Acupuncture May Help Depression



A new study finds acupuncture to be highly effective in treating depression.


 

ACUPUNCTURE MAY HELP DEPRESSION

At least 1 in 10 Americans have been afflicted with major depression at some point in their lives, and some studies suggest that as many as 1 in 5 Americans have experienced significant depression before.  At any given time, an estimated 7 percent of adults in the United States are suffering from major depression.  (For reasons that are not entirely clear, women are twice as likely as men to be diagnosed with major depression.)  In view its very high incidence, it is not surprising that major depression is the leading cause of disability in the U.S. for people between the ages of 15 and 44.

There are a variety of potentially effective therapies available for depression including, primarily, cognitive therapy (i.e., meeting with a therapist for counseling) and antidepressant medications.  However, in view of the limited coverage made available for cognitive therapy by health insurers, there has been an increasing reliance upon antidepressant medications in the U.S. for many years.  While many of these medications can significantly reduce the signs and symptoms of major depression, they are often associated with significant side effects, and as many as half of all patients with severe chronic depression will fail to respond to most such medications.

A newly published prospective randomized controlled study from England suggests that acupuncture may be as effective as cognitive therapy and antidepressant medications as a treatment for depression.  This study appears in the online journal PLOS Medicine.

In this study, 755 patients with documented chronic major depression were randomized to one of three different treatment groups: acupuncture, cognitive therapy (counseling), and “usual care alone.”  (The latter group, which also included the use of antidepressant medications, served as the “control group” for this clinical study.)  All patient volunteers were subsequently reassessed with validated diagnostic tests throughout the 12-month course of this clinical study.

On average, the patient volunteers who participated in this clinical trial underwent 10 acupuncture sessions and 9 counseling sessions.  Compared to “usual care,” there was a statistically significant decrease in depression-associated symptoms in both the acupuncture and the counseling groups at 3 months and at 6 months after the start of this clinical study (by 12 months, however, the patients in the “usual care” group had improved to a level comparable to the acupuncture and counseling groups).  To summarize, acupuncture and counseling were each found to be highly effective in reducing the severity of depression-associated symptoms in patients with moderate-to-severe depression, and both were actually found to be more effective than the “usual care” (including antidepressant medications) received by the control group of patient volunteers at 3 months and at 6 months. 

This small study suggests a potential role for acupuncture in the treatment of major depression, and should stimulate additional research in this, and other, non-pharmacologic therapies for depression, particularly given the minimal risks associated with acupuncture in otherwise healthy patients.  However, if you are already taking antidepressant medications, and you are interested in trying acupuncture as a treatment for depression, please do not stop taking your medications without your doctor’s approval, as doing so could result in a worsening of your depression!

 

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According to recent Bureau of Labor Statistics, the unemployment rate for veterans who served on active duty between September 2001 and December 2011 is more than 12 percent.  A new website, Veterans in Healthcare, seeks to connect veterans with potential employers.  If you are a veteran who works in the healthcare field, or if you are an employer who is looking for physicians, advanced practice professionals, nurses, corpsmen/medics, or other healthcare professionals, then please take a look at Veterans in Healthcare. As a retired veteran of the U.S. Army, I would also like to personally urge you to hire a veteran whenever possible.


Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


 

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Deep Brain Stimulation May Help Severe, Refractory Depression

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DEEP BRAIN STIMULATION MAY HELP SEVERE, REFRACTORY DEPRESSION

Depression is both a common and a potentially very serious mental health disorder.  According to the Centers for Disease Control (CDC), nearly 10 percent of the adult population in the United States can currently be classified as having active depression, and approximately 4 percent of the population currently meets criteria for severe, major depression.

The incidence of depression varies considerably between different groups of people.  For example, women are 70 percent more likely than men to experience depression.  Although depressed women are more likely than men to attempt suicide, men are far more likely to be successful in their suicide attempts.  Other high risk groups include people between the ages of 45 and 64 years, people from ethnic minority groups, people with less than a high school education, people who are divorced and who have not remarried, the unemployed, and those without health insurance.  (Clearly, in view of the still ongoing recession in the United States, the number of people in several of these high-risk categories has increased significantly over the past four years.)

