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Posts Tagged ‘acupuncture’

 

Effectiveness of Acupuncture on Allergy Treatment

Sunday, November 24th, 2013

By Yeseul Kim, PharmD student

Many people in the world are suffering from allergies and they want some relief from the symptoms whether they are mild or serious. Some are using OTC allergy medications, such as Allegra, Benadryl, and Claritin, for treatment. However, these OTC allergy medications can cause some side effects, such as drowsiness, dizziness, constipation, or dry mouth.1 Therefore, people often try another treatment like acupuncture which may have fewer side effects than OTC medications. According to National Center for Complementary and Alternative Medicine (NCCAM), this therapy originally came from Asian countries and has been studied for over a thousand years for a wide range of conditions.2

The article, “Acupuncture may be antidote for allergies”, from CNN Health, deals with treating allergy patients with the therapy of acupuncture.3 Since some patients have already adopted the acupuncture method for relieving pain, one study tried to evaluate the effect of acupuncture on patient’s allergies. The researchers divided allergy patients into three groups.4 The first group received acupuncture treatments with antihistamines as needed, the second group received fake acupuncture treatments with antihistamines as needed, and the third group did not receive any acupuncture, and only took antihistamines for treatment.4

The study results showed some effectiveness of acupuncture for allergy treatment. The first group took less antihistamines and showed improvement in symptoms.4 There is a placebo effect also as shown in second group, in which some patients improved with fake acupuncture.4 Based on improvement seen in this study, I agree with and support the use of acupuncture in addition to antihistamines for allergy treatment. Another study found similar results and helps increase the validity of this study. The 2008 Berlin allergic rhinitis acupuncture study concluded that “the result of this trial suggests that treating patients with allergic rhinitis in routine care with additional acupuncture leads to clinically relevant and persistent benefits.”5

Although the study reported a higher quality of life for allergy patients after acupuncture treatment, there are some limitations to the study. The researchers noted, “We found that acupuncture led to statistically significant improvements in disease-specific quality of life and antihistamine use after eight weeks of treatment compared with sham acupuncture and with antihistamine alone, but the clinical significance of the findings remains uncertain.”6 Also, acupuncture was less effective on severe allergy symptoms. If patients with severe allergies do not get relief from OTC medication or acupuncture, they may want to try prescription products for their allergies.

Another study, Effect of Acupuncture in the Treatment of Seasonal Allergic Rhinitis: A Randomized Controlled Clinical Trial, found a significant improvement in nasal and non-nasal symptoms between the two types of acupuncture treatments.7 The study concluded at the end that “no side effects were observed for both groups. The results indicate that acupuncture is an effective and safe alternative treatment for the management of Seasonal Allergic Rhinitis.”7

I want to recommend acupuncture therapy with use of antihistamines for allergy patients, even though this is different from the standard of care. The current standard of care is taking antihistamines only for treatment. Several studies have found a positive result in treating allergies and acupuncture is a safe treatment as reported side effects are rare. Acupuncture treatment also contains some placebo effect which I believe is another important mechanism in patient treatment. A positive state of mind largely influences the improvement of symptoms  

Through various research, the efficacy of acupuncture on allergies is proven, but some are still questioning the exact scientific mechanism of how the acupuncture works. Some patients will get better with acupuncture but others will not.  We should think about “What are the factors that can lead to less effectiveness?” and “Should we recommend an acupuncture treatment for a patient before recommending OTC medications to a patient?”

References

 

1. Berardi RR, Kroon LA, McDermott JH et al. Handbook of nonprescription drugs, an interactive approach to self-care. APhA Publications; 2006.

2. Acupuncture: An Introduction. National Center for Complementary and Alternative Medicine Web Site. http://nccam.nih.gov/health/acupuncture/introduction.htm. Updated 2012. Accessed October 30, 2013.

3. Sifferlin A. Acupuncture may be antidote for allergies. CNN.com Web Site. http://www.cnn.com/2013/02/19/health/acpuncture-allergies/. Updated 2013. Accessed October 29, 2013.

