Acupuncture for anxiety and anxiety disorders – a systematic literature review
- Karen Pilkington, senior research fellow1,
- Graham Kirkwood, research assistant2,
- Hagen Rampes, consultant psychiatrist3,
- Mike Cummings, medical director4,
- Janet Richardson, reader in nursing and health studies5
- 1School of Integrated, Health University of Westminster, London, UK
- 2Division of Epidemiology, Public Health and Primary Care Medicine, Imperial College, London, UK[previously] Research Council for Complementary Medicine, London, UK
- 3Barnet, Enfield & Haringey Mental Health, NHS Trust, Northwest Community, Mental Health Team, Edgware, Middlesex, UK
- 4British Medical, Acupuncture Society, London, UK
- 5Faculty of Health and Social Work, University of Plymouth, Plymouth, Devon, UK
Introduction The aim of this study was to evaluate the evidence for the efficacy of acupuncture in the treatment of anxiety and anxiety disorders by systematic review of the relevant research.
Methods Searches of the major biomedical databases (MEDLINE, EMBASE, ClNAHL, PsycINFO, Cochrane Library) were conducted between February and July 2004. Specialist complementary medicine databases were also searched and efforts made to identify unpublished research. No language restrictions were imposed and translations were obtained where necessary. Study methodology was appraised and clinical commentaries obtained for studies reporting clinical outcomes.
Results Twelve controlled trials were located, of which 10 were randomised controlled trials (RCTs). Four RCTs focused on acupuncture in generalised anxiety disorder or anxiety neurosis, while six focused on anxiety in the perioperative period. No studies were located on the use of acupuncture specifically for panic disorder, phobias or obsessive-compulsive disorder. In generalised anxiety disorder or anxiety neurosis, it is difficult to interpret the findings of the studies of acupuncture because of the range of interventions against which acupuncture was compared. All trials reported positive findings but the reports lacked many basic methodological details. Reporting of the studies of perioperative anxiety was generally better and the initial indications are that acupuncture, specifically auricular acupuncture, is more effective than acupuncture at sham points and may be as effective as drug therapy in this situation. The results were, however, based on subjective measures and blinding could not be guaranteed.
Conclusions Positive findings are reported for acupuncture in the treatment of generalised anxiety disorder or anxiety neurosis but there is currently insufficient research evidence for firm conclusions to be drawn. No trials of acupuncture for other anxiety disorders were located. There is some limited evidence in favour of auricular acupuncture in perioperative anxiety. Overall, the promising findings indicate that further research is warranted in the form of well designed, adequately powered studies.