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Abstract

Background

Major depressive disorder (MDD) is a leading cause of disability. Real-world evidence for adjunctive acupuncture with antidepressants is limited.

Methods

We retrospectively analyzed adults with MDD, diagnosed using the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), treated at Southwest Medical University Affiliated Hospital (China) from October 2024 to August 2025 who received pharmacotherapy alone or pharmacotherapy plus manual acupuncture. Propensity score matching (1:1) balanced baseline characteristics. Outcomes [17-item Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), Pittsburgh Sleep Quality Index (PSQI), Short Form-36 Health Survey (SF-36)] were assessed at baseline and week 8.

Results

After matching, 100 patients were included (50 per group) with comparable baseline scores. At week 8, the combination group showed lower HAMD-17 (11.2 ± 3.3 vs 17.0 ± 4.0), lower HAMA (9.8 ± 2.9 vs 14.5 ± 3.5), lower PSQI (8.0 ± 2.2 vs 10.9 ± 2.6), and higher SF-36 (62.8 ± 9.1 vs 56.7 ± 10.2) than those of the pharmacotherapy-alone group (HAMD-17/HAMA/PSQI all P < 0.001; SF-36 P = 0.012). Response (70.0% vs 54.0%) and remission (38.0% vs 28.0%) rates were numerically higher with combination therapy, while adverse events were similar (16.0% vs 14.0%; all P > 0.05) and mild. Benefits were consistent across key subgroups.

Conclusion

In this propensity score–matched real-world cohort, adjunctive acupuncture was associated with greater improvements in depressive symptoms, anxiety, sleep quality, and health-related quality of life without increased adverse events, supporting integrative care and prospective validation.

Keywords

major depressive disorder acupuncture pharmacotherapy treatment outcomes

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References

Cai

Huang

Qiu

Hong

, et al. (2023). Predicting acupuncture efficacy for major depressive disorder using baseline clinical variables: A machine learning study. Journal of Psychiatric Research, 168, 64–70. https://doi.org/10.1016/j.jpsychires.2023.10.040

Jiang

T. F.

Chen

Z. Y.

Liu

Yin

X. J.

Tan

Z. J.

Wang

G. L.

, et al. (2024). Acupuncture modulates emotional network resting-state functional connectivity in patients with insomnia disorder: A randomized controlled trial and fMRI study. BMC Complementary Medicine and Therapies, 24(1), 311. https://doi.org/10.1186/s12906-024-04612-0

Kishi

Ikuta

Sakuma

Okuya

Hatano

Matsuda

, et al. (2023). Antidepressants for the treatment of adults with major depressive disorder in the maintenance phase: A systematic review and network meta-analysis. Molecular Psychiatry, 28(1), 402–409. https://doi.org/10.1038/s41380-022-01824-z

Lam Ching

H. J.

Guo

Yao

Chau

, et al. (2023). Acupuncture for post-stroke depression: A systematic review and network meta-analysis. BMC Psychiatry, 23(1), 314. https://doi.org/10.1186/s12888-023-04749-1

Gao

Feng

Luo

, et al. (2020a). SNRIs achieve faster antidepressant effects than SSRIs by elevating the concentrations of dopamine in the forebrain. Neuropharmacology, 177, 108237. https://doi.org/10.1016/j.neuropharm.2020.108237

Niu

Yan

Yao

Wang

, et al. (2020b). The effectiveness and safety of acupuncture for depression: An overview of meta-analyses. Complementary Therapies in Medicine, 50, 102202. https://doi.org/10.1016/j.ctim.2019.102202

Lundberg

Cars

Lööv

Söderling

Tiihonen

Leval

, et al. (2022). Clinical and societal burden of incident major depressive disorder: A population-wide cohort study in Stockholm. Acta Psychiatrica Scandinavica, 146(1), 51–63. https://doi.org/10.1111/acps.13414

Matar

Serhan

El Bilani

Faraj

R. A.

Hadi

B. A.

Fakhoury

(2024). Psychopharmacological approaches for neural plasticity and neurogenesis in major depressive disorders. Advances in Experimental Medicine and Biology, 1456, 27–48. https://doi.org/10.1007/978-981-97-4402-2_2

Z. Y.

Qin

Z. Z.

J. J.

X. X.

Wang

Zhao

Y. Y.

, et al. (2024). The long-term spatio-temporal trends in burden and attributable risk factors of major depressive disorder at global, regional and national levels during 1990–2019: A systematic analysis for GBD 2019. Epidemiology and Psychiatric Sciences, 33, e28. https://doi.org/10.1017/S2045796024000295

10.

Mosiołek

Pięta

Jakima

Zborowska

Mosiołek

Szulc

(2021). Effects of antidepressant treatment on peripheral biomarkers in patients with major depressive disorder (MDD). Journal of Clinical Medicine, 10(8), 1706. https://doi.org/10.3390/jcm10081706

11.

