Randomized non-invasive sham-controlled pilot trial of electroacupuncture for postpartum depression.

BACKGROUND: Postpartum depression affects 10-15% of mothers. Although acupuncture was efficacious for major depressive disorder in pregnancy and in women outside the perinatal period, there has been no randomized controlled study on the feasibility, tolerability, and efficacy of acupuncture for postpartum depression. METHODS: This was a randomized, subject- and assessor-blind, parallel-group, sham-controlled trial. Twenty women within six months postpartum with DSM-IV-diagnosed major depressive disorder of mild severity, defined as a 17-item Hamilton Depression Rating Scale (HDRS(17)) score of 12 to 19, were randomly assigned to either electroacupuncture or non-invasive sham acupuncture two sessions weekly for four weeks. RESULTS: There was significant reduction in HDRS(17) score from baseline to 4-week posttreatment in both groups, with an effect size 1.4 and 1.8 for electroacupuncture and sham acupuncture, respectively. Improvement was observed as early as two weeks after commencing acupuncture. The response and remission rate in the electroacupuncture group at 4-week posttreatment was 33% and 44%, respectively; for the sham acupuncture group, it was 60% and 50%, respectively. There was no significant between-group difference in all outcome measures, including the HDRS(17), Edinburgh Postnatal Depression Scale, Hospital Anxiety and Depression Scale, Clinical Global Impression, and Sheehan Disability Scale. Treatment credibility, success of blinding, and adverse events were similar between groups. LIMITATION: Small sample size and high attrition rate. No waiting list observation group. CONCLUSION: Both electroacupuncture and non-invasive sham acupuncture were effective for postpartum depression. Further studies utilizing larger sample size, better recruitment strategies, and home-based acupuncture treatment are warranted. CLINICAL TRIAL INFORMATION: Pilot Study on the Use of Acupuncture for Postpartum Depression; ClinicalTrials.gov Registration #NCT01178008; URL - http://clinicaltrials.gov/ct2/show/NCT01178008?term=postpartum+acupuncture&rank=1.

Are herbal medicinal products less teratogenic than Western pharmaceutical products.

AIM: To determine the use and teratogenicity of herbal medicinal products (HMP). METHODS: A retrospective study was conducted in a University hospital to compare the difference in the pattern of use and fetal outcomes between pregnant women who took HMP and Western pharmaceutical products (WPP). RESULTS: From 1995 Jan to 2001 Dec, 61 and 372 women took HMP and WPP one month before or during their current pregnancies respectively. There was an increase in the prevalence of pregnant women who took HMP from 0 % in 1995 to 0.8 % in 2001. Among HMP users, 51.6 %, 82.8 % and 58.6 % of them had low monthly family income (<15 000), low education level (secondary education or below) and were unemployed respectively. In comparison to WPP, pregnant women used smaller number of HMP (1.4 vs 3.0, P < 0.01) at a later gestation (4.8 weeks vs 3.1 weeks, P <0.01) and within a shorter duration (11.1 d vs 47.9 d, P < 0.01). The prevalence of congenital fetal abnormalities in the group of women who took HMP (3.3 %) was not significantly higher than that who took WPP (0.8 %). There were no and two abnormal fetal karyotypes in the former and latter group respectively. No and ten women in the former and latter group underwent termination of pregnancy for anxiety respectively. The proportions of silent miscarriage in the former and latter group were similar (6.6 % vs 5.4 %). CONCLUSION: Pregnant users of HMP were from lower socio-economical status. There was no significant difference in the teratogenicity between HMP and WPP.