Depression and anxiety together constitute a significant contribution to the global burden of disease. Acupuncture is widely used for treatment of anxiety and depression and use is increasing. The theoretical basis for acupuncture diagnosis and treatment derives from traditional Chinese medicine theory. An alternative approach is used in medical acupuncture which relies more heavily on contemporary neurophysiology and conventional diagnosis. Trials in depression, anxiety disorders and short-term acute anxiety have been conducted but acupuncture interventions employed in trials vary as do the controls against which these are compared. Many trials also suffer from small sample sizes. Consequently, it has not proved possible to accurately assess the effectiveness of acupuncture for these conditions or the relative effectiveness of different treatment regimens. The results of studies showing similar effects of needling at specific and non-specific points have further complicated the interpretation of results. In addition to measuring clinical response, several clinical studies have assessed changes in levels of neurotransmitters and other biological response modifiers in an attempt to elucidate the specific biological actions of acupuncture. The findings offer some preliminary data requiring further investigation.
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