Na-Na

Lu-Lu

Yue-Jie

Hong-Ping

Yan

Chun-Xia

, et al. (2021). Potential mechanisms and clinical effectiveness of acupuncture in depression. Current Neuropharmacology, 20(4), 738–750. https://doi.org/10.2174/1570159X19666210609162809

12.

Peng

Wang

Huang

Liu

, et al. (2022). The association of depressive symptoms with disability among adults in China. Journal of Affective Disorders, 296, 189–197. https://doi.org/10.1016/j.jad.2021.09.030

13.

Schmidt

M. E.

Kezic

Popova

Melkote

Van Der Ark

Pemberton

D. J.

, et al. (2024). Efficacy and safety of aticaprant, a kappa receptor antagonist, adjunctive to oral SSRI/SNRI antidepressant in major depressive disorder: Results of a phase 2 randomized, double-blind, placebo-controlled study. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 49(9), 1437–1447. https://doi.org/10.1038/s41386-024-01862-x

14.

Wang

Liu

Chen

Liu

Nie

, et al. (2017). Acupuncture treatment modulates the corticostriatal reward circuitry in major depressive disorder. Journal of Psychiatric Research, 84, 18–26. https://doi.org/10.1016/j.jpsychires.2016.09.014

15.

Cao

Chen

, et al. (2025). The efficacy and cerebral mechanism of intradermal acupuncture for major depressive disorder: A multicenter randomized controlled trial. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 50(7), 1075–1083. https://doi.org/10.1038/s41386-024-02036-5

16.

Xiao

Huang

Lei

Yin

Huang

, et al. (2023). Clinical evidence for association of acupuncture with improved major depressive disorder: A systematic review and meta-analysis of randomized control trials. Neuropsychobiology, 82(1), 1–13. https://doi.org/10.1159/000527903

17.

M. M.

Guo

Q. Y.

Zhou

Wei

Y. L.

Wang

, et al. (2022). Can acupuncture enhance therapeutic effectiveness of antidepressants and reduce adverse drug reactions in patients with depression? A systematic review and meta-analysis. Journal of Integrative Medicine, 20(4), 305–320. https://doi.org/10.1016/j.joim.2022.05.002

18.

Wei

Y. N.

Bai

Wang

(2025). Possible antidepressant mechanism of acupuncture: Targeting neuroplasticity. Frontiers in Neuroscience, 19, 1512073. https://doi.org/10.3389/fnins.2025.1512073

19.

Hua

Jin

Guo

Huang

(2025). Improving hemodialysis patient depression outcomes with acupuncture: A randomized controlled trial. Acta Psychologica, 253, 104728. https://doi.org/10.1016/j.actpsy.2025.104728

20.

Zhang

Chen

Yao

Chen

Yang

, et al. (2021). Comparison between acupuncture and antidepressant therapy for the treatment of poststroke depression: Systematic review and meta-analysis. Medicine, 100(22), e25950. https://doi.org/10.1097/MD.0000000000025950

21.

Zhang

Liu

Ning

Yan

Zhang

, et al. (2022). Efficacy of the integrative acupuncture and moxibustion treatment in patients with major depressive disorder: The study protocol for a multicenter, single-blinded, randomized trial in China. Frontiers in Medicine, 9, 761419. https://doi.org/10.3389/fmed.2022.761419

22.

Zhao

F. Y.

Q. Q.

Spencer

S. J.

Kennedy

G. A.

Conduit

Zhang

W. J.

, et al. (2021). Acupuncture: A promising approach for comorbid depression and insomnia in perimenopause. Nature and Science of Sleep, 13, 1823–1863. https://doi.org/10.2147/NSS.S332474

23.

Zhao

F. Y.

Zhang

W. J.

Kennedy

G. A.

Zheng

, et al. (2024). Inadequate evidence for acupuncture as an alternative or adjunct to antidepressants/psychotherapy for postpartum depression: A Bayesian systematic review and network meta-analysis. Neuropsychiatric Disease and Treatment, 20, 1741–1755. https://doi.org/10.2147/NDT.S484387

24.

Zixuan

Shaoyuan

Hong-yu

Yifei

Yue

Mozheng

, et al. (2021). Efficacy and safety of acupuncture in the treatment of depression: A systematic review of clinical research. The Anatomical Record, 304(11), 2436–2453. https://doi.org/10.1002/ar.24783

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Clinical Outcomes of Acupuncture Combined with Antidepressant Therapy for Major Depressive Disorder: A Propensity Score–Matched Retrospective Observational Study

Abstract

Background

Methods

Results

Conclusion

Keywords

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References

Supplementary Material