Introduction Traditional Chinese medicine (TCM) has long recognised the use of acupuncture in psychological medicine. Classically the acupuncture meridians or channels are each linked to particular emotions, for example, joy and sadness (heart channel), panic and anxiety (kidney channel), anger and frustration (liver channel). By correct diagnosis, acupuncture intervention can be useful in the restoration of emotional well-being. Today it is realised that this restoration of emotional health is due to neuromodulation at the higher centres. Results of the NIH funded depression study by Allen, Hitt and Schnyer (1998) were encouraging. The study demonstrated acupoint specificity (p < 0.05) for mood disorders. Unfortunately, the study was single blinded. This study is based on the NIH study. The research team hoped to reproduce the significant results achieved then. With laser as the modality, the advantages were obvious: non-invasive modality, randomised double blind control achievable, no infection risk and ease of training community-based doctors to utilise the technique. Method This pilot study utilised laser acupuncture in an outpatient population with mild to moderately severe depression with Beck Depression Inventory (BDI) scale of 12 to 30. Normal was less than or equal to BDI of 10. Recruitment was through family practices (called general practices in Australia) and newspapers. Recruits were each screened by a psychiatrist to confirm their suitability. They were then randomised into sham laser and true laser groups. Each patient received twice a week sessions for a month, followed by once a week sessions for another month. BDI scores were taken fortnightly to ensure none of the patients deteriorated. The acupuncturist was also blinded. BDIs were repeated at one month and three months post laser. Results Thirty patients were recruited and randomised into true and sham laser. Four patients were withdrawn, two from each arm of the study. The rest completed the laser sessions. Of those who completed the study, one patient did not respond to any of the post laser follow up BDI requests. Another patient did not complete the three-month follow up BDI. Results showed a markedly significant improvement in the active group (p< 0.001) at the end of the course of treatment with a sustained difference one month after treatment (p<0.05). Discussion The markedly significant results were unexpected. They do however make laser acupuncture a serious contender as a third standard management option in the treatment of depression in the community. Laser acupuncture could stand alone, or be used together with counselling, psychotherapy or drug therapy. These latter areas of mixed management need to be explored. In the National Institute of Mental Health Treatment of Depression Collaborative Research Programme over 30% of participants terminated treatment early due to adverse effects, lack of improvement or desire to change therapies. These were based on psychological and/or pharmacological treatments. Patients were obviously searching for more satisfactory treatments, non-chemical in nature and without adverse effects. An important point to note from this laser study is that the series of treatments maintained their significance for the month after completion. This suggested that follow-up or maintenance laser acupuncture sessions were important for patient well-being and the one month mark could be indicative of appropriate timing. The research team recommends larger and more specific studies to confirm these findings and explore the wider clinical implications. The team is keen to perform a multicentre study but is restricted by funding issues.
MEDICINAL HERBS AND PHYTOCHEMICALS USED IN THE TREATMENT OF DEPRESSION: A REVIEW
