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The Available Evidence in Support of Acupuncture for PTSD Is Limited

• We found statistically significant effects in favor of acupuncture (as adjunctive or monotherapy) versus any comparator for PTSD symptoms at postintervention and between one and six months follow-up, as well as for depressive symptoms at follow-up. However, the number of available studies is small, and the quality of evidence is low to very low.
• Safety data suggested that acupuncture is not associated with any serious adverse events, although some participants reported mild adverse events due to needling procedures. However, adverse events were not systematically collected in most studies.
• We did not identify any evidence to suggest that results differ by type of acupuncture, co-intervention status, or comparator, although these analyses are limited by the small number of identified RCTs and lack of direct comparisons.

RAND researchers conducted a systematic review that synthesized evidence from randomized controlled trials (RCTs) of needle acupuncture — used adjunctively or as monotherapy — to provide estimates of its efficacy and safety for treating adults diagnosed with posttraumatic stress disorder (PTSD).

Outcomes of interest included PTSD symptoms (primary outcome), health-related quality of life, functional status, anxiety and depression symptoms, sleep quality, and adverse events. Meta-analyses were conducted using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. Quality of evidence was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.

Seven studies with 709 total participants were included. We identified potential benefits of acupuncture for PTSD and depression symptoms compared with control groups in the months following treatment, although the quality of the evidence underpinning these estimates is limited. Few minor adverse events and no serious adverse events were reported, but safety assessments were limited. Additional well-designed, rigorous, and large RCTs have the potential to further develop the evidence base to provide more-conclusive evidence.

• Chapter One

  Introduction

• Chapter Two

  Methods

• Chapter Three

  Results

• Chapter Four

  Discussion

• Appendix A

  Search Methodology

• Appendix B

  Cochrane Risk of Bias Criteria

• Appendix C

  Excluded Full-Text Articles

• Appendix D

  Included Studies

• Appendix E

  Evidence Table of Included Studies

• Appendix F

  Sensitivity Analyses