A Population-Based Cohort Study on the Ability of Acupuncture to Reduce Post-Stroke Depression

Abstract

Objective: Post-stroke depression (PSD) is common and has a negative impact on recovery. Although many stroke patients in Taiwan have used acupuncture as a supplementary treatment for reducing stroke comorbidities, little research has been done on the use of acupuncture to prevent PSD. Accordingly, our goal is to investigate whether using acupuncture after a stroke can reduce the risk of PSD. Method: This population-based cohort study examined medical claims data from a random sample of 1 million insured people registered in Taiwan. Newly diagnosed stroke patients in the period 2000–2005 were recruited in our study. All patients were followed through to the end of 2007 to determine whether they had developed symptoms of depression. A Cox proportional hazard model was used to estimate the relative risk of depression in patients after being diagnosed as having had a stroke, with a focus on the differences in those with and without acupuncture treatment. Results: A total of 8487 newly-diagnosed stroke patients were included in our study; of these, 1036 patients received acupuncture more than five times following their stroke, 1053 patients received acupuncture 1–5 times following their stroke and 6398 did not receive acupuncture. After we controlled for potential confounders (e.g., age, sex, insurance premium, residential area, type of stroke, length of hospital stay, stroke severity index, rehabilitation and major illness–related depression), we found that acupuncture after stroke significantly reduced the risk of depression, with a hazard ratio (HR) of 0.475 (95% CI, 0.389–0.580) in frequent acupuncture users and 0.718 (95% CI, 0.612–0.842) in infrequent acupuncture users, indicating that acupuncture may lower the risk of PSD by an estimated 52.5% in frequent users and 28.2% in infrequent users. Conclusions: After we controlled for potential confounders, it appears that using acupuncture after a stroke lowers the risk of depression. Additional strictly-designed randomized controlled trials are needed to better understand the specific mechanisms relating acupuncture to health outcomes.

The effectiveness of acupuncture therapy in patients with post-stroke depression

“…[28] One study reported that patients with PSD who underwent higher frequency acupuncture treatments may have experienced greater improvement of depressive symptoms. [29] Because of the small number of studies, we cannot compare the effects of electroacupuncture, acupuncture combined with moxibustion, and traditional acupuncture. Moreover, the selection of acupoints in the included studies was not the same and, therefore, further research to optimize acupoint selection and improve the therapeutic schedule is warranted.…”

Contextual factors that shape recovery after stroke in Malaysia

“…A few, however, claim no benefit came from the treatments. Studies in CAM for stroke recovery have highlighted the benefits of acupuncture, massage, exercises and herbal or vitamin supplements [64][65][66][67][68][69]. These studies argue that CAM aids with symptom relief increased mobility and improved mood in stroke survivors.…”

Does acupuncture combined with antidepressants have a better therapeutic effect on post-stroke depression? A systematic review and meta-analysis

“…Studies have suggested that acupuncture can reduce the incidence of PSD and relieve its symptoms. [10][11][12] Several existing meta-analyses [13][14][15] also indicate that acupuncture has a superior therapeutic effect to antidepressants on PSD. However, these studies only compared acupuncture versus antidepressants, while, in clinical practice, the use of acupuncture together with antidepressants is more prevalent.…”