Acupuncture in Depression: From the Clinical Trial, Biomarkers to Molecular Biology
Acupuncture in Depression: From the Clinical Trial, Biomarkers to Molecular Biology
Major depressive disorder (MDD) is a serious psychiatric illness with a high lifetime
 prevalence rate and causes major clinical, social and economic burden to patients and their
 family. Despite more than 40 antidepressants with various mechanisms are available on the
 market, half of patients fail to achieve remission with optimized medication treatment. Due
 to unsatisfactory efficacy, frequent intolerability and poor compliance of
 psychopharmacotherapies, novel and safe alternative therapies are critically in need to
 improve the treatment of depression.

 Traditional Chinese medicine (TCM) theory describes a state of health maintained by a balance
 of energy in the body. If imbalanced, it can be corrected by acupuncture, the insertion of
 fine needles into different parts of the body. Although there are several clinical trials to
 demonstrate the antidepressant effects of acupuncture, its biological and physiological
 mechanisms are still unknown. In addition, clinical depression is frequently accompanied with
 somatic presentations, which are related to autonomic nervous dysfunction. It would be of
 interest to know if acupuncture could regulate autonomic nervous system (ANS) and improve the
 somatic symptoms in depression. The purpose of this study is to assess the effectiveness of
 acupuncture in the treatment of depression and to determine the influence of acupuncture on
 the molecular and ANS systems.
In this study,the investigators will test the antidepressant effect of acupuncture versus
 sham intervention on major depression, in an eight-week, double-blind, randomized-controlled
 trial in 40 MDD patients who still have significant depressive symptoms without changing at
 their treatment modality for the last 4 weeks. During the visits at weeks 0 (baseline), 1, 2,
 4, 6, 8 (intervention), and 12 (4 weeks after intervention), subjects will be assessed
 depressive symptoms with the 21-item Hamilton Rating Scale for Depression (HAM-D). Before and
 after the intervention (Weeks 0 and 8),Computerized TCM constitution diagnosis will be
 measured and the blood samples will be collected for biomarker analyses, including
 neurotransmitter, inflammatory molecules and immunologic function. All parts of this research
 will start after being approved by the Institution Review Board in study sites.

 The outcomes of this study could provide the evidence of applying acupuncture as an
 alternative effective treatment for depression and to improve the understanding of biological
 mechanisms for its antidepressant effects.
Inclusion Criteria:

 -  Clinical diagnosis of major depressive disorder (MDD)

 -  Over 18 on the 21-item Hamilton Rating Scale for Depression

 Exclusion Criteria:

 -  Schizophrenia

 -  Ubstance dependence disorders