Abstract
Objective To determine the effectiveness and safety of acupuncture for perimenopausal depression. Methods We searched the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, CNKI, VIP Citation Databases, Wan Fang, and online trial registries such as ClinicalTrials.gov for randomized controlled trials (RCTs) assessing the efficacy and safety of acupuncture for perimenopausal depression. Literature screening, data extraction, and determination of the risk of bias were performed by two researchers independently. The extracted data were pooled and meta-analyzed using RevMan5.3 software. Results In total, 16 RCTs covering 1311 patients were enrolled. Overall, the results showed that acupuncture was more effective in the treatment of perimenopausal depression than antidepressants (OR = 2.68, 95% CI (1.84, 3.90), P < 0.00001). Furthermore, HAMD scores in the manual acupuncture group and electroacupuncture group were lower than those of antidepressants (manual acupuncture vs. antidepressants (MD = −2.35, 95% CI (−2.93, −1.77), P < 0.00001) and electroacupuncture vs. antidepressants (MD = −1.2, 95% CI (−1.92, −0.48), P=0.001)). Data analysis revealed that the treatment effect of acupuncture was more stable than that of antidepressants (MD = −2.4, 95% CI (−3.37, −1.43), P < 0.00001). Moreover, acupuncture was safer than antidepressants based on the incidence of adverse events (OR = 0.23, 95% CI (0.1, 0.52), P=0.0004). But acupuncture has no effect on estrogen levels (P ≥ 0.05). Conclusions Acupuncture for perimenopausal depression is safe and effective. Moreover, it has more stable long-term effects than antidepressants and hormone replacement therapy (HRT). We recommend acupuncture as a clinical treatment of perimenopausal depression.
Highlights
Perimenopausal women are at a higher risk of developing depression and other undesirable changes than at any other stage of women’s lives [1, 2]. e prevalence of perimenopausal depression is estimated to range between 4.7% and 41.8% [3,4,5]
Our analysis evaluated primary and secondary outcomes of acupuncture. e primary outcome computed two measures: the effective rate and the Hamilton depression scale (HAMD) score
Results of our meta-analysis revealed significantly lower HAMD scores for the acupuncture groups (P < 0.05) (MD − 1.89, 95% confidence intervals (95% CI) (− 2.35, − 1.44), P < 0.00001)
Summary
Perimenopausal women are at a higher risk of developing depression and other undesirable changes than at any other stage of women’s lives [1, 2]. e prevalence of perimenopausal depression is estimated to range between 4.7% and 41.8% [3,4,5]. Perimenopausal women are at a higher risk of developing depression and other undesirable changes than at any other stage of women’s lives [1, 2]. E onset of perimenopause is characterized by feelings of depression, despair, and sometimes suicidal thoughts. It is frequently accompanied by dysfunction of the endocrine and autonomic nervous systems, leading to hot flashes, night sweats, sleeping difficulty, reduced sex drive, and fluctuations in weight, energy, and cognitive ability [6]. Perimenopausal depression is managed pharmacologically using antidepressants or through psychotherapy [6]. These therapeutic options are not always effective. Antidepressants are frequently associated with numerous negative side effects including mouth dryness, fatigue, drowsiness, weight gain, and sexual dysfunction, thereby contributing to low patient compliance
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