Is Electroacupuncture an Effective and Safe Treatment for Poststroke Depression? An Updated Systematic Review and Meta-Analysis

Wang, Xiafei; Cai, Wa; Wang, Yongpeng; Huang, Song; Zhang, Quanbin; Wang, Feng

doi:10.1155/2021/8661162

Cited by 8 publications

(10 citation statements)

References 6 publications

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“…In all, 19 studies were excluded due to the following reasons: No necessary sample data ( n = 8), Other outcomes ( n = 5), Other reviews ( n = 4), and Other languages ( n = 2) ( Figure 1 ). Thus, 17 studies were included in the umbrella review (Yi et al, 2010 ; Eng and Reime, 2014 ; Ren et al, 2015 ; Tan et al, 2015 ; Feng et al, 2018 , 2022 ; Jin et al, 2018 ; Wang et al, 2018 , 2021 ; Liu et al, 2019 , 2021 ; Li et al, 2020 ; Cai et al, 2021 ; Lee et al, 2021 ; Zhang et al, 2021a , b ; Guo et al, 2022 ). Study characteristics and quality ratings of 17 meta-analyses/systematic reviews were summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

The efficacy of therapies for post-stroke depression in aging: An umbrella review

Xie

Geng²,

Fan³

et al. 2022

Front. Aging Neurosci.

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Post-stroke depression (PSD) is a common complication after stroke. PSD is associated with emotional disorders and psychological dependence, which are potential risk factors for stroke recurrence and suicidality. This study aimed to perform an umbrella review of therapies for PSD through a comprehensive literature search. A systematic search was conducted in the PubMed and Web of Science by two independent authors. We examined the Hamilton Depression Scale (HAMD), Activities of daily living (ADL), Neurologic function as efficacy endpoints, and the incidence of adverse events as safety profiles. Seventeen eligible studies, including 267 clinical trials were included in this study. The results showed that High-Frequency Repetitive Transcranial Magnetic Stimulation (HfrTMS), Acupuncture/EA+conventional treatment, Escitalopram, Modified Sini San, Moxibustion, Xiaoyao Formula, Paroxetine, Chinese herbal medicine, Exercise, Citalopram, and Cognitive behavioral therapy are beneficial for improving the depression symptoms of patients with PSD. HfrTMS and Sertraline may have an impact on slowing the scores of activities of daily living or neurologic function. In addition, Acupuncture/EA+conventional, Escitalopram, Citalopram, Sertraline, and Fluoxetine showed no serious adverse events in PSD patients. Our study demonstrated that 11 treatment methods can effectively improve the condition of PSD patients.

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Section: Resultsmentioning

confidence: 99%

The efficacy of therapies for post-stroke depression in aging: An umbrella review

Xie

Geng²,

Fan³

et al. 2022

Front. Aging Neurosci.

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“…In 2021, two related reviews were published. One was an update of a meta-analysis of EA for post-stroke depression in 2018 (19 trials) (18), which indicated that in comparison with antidepressants, EA has a similar effect in improving depression symptoms and shows better safety in post-stroke depression patients. Another systematic review focused on the neuroimaging effects of acupuncture (including EA) in depression (10 trials of EA) (65).…”

Section: Discussionmentioning

confidence: 99%

“…A review in 2018 exploring the overall efficacy of acupuncture (both EA and MA) on depression found weak evidence suggesting that the efficacy and safety of acupuncture was no less than that of antidepressants, and that acupuncture combined with antidepressants may have better efficacy than antidepressants alone (15). Some reviews focusing on EA for specific subtype of depression, such as PSD (16) postpartum depression (17,18) found EA had similar efficacy to other therapy and better safety. But most of these reviews did not carry subgroups comparison and the evidence grade was low mainly due to lack of included studies.…”

