Acupuncture versus antidepressants in the management of postpartum depression: A systematic review
Antidepressants for postnatal depression may not be acceptable to women and so many may seek alternative therapies.
To evaluate the effectiveness and safety of acupuncture for postnatal depression compared with antidepressant treatment.
A literature search was conducted in English, Chinese, Japanese and Korean databases. Details of the trials were extracted and analysed.
Of the 1592 studies reviewed, three met the inclusion criteria for quantitative analysis. Two studies reported no significant differences between acupuncture and fluoxetine for depression, while the third reported significant improvements.
Acupuncture in postpartum depression was at least as effective as fluoxetine hydrochloride, supporting the notion that acupuncture may be a safe and effective option.
Postnatal depression is a significant global health issue and affects 26–85% of postpartum women who experience the so-called ‘baby blues’. Of these, 10–15% have been found to deteriorate to a major depressive disorder (Epperson and Ballew, 2008). In the UK, it is estimated that 1 in every 10 women are affected by postnatal depression (NHS Choices, 2016), while in Australia and the USA the estimate is as high as 1 in 5 women (Australian Institute of Health and Welfare, 2012; Centers for Disease Control and Prevention, 2017). Postnatal depression often presents with a greater incidence with a comorbid anxiety or may develop into bipolar affective disorder (Munk-Olsen et al, 2012). Postpartum psychosis is another comorbidity that may co-occur in 0.1–0.2% of all new postnatal women (Kendall-Tackett, 2010). Suicide occurs in some severe cases of postnatal depression and in Australia, New Zealand and the UK has been identified as the most common yet most preventable cause of maternal death (Knight et al, 2017; Australian Institute of Health and Welfare, 2017; Perinatal and Maternal Mortality Review Committee, 2017). In the UK, £8.1 billion is spent on perinatal mental health each year (Bauer et al, 2014) and it is considered a priority for health policy (Royal College of Obstetricians and Gynaecologists, 2017).
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