Research and News
Up to a quarter of all women suffer from depression during pregnancy, and many are reluctant to take antidepressants. Now a new study suggests that acupuncture may provide some relief during pregnancy, even though it has not been found to be an effective treatment against depression in general.
The Stanford University study recruited 150 depressed women who were 12 to 30 weeks pregnant, and randomly assigned 52 to receive acupuncture specifically designed for depressive symptoms, 49 to regular acupuncture and 49 to Swedish massage.
Each woman received 12 sessions of 25 minutes each; those given acupuncture did not know which type they were getting. (In the depression-specific treatment, needles are inserted at body points that are said to correspond to symptoms like anxiety, withdrawal and apathy.)
After eight weeks, almost two-thirds of the women who had depression-specific acupuncture experienced a reduction in at least 50 percent of their symptoms, compared with just under half of the women treated with either massage or regular acupuncture.
There was no significant difference in the rates of complete remission â€” about a third in each group. The findings appear in the March issue of Obstetrics & Gynecology.
The lead author, Rachel Manber, a professor of psychiatry and behavioral sciences at Stanford, said the results suggested that some symptoms of depression during pregnancy might be related to physical discomfort that is alleviated by acupuncture.
Still, the results were striking, she said, adding, “it’s quite remarkable, especially since the prevalence of depression is highest in the third trimester of pregnancy, so it goes against the course of how you would expect depression to go.”
Researchers at the University of Michigan Chronic Pain and Fatigue Research Center are first to provide evidence of acupuncture’s effect on opoid receptors
ANN ARBOR, Mich. Acupuncture has been used in East-Asian medicine for thousands of years to treat pain, possibly by activating the body’s natural painkillers. But how it works at the cellular level is largely unknown.
Using brain imaging, a University of Michigan study is the first to provide evidence that traditional Chinese acupuncture affects the brain’s long-term ability to regulate pain. The results appear online ahead of publication in the September issue of Journal of NeuroImage.
In the study, researchers at the U-M Chronic Pain and Fatigue Research Center showed acupuncture increased the binding availability of mu-opoid receptors (MOR) in regions of the brain that process and dampen pain signals, specifically the cingulate, insula, caudate, thalamus and amygdala.
Opioid painkillers, such as morphine, codeine and other medications, are thought to work by binding to these opioid receptors in the brain and spinal cord.
“The increased binding availability of these receptors was associated with reductions in pain,” says Richard E. Harris, Ph.D., researcher at the U-M Chronic Pain and Fatigue Research Center and a research assistant professor of anesthesiology at the U-M Medical School.
“One implication of this research is that patients with chronic pain treated with acupuncture might be more responsive to opioid medications since the receptors seem to have more binding availability”, Harris says.
These findings could spur a new direction in the field of acupuncture research following recent controversy over large studies showing that sham acupuncture is as effective as real acupuncture in reducing chronic pain.
“Interestingly both acupuncture and sham acupuncture groups had similar reductions in clinical pain,” Harris says. “But the mechanisms leading to pain relief are distinctly different.”
The study participants included 20 women who had been diagnosed with fibromyalgia, a chronic pain condition, for at least a year, and experienced pain at least 50 percent of the time. During the study they agreed not to take any new medications for their fibromyalgia pain.
Patients had position emission tomography, or PET, scans of the brain during the first treatment and then repeated a month later after the eighth treatment.
Additional authors: Jon-Kar Zubieta, M.D., Ph.D., David J. Scott, Vitaly Napadow, Richard H. Gracely, Ph.D, Daniel J. Clauw, M.D.
Funding: Department of Army, National Institutes of Health
Reference: Journal of NeuroImage, Vol. 5, No. 83, 2009
Resources: U-M Department of Rheumatology http://www.med.umich.edu/intmed/rheumatology/
U-M Chronic Pain and Fatigue Research Center: http://www.med.umich.edu/painresearch/
Written by Shantell M. Kirkendoll
Relaxation techniques decrease anxiety in dementia
NEW YORK (Reuters Health) – Acupressure and Montessori-based activities decrease agitation in institutionalized residents with dementia, according to a report in The New England Journal of Medicine.
Nonpharmacological interventions such as acupuncture, Montessori methods, and massage have all been used to manage agitation and promote relaxation in patients with dementia, the authors explain. A number of studies have tested the effects of these approaches, but the studies had significant limitations.
Dr. Li-Chan Lin from National Yang-Ming University, Taipei, and colleagues explored the effectiveness of acupressure and Montessori-based activities in decreasing agitated behaviors of 133 institutionalized residents with dementia. This was compared with the potentially calming presence of a visitor who acted as a control. All participants underwent all three treatments in three different sequences.
Acupressure daily (6 days weekly) for 4 weeks significantly decreased overall agitated behaviors, the authors report, especially in the Cohen-Mansfield Agitation Inventory (CMAI) subcategories of physically nonaggressive and physically aggressive behaviors.
Montessori-based activities on the same schedule significantly improved aggressive behavior and physically nonaggressive behavior, the researchers note.
Although neither approach decreased verbally agitated behaviors, Montessori treatment was associated with a significant increase in positive affect.
Nurses’ aides noted that ease of care improved when they assisted residents with eating, toileting, bathing, grooming, sleeping, walking, and various other activities after the acupressure or Montessori-based activities.
“This study confirms that a noninvasive, traditional Chinese medical procedure, acupressure, coupled with a Western activities program, could be useful in caring for people with dementia and that in-service training for formal caregivers in private and institutional settings would be beneficial,” the investigators conclude.
SOURCE: The New England Journal of Medicine, July 2009.