Section: Introductionmentioning

confidence: 99%

Electroacupuncture as a rapid-onset and safer complementary therapy for depression: A systematic review and meta-analysis

et al. 2023

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BackgroundElectroacupuncture (EA) is a promising therapy for depression. However, a comprehensive review of EA for depression is needed.MethodsWe conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA 2020) guidelines to evaluate the efficacy and safety of EA for depression. Potentially relevant trials and reviews were searched in MEDLINE, EMBASE, PsycINFO, and CENTRAL from inception to March 2022. EA alone and combined with other therapy were eligible for inclusion. The severity of depression during and after treatment and the number of adverse events were assessed as outcomes. Risk of bias (ROB) evaluation, subgroup analysis, sensitivity analysis, reporting bias assessment, and GRADE system evaluation were also conducted.ResultsThirty-four trials were included. The overall ROB was medium. Low-quality evidence showed that the efficacy of EA was not less than that of antidepressants [EA + selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs)] and manual acupuncture (MA). EA and EA + SSRIs had better efficacy than SSRIs alone in decreasing the severity of depression during the early treatment. Moderate-quality evidence also showed that EA and EA + SSRIs were safer than SSRIs alone. Sensitivity analysis was mostly not feasible. Major publication bias was unlikely.ConclusionThese results indicate that the efficacy of EA is not less than that of antidepressants and MA. Moreover, EA and EA + SSRI treatments show a more rapid onset and greater safety than SSRIs. More high-quality trials are needed for further confirmation.Systematic review registration[www.crd.york.ac.uk/prospero/display_ record.php?RecordID=329143], identifier [CRD42022329143].

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“…Moxibustion facilitates antidepressant effects by promoting the brain’s uptake of tryptophan and converting tryptophan metabolism to 5-HT ( 70 ). Electroacupuncture can enhance the body’s defense function, inhibit the secretion of inflammatory factors after stroke, and thus reduce the treatment of injury PSD ( 71 ). Acupuncture points on the abdomen can stimulate signals to the gut-brain through the abdominal wall, thus exerting the abdominal-brain correspondence regulation mechanism to treat PSD ( 72 ).…”

Section: Discussionmentioning

confidence: 99%

Effect of acupuncture combined with antidepressants on post-stroke depression: A network meta-analysis of nine acupuncture therapy

Chen

Liu

et al. 2023

Front. Neurol.

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BackgroundPost-stroke depression (PSD) is a common psychiatric complication of mental disorders after stroke. Acupuncture for PSD is effective and has few adverse effects. As a classical complementary and alternative therapy, acupuncture is often used in combination with antidepressants for PSD. However, there is a wide variety of acupuncture therapies, and the efficacy of different acupuncture varies. In this study, a network meta-analysis (NMA) was used to assess the clinical efficacy of different acupuncture combined with antidepressants for the treatment of PSD.MethodsA comprehensive search of PubMed, The Cochrane Library, EMbase, Web of Science, CNKI, CBM, VIP, and Wan-Fang databases for published randomized controlled trials of acupuncture combined with antidepressants for the treatment of PSD was conducted. The time frame for the literature search was from the date of database creation to April 30, 2022. The Cochrane risk of bias tool for randomized trials (RoB 2.0) was used to evaluate the bias risk of the included studies. Data analysis was performed by STATA 14.0 software.ResultsA total of 38 literatures with 2,898 patients involving nine acupuncture therapies were included. NMA results were as follows: moxibustion plus antidepressants had the best efficacy in terms of improving total effective rate. Conventional acupuncture plus antidepressants was the most effective in improving HAMD scores. In terms of improving SDS scores, acupressure plus antidepressants was the most effective. In terms of improving NIHSS scores, moxibustion plus antidepressants showed the best results.ConclusionA comparison of the efficacy indicators of the nine different acupuncture therapies combined showed that moxibustion plus antidepressants, conventional acupuncture plus antidepressants and acupressure plus antidepressants were superior in the treatment of PSD. Based on the shortcomings of the existing studies, this conclusion needs to be validated by additional high-quality randomized controlled trials.

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Is Electroacupuncture an Effective and Safe Treatment for Poststroke Depression? An Updated Systematic Review and Meta-Analysis

Cited by 8 publications

References 6 publications

The efficacy of therapies for post-stroke depression in aging: An umbrella review

The efficacy of therapies for post-stroke depression in aging: An umbrella review

Electroacupuncture as a rapid-onset and safer complementary therapy for depression: A systematic review and meta-analysis

Effect of acupuncture combined with antidepressants on post-stroke depression: A network meta-analysis of nine acupuncture therapy

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