TREATING ANXIETY WITH  
ACUPUNCTURE
Phoenix AZ
Please call or email with questions:
480-650-1047
az.medical@yahoo.com
6064 N 16th Street
Phoenix AZ 85016
(Just north of Bethany Home RD)

NOW RECRUITING PEDIATRIC patients
for continuing research treating anxiety
with acupuncture. No diagnosis needed.
Any caregiver/parent who feels their
child has excess anxiety is welcome.
Please read research below.
No blood tests or medicine involved


5-22 YEARS OLD
6 WEEKS
10 TREATMENTS

Paul Sweeney
D.O.M. Lic. Ac.
Certified in Child and Adolescent Mental Health
10 years clinical experience in Asia
20 years in clinical work
(Dr Sweeney is the only licensed acupuncturist/DOM in AZ who is
also certified in pediatric mental health)

Acupuncture for Psychiatric Illness: A Literature Review
Posted on: Saturday, 30 August 2008, 09:00 CDT

The use of complementary and alternative medicine (CAM) is on
the rise, especially among psychiatric patients. Acupuncture is
considered a safe and effective treatment modality, and
traditional Chinese medicine teaches that acupuncture
harmonizes the body's energies. Scientific research has found
that acupuncture increases a number of central nervous system
hormones (ACTH, beta-endorphins, serotonin, and noradrenaline)
and urinary levels of MHPG-sulfate, an adrenergic metabolite
inversely related to the severity of illness in schizophrenics.
Acupuncture can have positive effects on depression and
anxiety, although evidence is still lacking as to its true efficacy for
these conditions. To the authors' knowledge, no trials have been
conducted for schizophrenia, and researchers evaluating
acupuncture in cases of substance abuse have found conflicting
results. Further research is warranted. Index Terms: acupuncture,
anxiety, depression, schizophrenia, substance abuse

The use of complementary and alternative medicine (CAM) is on
the rise,1,2 with psychiatric patients, especially those diagnosed
with disorders such as anxiety or depression, more likely to use
CAM than are patients with nonpsychiatric illness.3,4 The ancient
Chinese treatment of acupuncture incorporates the use of
ultra-fine needles (diameter 0.15-0.30 mm), which are inserted
into specific points on the skin (acupoints). Acupuncture is central
to the treatment regimen of traditional Chinese medicine (TCM),
along with other manual therapies (eg, Tui Na, Chi Gong), herbal
remedies, and nutritional and lifestyle changes. TCM promotes a
holistic, energy- based approach to well-being, as opposed to the
disease-oriented approach of Western (scientific) medicine. Both
the US National Institutes of Health and British Medical
Association recognize acupuncture as an effective treatment for
many medical conditions,5,6 although for many in the medical
profession, acupuncture and other CAM treatments remain
enigmatic.

According to TCM, the body's energy, or Qi (pronounced chee),
flows along series of points called meridians. Each of the internal
organs has a corresponding meridian, and applying pressure
(acupressure, Shiatsu), heat (Moxibustion), or needles
(acupuncture) to relevant acupoints is believed to influence each
of the internal organs and harmonize the body's Qi. There are
many schools of acupuncture (eg, Chinese, Japanese, Korean,
Indian), each with its own approach to diagnosis and allocation of
acupoints. Modern acupuncture has branched out into related
fields, such as electroacupuncture (low-voltage stimulation of
needles) and laser acupuncture. Auricular acupuncture is a
related field in which needles are inserted into points located on
and around the earlobe that correspond to internal organs.

TCM teaches that Qi exists in many forms in the human body. For
example, Jing-considered the most concrete form of Qi-is housed
in the kidneys. Levels of Jing increase and decrease in 7-year
cycles in women in a circadian fashion that is similar to levels of
estradiol in the fertility cycle. Shen (meaning "of the mind") is the
most spiritual form of energy and is housed in the heart. Shen is
responsible for the various mental activities required for day-
to-day functioning. Mental illness can result when there is
disharmony or imbalance in the body's energy system, especially
when the Shen is affected. A number of etiological factors-such
as constitutional makeup, fetal trauma, improper diet, overwork,
excessive sexual activity, and narcotic drugs-can create such an
imbalance.

