncture sessions are often required for optimal results. Of course, only a qualified reflexologist conducts them.

The acupuncture procedure is practically not accompanied by pain (the patient may feel aches, heaviness, bursting, there may be slight discomfort at the time of insertion of the needles).

Diseases for which acupuncture is indicated

Psychoneurological diseases:

  • Cerebrovascular diseases
  • Neuroses of the gastrointestinal tract
  • Neurasthenia
  • Vertigo
  • Headache (migraine, cluster headache, tension headache, traumatic headache)
  • Facial paralysis
  • Pain syndromes associated with spinal osteochondrosis
  • Cervicalgia, torticollis, "lumbago"
  • Sciatic neuralgia, sciatica
  • Polyneuritis
  • Trigeminal neuralgia
  • Plexit
  • Sleep disorders
  • Radiculopathy
  • Herniated discs
  • Consequences of stroke, concussion and brain contusion

Gynecological diseases:

  • Infertility
  • Chronic salpingo-oophoritis
  • Endometrial hyperplasia
  • Climacteric syndrome
  • Menstrual disorders
  • Mastopathy
  • Dysfunctional uterine bleeding

Diseases of the endocrine system:

  1. Diseases of the thyroid gland
  2. Diabetes mellitus (type 2)
  3. Obesity, overweight

Diseases of the genitourinary system:

  • Chronic cystitis
  • Chronic pyelonephritis
  • Prostatitis
  • Erectile dysfunction

Diseases of the lungs and bronchi:

  • Chronic bronchitis
  • Bronchial asthma
  • Laryngitis
  • Pharyngitis
  • ARVI, acute respiratory infections

Diseases of the gastrointestinal tract:

  • Chronic gastritis, duodenitis
  • Chronic pancreatitis
  • Biliary dyskinesia
  • Chronic non-calculous cholecystitis
  • Peptic ulcer of the stomach and duodenum
  • Diarrhea, constipation

Diseases of the cardiovascular system:

  • Angina pectoris
  • Hypertension
  • Hypotension
  • Arrhythmias

Diseases of the musculoskeletal system with pain syndrome:

  • Arthritis and polyarthritis
  • Arthrosis

ENT diseases:

  • Sinusitis
  • Rhinitis
  • Tinnitus
  • Deafness

Bad habits: