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Ask the Mental Health Expert Archives 2001-2004

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Complimentary Therapy

Q. Have you ever heard of acupuncture being used as a complimentary therapy (along with traditional drug therapies), to treat bipolar disorder/manic depression? If you have heard of such treatment, what was the outcome?

A. There are very few reliable, controlled studies examining the use of acupuncture in bipolar or other major psychiatric disorders--even though there are anecdotal reports of success with this intervention in various anxiety and depressive disorders. I am aware of a Russian study (SE Poliakov: Zh Nevropatol Psikhiatr Im S S Korsakova 1987;87(4):604-8) claiming that in a sample of 167 patients with depression "associated with manic-depressive psychosis and schizophrenia", acupuncture "...was found to be effective in some patients showing resistance to antidepressants".

However, I have seen only the abstract of this study, and can't comment on the quality of the methodology. Similarly, I am aware of a report from the Chinese literature (Hu J: Acupuncture treatment of manic psychosis. J Tradit Chin Med 1996 Sep;16(3):238-40), but again, I have not seen the paper.

I am not aware of any published studies using acupuncture as an adjunctive treatment (as per your question) in bipolar disorder. In an excellent article by E. Ernst in the Nov. 1998 Archives of General Psychiatry, there is a good review of acupuncture for the treatment of depression (which is not the same thing as manic-depression or bipolar disorder). The review cites two randomized, controlled trials comparing electroacupuncture (EA) with the tricyclic antidepressant amitriptyline [Elavil], and finds that in both studies, EA was comparable to the tricyclic in efficacy (Luo et al, 1985; Luo et al, 1990). However, Ernst notes that the role of time and attention (rather than the effect of EA per se) may not have been adequately controlled for in these studies.

So, at this time, I think it's fair to say that there is no credible, controlled evidence showing that acupuncture is effective either alone or as an adjunct in the treatment of bipolar disorder. Of course, who knows what future research will show?

May 2002

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