The exact mechanism by which acupuncture induces
physiological changes, relieves pain, and alleviates illness is still
unclear. Research has shown that treatment with acupuncture
results in local and systemic effects, such as an increased
release of pituitary beta- endorphins and ACTH.7 The release of
endorphins may partly explain the analgesic effects of this
treatment, whereas increased ACTH secretion-which leads to
elevated serum cortisol levels-may account for its
antiinflammatory effects. Acupuncture can also lead to
accelerated synthesis and release of serotonin and noradrenaline
in the central nervous system,8 with activation of descending
antinociceptive pathways and deactivation of multiple limbic
areas subserving pain association.9 Clinical studies of the
efficacy of acupuncture for psychiatric illness are often
convincing but still inconclusive in many areas. Thus, we present
a literature review (using Medline, 1966-2007) on the
effectiveness of acupuncture for 4 Axis I disorders: depression,
anxiety disorders, schizophrenia, and substance abuse.

.TCM teaches that depressive symptoms result from disharmony
between the physical Qi and the spiritual Shen energies of the
body. According to the Five-Element school of TCM, 3 distinct
forms of depression exist, each with its own predominant
emotional imbalance: Earth type (worry), Water type (fear), and
Wood type (anger). Each of these forms of depression correspond
to an imbalance in one of 3 internal organ systems: the
spleen/stomach (Earth), the kidneys (Water), and the liver (Wood).
In most instances, the depressed patient may suffer from more
than 1. The imbalance can be caused by internal organ
deficiencies (eg, innate deficiency of kidney Qi), excesses (eg,
stagnation of liver Qi caused by repressed anger), or both. As
with many other ailments, TCM recommends an integrated
approach to treatment, using herbal remedies and acupuncture in
addition to nutrition and other lifestyle changes.


Anxiety Disorders

Anxiety disorders are the second most prevalent psychiatric
condition in the United States, with a lifetime prevalence of 5%.24
Anxiety is also a common complaint in any medical environment,
especially in prehospital and inhospital settings. Because
preoperative anxiety has a negative effect on postoperative
outcomes,25 physicians use sedative medications and
preparation programs to treat preoperative anxiety, which is a
practice that incurs increased operational costs for the healthcare
system. According to TCM, anxiety results from an innate
deficiency of the heart and kidney energies, excess of liver Qi,
and a lack of communication between the heart and the kidneys,
among other imbalances.

Acupuncture may alleviate anxiety through a number of
mechanisms. Acupuncture results in a "stillness," with prominent
alpha rhythm in electroencephalography readings, deep general
relaxation, and a high degree of unresponsiveness to ordinarily
painful stimuli.26 Acupuncture also can modulate the
neuropeptide Y system in the basolateral amygdale of rats,27
increase nocturnal endogenic melatonin secretion in humans,28
and increase the release of previously mentioned endogenous
endorphins. Investigators studying acupuncture as a treatment
for anxiety have observed beneficial responses. In a prospective,
randomized, placebo-controlled trial of 30 patients scheduled to
undergo colonoscopy, Fanti et al29 found that treatment with
acupuncture decreased patients' demand for sedative drugs,
reducing both discomfort and anxiety during the procedure. In
another randomized, blinded, controlled trial of 91 ambulatory
surgery patients, Wang et al30 found that patients treated with
auricular acupuncture at relaxation points reported significantly
lower levels of anxiety than did controls. Table 2 summarizes
results from clinical studies of the efficacy of acupuncture on
anxiety-related conditions.

Depression

Depression is the most common psychiatric illness in the United
States, with a prevalence as high as 18.9% in the primary care
setting.10 Many who suffer from depression may remain
undiagnosed or inadequately treated because of a failure to
recognize symptoms, underestimation of severity, limited access
to health care, reluctance to see a mental healthcare specialist,
noncompliance with treatment, or lack of health insurance.11
Conventional medical treatment is problematic for several
reasons. First, as many as 35% of patients do not respond to
conventional treatment, perhaps more so among those with
chronic illness.12 Second, although compliance with
next-generation selective serotonin reuptake inhibitor
medications has improved, the dropout rate is as high as 15%.13
Last, a number of clinical trials have failed to demonstrate a
significant difference between active treatment and placebo
groups,14 undermining the public's confidence in these drugs.

REFERENCES

1. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United
States. Prevalence, costs, and patterns of use. N Engl J Med. 1993;328:246- 252.

2. Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States 1990-1997:
results of a follow-up national survey. JAMA. 1998;280:1569-1575.

3. Mamtani R, Cimino A. A primer of complementary and alternative medicine and its relevance in the treatment of
mental health problems. Psychiatr Q. 2002;73:367-381.

4. Kessler RC, Soukup J, Davis RB, et al. The use of complementary and alternative therapies to treat anxiety and
depression in the United States. Am J Psychiatry. 2001;158:289-294.

