About 1 in 7 pregnant women experiences full-blown depression during pregnancy and must make the difficult choice of whether to take drugs to treat it. Take antidepressants and risk the small possibility of fetal malformations, cardiac defects, and reduced birth weight? Or forgo the drugs and risk suffering disabling symptoms that have been shown to increase a baby's chances of showing irritability, low activity levels, and poor attentiveness during the first year of life? Well, depressed pregnant women may have another option: acupuncture. A new study published in the journal Obstetrics & Gynecology found that depressed pregnant women who had specifically designed acupuncture treatments experienced significant relief from their symptoms, compared with those who had control treatments like standard acupuncture or massage. (None of the participants opted to take antidepressants.)
The study of 150 pregnant volunteers found that 63 percent of those who received depression-specific acupuncture treatments (one to two times per week for eight weeks) felt a lifting of their symptoms, compared with 44 percent of those who had either control treatment. That puts acupuncture on par with antidepressants—but without the risks to the fetus. "If you look at the response rates we got in our study and compare to response rates in studies using antidepressants, you see pretty comparable effectiveness," says study author Rachel Manber, a professor of psychiatry and behavioral sciences at Stanford University School of Medicine.
The study participants had moderate to severe depression, as evaluated on the Hamilton Rating Scale, and had suffered an average of three depressive episodes in the past. About two-thirds of the participants developed depression during their pregnancy, while the rest had it before becoming pregnant. And one quarter of the study volunteers had been on antidepressants before becoming pregnant but decided to stop taking the drugs either before they conceived or soon after they found out they were pregnant.
While the randomized, controlled study was well designed, it has some pretty big caveats. The results, says Manber, run counter to other studies in nonpregnant individuals showing that depression-specific acupuncture treatments don't work better than placebos at relieving depression. Manber says she can't explain why these treatments would work during pregnancy but not at other times. "I don't think we have a universal conclusion at this point that acupuncture works for depression, but we do have some evidence that's growing." (She found similar results in a smaller study involving 50 pregnant women published a few years ago.)
It also may be difficult to find an acupuncturist who performs treatments tailored for depression. There's no way of knowing whether the needle sticks are placed in the right spots on the forehead, torso, or arms. (The American Association of Acupuncture and Oriental Medicine website can provide you with a referral, but you might still want to ask your doctor for a recommendation.) There's also the cost factor: Acupuncture isn't always covered by insurance, and costs range from $75 to $95 for the first session and $50 to $70 for each additional session. (The study participants had about 12 sessions.)
Still, the study could have some very real implications for those who don't want to be on antidepressants while pregnant and suffering through the darkness for nine months. I asked Manber: Should they try acupuncture? She says she's not ready to universally recommend the treatment for all depressed pregnant women but says she'd like to send the message that "overall depression during pregnancy is underrecognized and undertreated" and that "if a woman thinks that she's depressed, she should seek help."
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