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Date of Award

Spring 2020

Degree Name

Master of Medical Science (Physician Assistant)

Department

Physician Assistant; College of Health Sciences

First Advisor

Elizabeth Masten, MMS

Abstract

Introduction: Depression is a serious mental illness that affects hundreds of millions of people around the world, characterized by a depressed mood and loss of interest/pleasure. Other symptoms associated with Major Depressive Disorder include significant weight changes or appetite changes, slowing down of thought and reduction of physical movement, fatigue or loss of energy, feeling worthless or excessive guilt, a diminished ability to think/concentrate, and suicidal ideation. The standard first-line medications for Major Depressive Disorder are Selective Serotonin Reuptake Inhibitors (SSRIs) including fluoxetine and paroxetine. These drugs are associated with various side-effects. Therefore, this review analyzes the use of acupuncture therapy in combination with SSRI medication (I) in reducing the amount and severity of the symptoms (O) in adult patients suffering from Major Depressive Disorder (P) compared to standard first-line SSRI medications (C).

Methods: A literature search was completed on Academic Search Ultimate and PubMed in November 2018. Seven articles were selected based on their relevance to the research question, study design, outcome measurements, and results.

Results: Based on the literature review, there is hopeful evidence that acupuncture in addition to SSRI medications may be efficacious in controlling Major Depressive Disorder in adult patients compared to only SSRI medications alone. Four studies compared an only SSRI control group to an acupuncture treatment group and found statistically significant improvement in the HAMD-17 scale, symptom checklist 90 scores, the SDS, MADRS, and SERS scales. Three studies compared pseudo-acupuncture to acupuncture and each had mixed results, one study having statistical significance, and two have clinically significant results.

Discussion: Significant positive results were found in most of the articles, but the method of measuring the outcomes differs among the studies, ranging from six different outcome measurements. Most of the studies had similar inclusion criteria to ensure the patients had a similar degree of Major Depressive Disorder. However, some of the studies had limitations such as observer bias and inadequate follow-up.

Conclusion: Acupuncture in combination with SSRI medication should be considered in adult patients with moderate Major Depressive Disorder who may suffer from side-effects from SSRI medication alone. The addition of acupuncture to a treatment plan may be efficacious in reducing depressive symptoms. One major drawback of this therapy is the lack in long-term follow-up of patients undergoing acupuncture treatment. However, future studies should consider a long-term treatment plan, and a long-term follow-up.

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The efficacy of acupuncture therapy in combination with SSRIs in the treatment of Major Depressive Disorder

Introduction: Depression is a serious mental illness that affects hundreds of millions of people around the world, characterized by a depressed mood and loss of interest/pleasure. Other symptoms associated with Major Depressive Disorder include significant weight changes or appetite changes, slowing down of thought and reduction of physical movement, fatigue or loss of energy, feeling worthless or excessive guilt, a diminished ability to think/concentrate, and suicidal ideation. The standard first-line medications for Major Depressive Disorder are Selective Serotonin Reuptake Inhibitors (SSRIs) including fluoxetine and paroxetine. These drugs are associated with various side-effects. Therefore, this review analyzes the use of acupuncture therapy in combination with SSRI medication (I) in reducing the amount and severity of the symptoms (O) in adult patients suffering from Major Depressive Disorder (P) compared to standard first-line SSRI medications (C).

Methods: A literature search was completed on Academic Search Ultimate and PubMed in November 2018. Seven articles were selected based on their relevance to the research question, study design, outcome measurements, and results.

Results: Based on the literature review, there is hopeful evidence that acupuncture in addition to SSRI medications may be efficacious in controlling Major Depressive Disorder in adult patients compared to only SSRI medications alone. Four studies compared an only SSRI control group to an acupuncture treatment group and found statistically significant improvement in the HAMD-17 scale, symptom checklist 90 scores, the SDS, MADRS, and SERS scales. Three studies compared pseudo-acupuncture to acupuncture and each had mixed results, one study having statistical significance, and two have clinically significant results.

Discussion: Significant positive results were found in most of the articles, but the method of measuring the outcomes differs among the studies, ranging from six different outcome measurements. Most of the studies had similar inclusion criteria to ensure the patients had a similar degree of Major Depressive Disorder. However, some of the studies had limitations such as observer bias and inadequate follow-up.

Conclusion: Acupuncture in combination with SSRI medication should be considered in adult patients with moderate Major Depressive Disorder who may suffer from side-effects from SSRI medication alone. The addition of acupuncture to a treatment plan may be efficacious in reducing depressive symptoms. One major drawback of this therapy is the lack in long-term follow-up of patients undergoing acupuncture treatment. However, future studies should consider a long-term treatment plan, and a long-term follow-up.