Abstract

VAZQUEZ, Roxana D.; GONZALEZ-MACIAS, Laura; BERLANGA, Carlos  and  AEDO, Francisco J.. Effect of acupuncture treatment on depression: Correlation between psychological outcomes and salivary cortisol levels. Salud Ment [online]. 2011, vol.34, n.1, pp.21-26. ISSN 0185-3325.

Introduction There are growing scientific data that show the potential therapeutic benefit of treating depression with acupuncture. The most studied mechanisms of action of antidepressants, such as the monoamine oxidase inhibitors, tricyclic antidepressants or serotonine reuptake inhibitors, are their ability to enhance the synaptic availability or the binding of these monoamines to their respective receptors and their effect on adaptations within signal transduction pathways downstream from monoamine receptors. Life stressors or psycho-social events play a significant role in precipitating a first or second episode of major depression. Physiologically, stress activates the Hypothalamic-Pituitary-Adrenal (HPA) axis. Activation of the axis begins with the release of a corticotrophin-releasing factor (CRF), which stimulates the remainder of the cascade, successively prompting the release of adrenocorticotrophic hormone (ACTH) and cortisol. Multiple reports have related HPA axis hyperactivity, including CNS (i.e., corticotrophin-releasing factor), pituitary (i.e., adrenocorticotrophic hormone), and adrenal (i.e., cortisol) to major depression, and suicide behaviour. One of the resources of TCM for the treatment of depression is acupuncture, and it has been suggested as an alternative to antidepressants for its action on the brain monoaminergic systems. Up to now, there are a few examples of randomized and controlled clinical trials of the effect of acupuncture and electroacupuncture on major depression and we have obtained similar results when using acupuncture and electroacupuncture or conventional antidepressant drugs. Since the 1970's many reports have been done to explain the mechanism of action of acupuncture. Some studies performed in humans and animals studies had found an increment in the levels of 3-endorphin, ACTH and cortisol following low frequency electroacupuncture. The release of ACTH and cortisol suggests that electroacupuncture is acting on the HPA axis and through this mechanism could have a modulatory effect on the stress system and depression. The influence of acupuncture on different neurotransmitter systems like 3-endorphin itself or monoamines, like noradrenaline and serotonine, can also mediate effects of acupuncture on mood and behavior. The aim of this study was to establish the effect of a low frequency electroacupuncture point formula on the clinical improvement of depressed patients and its relation with changes on salivary cortisol. Material and methods Subjects: 42 patients, recruitment and Study Population, at a Universitary Primary Care clinic and randomly divided into control (sham acupuncture) or case group (real acupuncture). Intervention: Low frequency electroacupuncture point formula Main Outcome Measures: Clinical score in the Carroll Scale for Depression and psychiatric Symptoms Check List (SCL-90). Salivary cortisol Results The formula used in this study showed a major effect on the reduction of the depressive symptomatology of patients studied compared to the control group. Conclusions To our knowledge, this is the very first report on acupuncture treatment that evaluates depression symptoms and its evolution using the Carroll rating scale. Effect over depressive symptomatology was higher in the real acupuncture group than in the sham acupuncture group. Taking all data together, the formula used in this study showed a major effect on the reduction of the depressive symptomatology and Cortisol levels of patients studied compared to the sham control group.

Keywords : Acupuncture; depression and salivary cortisol.

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