Acupuncture Helps Back Pain
From the Chicago Associated Press, September 2007, German researchers have found that almost half the patients treated with acupuncture needles felt relief that lasted months. In contrast, only about a quarter of the patients receiving medications and other Western medical treatments felt better.
Studies Find Acupuncture Cuts Post-Surgical Pain
From researchers at Duke University Medical Center in North Carolina who analyzed the results of 15 clinical trials September 2007, they concluded that patients getting acupuncture before or during various types of operations had significantly less pain afterward than patients who did not get acupuncture.
Chinese Herbs Reduce Post-Chemo Nausea
From the Annals of Oncology, March 2007, researchers from Hong Kong, China and England’s University of Birmingham evaluated the effects of Chinese herbal medicine on 120 patients with early-stage breast or colon cancer. It was found that mild to medium levels of nausea were found in 14.6% of patients treated with Chinese herbs, as opposed to 35.7% of the control group. It was noted that the use of Chinese herbal medicine may “have a significant impact on control of nausea.”
Acupuncture-Massage Helps After Cancer Surgery
From the Journal of Pain and Symptom Management, March 2007, a study conducted by the University of California San Francisco found that two days of acupuncture and massage, in addition to post-operative care, led to a steeper decline for patients with pain symptoms over three days of measurement, as compared to those who received standard post-op care alone.
Tai Chi Effective Addition to Immunity Against Shingles, New Study Finds
From the National Institutes of Health, April 2007, a study reports that tai chi appears to significantly increase the effectiveness of the varicella vaccine, as well , giving even greater immunity to those who receive the vaccine and participated in a tai chi program.
Tension Headaches Dramatically Reduced by Acupuncture
From the British Medical Journal, July 2005, a randomized trial in Germany found that acupuncture cut tension headache rates almost in half. Researchers divided 270 patients who reported similar tension headaches into three groups. Over eight weeks, one group received traditional acupuncture, one received minimal acupuncture and one received sham acupuncture. The group receiving traditional acupuncture reported headache rates of nearly half that of those who received no treatments. The improvements lasted for months after the treatments had ended, rising slightly after time.
Chinese Herbal Medicine Could Help With Endometriosis
RESEARCHERS FOUND THAT A MIX OF TRADITIONAL CHINESE HERBS HAD FEWER SIDE EFFECTS, AND WORKED AS WELL OR EVEN BETTER THAN TWO CONVENTIONAL HORMONAL THERAPIES FOR ENDOMETRIOSIS.
Preliminary research shows that a Chinese herbal medicine could offer an alternative to standard hormonal treatments for endometriosis, according to an article from Reuters Health.
Endometriosis causes tissue (that normally lines the uterus) to grow in other areas of the pelvis – like the ovaries or the fallopian tubes – causing a build up of scar tissue outside the uterus. Thus, the symptoms – pelvic pain, heavy menstrual periods and fertility problems.
Researchers conducted two clinical trials (158 women) and found that a mix of traditional Chinese herbs had fewer side effects, and worked as well or even better than two conventional hormonal therapies. The herbs are considered to help regulate pelvic blood flow, as well as modulate immune system activity and inflammation.
In one trial, researchers randomly assigned women to take either an herbal mixture or a hormonal therapy called gestrinone. The herbal therapy was given both orally and by enema after the women underwent surgery to remove abnormal tissue growths. After three months, their symptoms improved and their chances of becoming pregnant increased over the next two years.
The second trial compared the same herbal mix with danazol, a drug that blocks estrogen secretion. After three months, their symptoms showed improvement. Plus, those who took the herb orally and by enema had a greater reduction in abnormal tissue growths.
“I think the positive message is that Chinese herbal medicine may offer equivalent benefits to conventional medicine but with fewer side effects,” lead researcher Andrew Flower, of the University of Southampton in the UK, told Reuters Health. “This may mean that Chinese herbal medicine is more suitable for long-term use,” he added, “but we need more studies to show this.”
Acupuncture Offers Relief for Breast Cancer Patients
by TARA PARKER-POPE
Treatments for breast cancer can lead to unpleasant side effects for most women, including hot flashes, sweating and lack of energy. Now, new research suggests relief can come from an unconventional therapy: acupuncture.
Research from the Henry Ford Hospital in Detroit, presented this week at the American Society for Therapeutic Radiology and Oncology’s annual meeting in Boston, studied acupuncture use among 47 women who were receiving anti-estrogen treatments, including tamoxifen or anastrozole (Arimidex). The drugs are known to lower the risk of breast cancer recurrence, but they can trigger menopause-like symptoms, including hot flashes and night sweats. Half the women were given the antidepressant Effexor, which has been shown to reduce hot flashes in breast cancer patients. The other half received acupuncture therapy once or twice a week during the 12-week study.
The acupuncture worked just as well as the antidepressant Effexor to curb hot flashes. Women who received acupuncture also reported fewer side effects and more energy, and some reported an increased sex drive, compared to women who used Effexor, the study showed.
Dr. Eleanor M. Walker, director of breast radiation oncology at the Henry Ford Hospital in Detroit, said that while she expected to see some benefits from acupuncture, the results were surprising.
“I was surprised by the duration of the effect,” Dr. Walker said in an interview. “I didn’t realize it would last so long or result in an increase in sex drive and energy. That was a surprise.”
Last year, a report in The Journal of Clinical Oncology suggested a benefit of acupuncture compared to a “sham” acupuncture treatment, but the results didn’t reach statistical significance.
Because the most recent study lasted only three months, it’s not clear how long the benefit of acupuncture lasts. The study authors said that more research is needed to find out if regular “booster” sessions after the initial treatment period will continue to relieve a woman’s symptoms.