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Evidence for Using Needle Acupuncture to Treat MDD Is Limited

• We identified 18 randomized controlled trials that examined acupuncture in the treatment of MDD. We found that the methodological quality of the studies was generally poor, with limited blinding, high attrition, and limited use of intention-to-treat analysis.
• The limited evidence suggests a higher rate of responders with adjunctive acupuncture plus antidepressants than with antidepressants alone, but the studies were of poor quality (low quality of evidence).
• Monotherapy acupuncture may be superior to waitlist (low quality of evidence), but findings for effect estimates compared with other comparators are inconclusive.
• Few studies reported on patients achieving remission. The effect of acupuncture on relapse rates could not be determined. Too few studies assessed quality of life to estimate treatment effects.
• Reported adverse events were typically mild in nature, but the assessment lacked rigor and studies were not designed to detect rare events.