Depression during pregnancy is relatively common, affecting about 10 to 15% of women. While there is a growing body of literature supporting the reproductive safety of certain antidepressants, many women and their physicians would prefer to avoid the use of these medications during pregnancy; thus, there is a clear need for effective non-pharmacologic treatments for women who suffer from depression during pregnancy.

In a recent study presented at the Society for Maternal-Fetal Medicine (SMFM) 30th Annual Meeting by Dr. Rachel Manber and her colleagues at Stanford University, the efficacy of acupuncture was assessed in a group of pregnant depressed women.  In this study, 150 pregnant women with DSM-IV major depressive disorder and a score >14 on the 17-item Hamilton Rating Scale for Depression (HAMD-17) were randomly assigned to receive one of three treatments:  acupuncture specifically targeting depressive symptoms (SPEC, n=52), an active control acupuncture (NSPEC, n=49), and massage therapy (MSSG, n=49). Participates received treatment over an 8-week period consisting of 12 sessions (25-30 min each).

Acupuncture treatments were provided in a blinded fashion.  At baseline, a senior acupuncturist (non-blinded) designed a set of treatments that was individually tailored for each patient.  A treating acupuncturist (blinded) needled the points that were prescribed by the senior acupuncturist.  Each SPEC and NSPEC treatment consisted of the same number of acupuncture points distributed across the same general areas of the body.

The HAMD-17 was administered at baseline, 4 weeks, and 8 weeks.  Responders were those with a HAMD-17 score of < 14 and a greater than 50% reduction from baseline.

At the end of the study, women in the SPEC group had lower HAM-D scores than those in the NSPIEC and massage therapy control groups.  In the SPEC group, 63.0% responded versus 37.5% in the NSPEC group and 50.0% in the massage group.

The findings suggest that acupuncture may be an effective treatment for women who suffer from depression during pregnancy.  Whether or not this modality is efficacious in all women, specifically those with more severe depressive symptoms or with comorbid anxiety disorders, is not yet clear; however, these results suggest that acupuncture may be an attractive option for women who wish to avoid the use of antidepressants during pregnancy.

Ruta Nonacs, MD PhD

Society for Maternal-Fetal Medicine (SMFM) 30th Annual Meeting: The Pregnancy Meeting: Abstract 8. Presented February 4, 2010.