5. NIH Consensus Development Panel on Acupuncture. Acupuncture. JAMA. 1998;280:1518-1524.

6. Silvert M. Acupuncture wins BMA approval. BMJ. 2000;321:11.

7. Malizia E, Andreucci G, Paolucci D, Crescenzi F, Fabbri A, Fraioli F. Electroacupuncture and peripheral
beta-endorphin and ACTH levels. Lancet. 1979;2:535-536.

8. Han JS. Electroacupuncture: an alternative to antidepressants for treating affective disease? J Neurosci.
1986;29:79-92.

9. Wu MT, Hsieh JC, Xiong J, et al. Central nervous pathway for acupuncture stimulation: localization of processing
with functional MR Imaging of the brain-preliminary experience. Radiology. 1999;212:133-141.

10. Olfson M, Shea S, Feder A, et al. Prevalence of anxiety, depression and substance use disorders in an urban
general medicine practice. Arch Fam Med. 2000;9:876-883.

11. Hirschfeld RM, Keller MB, Panio S, et al. The National Depressive and Manic-Depressive Association consensus
statement on the undertreatment of depression. JAMA. 1997;277:333-340.

12. Manber R, Allen JJB, Morris MM. Alternative treatments for depression: empirical support and relevance to
women. J Clin Psychiatry. 2002;63:628-640.

13. Keller MB, McCullough JP, Klein DN, et al. A comparison of nefazodone, the Cognitive Behavioral Analysis System
of Psychotherapy, and their combination for the treatment of chronic depression. N Engl J Med. 2000;342:1462-1470.

14. Lieberman JA, Greenhouse J, Hamer RM, et al. Comparing the effects of antidepressants: consensus guidelines
for evaluating quantitative reviews of antidepressant efficacy. Neuropsychopharmacology. 2005;30:445-460.

15. Astin JA. Why patients use alternative medicine. Results of a national survey. JAMA. 1998;279:1548-1553.

16. Luo H, Meng F, Jia Y, Zhao X. Clinical research on the therapeutic effect of the electroacupuncture treatment in
patients with depression. Psychiatry Clin Neurosci. 1998;52:S338-S340.

17. Yang X, Liu X, Luo H, Jia Y. Clinical observation on needling extra-channel points in treating mental depression. J
Tradit Chin Med. 1994;14:14-18.

18. Manber R, Schnyer RN, Allen JJB, Rush AJ, Blasey CM. Acupuncture: a promising treatment for depression during
pregnancy. J Affect Disord. 2004;83:89-95.

19. Allen JJB, Schnyer RN, Hitt SK. The efficacy of acupuncture in the treatment of major depression in women.
Psychol Sci. 1998;9:397-401.

20. Gallagher SM, Allen JJB, Hitt SK, Schnyer RN, Manber R. Six- month depression relapse rates among women
treated with acupuncture. Complement Ther Med. 2001;9:216-218.

21. Han C, Li X, Luo H, Zhao X, Li X. Clinical study on electro- acupuncture treatment for 30 cases of mental
depression. J Tradit Chin Med. 2004;24:172-176.

22. Macpherson H, Thorpe L, Thomas K, Geddes D. Acupuncture for depression: first steps toward a clinical
evaluation. J Altern Complement Med. 2004;10:1083-1091.

23. Roschke J, Wolf C, Muller MJ, et al. The benefit of whole body acupuncture in major depression. J Affect Disord.
2000;57:73- 81.

24. Fricchione G. Generalized anxiety disorder. N Engl J Med. 2004;351:675-682.

25. Johnston M. Pre-operative emotional states and post- operative recovery. Adv Psychosom Med. 1986;15:1-22. 26.
Freed S. Acupuncture as therapy of traumatic affective disorders and of phantom limb pain syndrome. Acupunct
Electrother Res. 1989;14:121- 129.

27. Park HJ, Chae Y, Jang J, Shim I, Lee H, Lim S. The effect of acupuncture on anxiety and neuropeptide Y
expression in the basolateral amygdala of maternally separated rats. Neurosci Lett. 2005;4:179-184.

28. Spence DW, Kayumov L, Chen A, et al. Acupuncture increases nocturnal melatonin secretion and reduces
insomnia and anxiety: a preliminary report. J Neuropsychiatry Clin Neurosci. 2004;16:19-28.

29. Fanti L, Gemma M, Passaretti S, et al. Electroacupuncture analgesia for colonoscopy: a prospective, randomized,
placebocontrolled study. Am J Gastroenterol. 2003;98:312-316.

30. Wang SM, Peloquin C, Kain ZN. The use of auricular acupuncture to reduce preoperative anxiety. Anesth Analg.
2001;93:1178-1180.
Counter