There are multiple effective therapies available or depression, including antidepressant medications, psychotherapy, and electroconvulsive therapy (ECT).  More recently, transcranial magnetic stimulation, vagus nerve stimulation, and other experimental treatments have been evaluated in patients with depression that fails to respond to conventional therapies.  Another recently developed experimental therapy for severe, refractory depression is deep brain stimulation (DBS).  In small pilot studies, small numbers of patients with severe depression, and who have failed every other form of depression treatment (including ECT), have had surgically implanted electrodes placed into their brains, followed by electrical stimulation of their brains through these deep brain electrodes.  While it is too soon to conclude that DBS is both safe and effective in the management of severe, refractory depression, a new prospective clinical research study suggests that DBS may, indeed, produce significant remissions in refractory major depression.  This newly published study appears in the current issue of theArchives of General Psychiatry.

In this small but innovative clinical trial, 10 patients with major depression and 7 patients with bipolar disorder underwent surgical implantation of deep brain stimulation electrodes into both hemispheres of the brain.  Initially, all patients underwent simulated (“sham”) DBS, without the patients’ knowledge.  (This sham stimulation was done to test whether or not the patients’ expectation of benefit, or a true potential benefit simply from having the electrodes surgically placed, might have influenced their depression independent of actually stimulating their brains.)  Following 4 weeks of sham stimulation, all patients then initially received 24 weeks of actual DBS.  Following this period of actual DBS, active stimulation of the deep brain electrodes was then temporarily stopped.  (Once again, this discontinuation of active DBS was not revealed to the patients.)  These patient volunteers were then treated with DBS and monitored for up to 2 years.

In this group of patients who had previously failed, literally, all other forms of conventional therapy for their severe depression, DBS was associated with complete remission of depression in 18 percent (3) of the patients, and a significant improvement in depressive symptoms was observed in 41 percent (7) of the patients after 24 weeks of active DBS.  After 2 years of active DBS, 12 patients remained in the study, and 92 percent (11) of these patients experienced significant improvement in their depressive symptoms, including 58 percent (7) who experienced a complete remission of their depression!

The findings of this small prospective, controlled clinical research study are both dramatic and important, and for several reasons.  First of all, the clinically significant improvement seen in almost all of these patients is extraordinary in view of the severity of their depression and the completely refractory nature of their depressive symptoms.  Secondly this study included several patients with bipolar disorder, a disease which is characterized by alternating episodes of mania (a state of extreme mental and physical hyperactivity) and depression.  (Earlier studies of DBS had suggested that this treatment might not be as effective in patients with bipolar disorder, and might also lead to an increased risk of episodes of mania.  However, in this small pilot study, DBS was as effective in treating the symptoms of depression in patients with bipolar disorder as it was in patients with depression alone.  Moreover, DBS did not appear to increase the likelihood of episodes of mania in patients with bipolar disorder.)

 

Depression is a common mental health disorder, and severe cases of depression can leave patients feeling miserable and hopeless.  In especially severe cases, depressed patients may be unable to function in their daily personal or professional lives.  For some unfortunate patients with depression, suicide or accidental causes of death may also end their lives prematurely.  Based upon the findings of this small, preliminary clinical study, DBS may be a safe and effective treatment option for patients with chronic, severe, and refractory depression.

 

If you are depressed, and you are having thoughts about harming yourself (or harming someone else), please immediately contact your mental health provider, a suicide hotline, your personal physician, a close and trusted friend or relative, or your clergy person.  Even during times when you feel like there is no hope that life will get better for you, it almost always will get better if you get some help.

 


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Disclaimer:  As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity


Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author


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I and the staff of Weekly Health Update would again like to take this opportunity to thank the more than 100,000 health-conscious people from around the world who visit this premier global health information website every month.  (More than 1.3 million pages of high-quality medical research findings were served to the worldwide audience of health-conscious people who visited Weekly Health Update in 2011!)  As always, we enjoy receiving your stimulating feedback and questions, and I will continue to try and personally answer as many of your inquiries as I possibly can.


 




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