4. Benno Brinkhaus, Miriam Ortiz, Claudia M. Witt, Stephanie Roll, Klaus Linde, Florian Pfab, Bodo Niggemann, Josef Hummelsberger, András Treszl, Johannes Ring, Torsten Zuberbier, Karl Wegscheider, Stefan N. Willich; Acupuncture in Patients With Seasonal Allergic RhinitisA Randomized Trial. Annals of Internal Medicine. 2013 Feb;158(4):225-234.

5. Louis PF. Banish allergies with acupuncture: Here’s how. Naturalnews.com Web Site. http://www.naturalnews.com/040305_allergies_acupuncture_studies.html. Updated May 13, 2013. Accessed October 30, 2013.

6. Radford B. Acupuncture for Allergies? Jury’s Still Out. Discovery.com Web Site. http://news.discovery.com/human/health/acupuncture-for-allergies-jurys-still-out-130222.htm. Updated 2013. Accessed October 30, 2013.

7. Xue C, English R, Zhang J, da Costa C, Li C. Effect of Acupuncture in the Treatment of Seasonal Allergic Rhinitis: A Randomized Controlled Clinical Trial. American Journal Of Chinese Medicine [serial online]. January 2002;30(1):1. Available from: Academic Search Complete, Ipswich, MA. Accessed October 31, 2013.

Acupuncture: Treatment for Depression?

Saturday, November 23rd, 2013

by Eric Huseman, Pharm D student

The practice of inserting needles into the body, known as acupuncture, has long been used in China and Japan and is implemented in a variety of styles including classical/tradition acupuncture, trigger point acupuncture, and single point acupuncture.1 An article recently published in Express, a UK based news source, reports that acupuncture may show potential for treating anxiety and depression, offering a new source of hope to those suffering from these mental ailments.2 According to the article’s author, Laura Milne, acupuncture can help reduce anxiety because, as shown in prior research, it acts on parts of the brain known to decrease sensitivity to pain and stress and also serves as a relaxation promoter and a way of deactivating an area of the brain responsible for anxiety and worry, an area referred to in the article as the “analytical brain.”2 However, despite this potential for relief, according to a study conducted by the British Acupuncture Council and Anxiety UK, only ten percent of those suffering from anxiety look to acupuncture for relief.2

While the article itself does not provide much evidence supporting acupuncture’s usefulness in treating anxiety and depression, the British Acupuncture Council’s website (the link to which was provided by the Express article) provides a wealth of information concerning acupuncture and its use in treating a variety of diseases, including depression.3 According to the Council’s fact sheet on depression, some current evidence supports the use of acupuncture as adjunctive or stand-alone therapy for depression, but the current evidence cannot justify the recommendation of acupuncture as stand-alone therapy.4 The Council’s fact sheet also contains numerous summaries of systematic reviews and clinical trials examining the effectiveness of acupuncture in alleviating depression.5

One article examining the efficacy of acupuncture in the treatment of depression is a 2010 Cochrane review by Smith et al titled “Acupuncture for depression.”1 This review included and analyzed thirty separate trials examining the use of various types of acupuncture in the treatment of depression. This review found several instances of evidence that supported the effectiveness of acupuncture either in comparison to a control or as an adjunct to medication therapy.1 However, as acknowledged by the authors, the majority of the trials included in the review carried a high risk of bias.1 The authors concluded that the evidence was not sufficient to demonstrate acupuncture’s benefit over various controls or as an addition to mediation therapy.1 They ended the article by calling for further studies to be conducted using higher quality methods and procedures.1

In evaluating the article written in Express, the information found on the British Acupuncture Counsel’s website, and the review conducted by Smith et al, I do not disagree with the premise that acupuncture may provide a way of alleviating depression. However, I find myself in agreement with Smith et al that I am not yet convinced that acupuncture is a proven method of alleviating depression either as a stand-alone therapy or as an adjunct to medication therapy. As such, I would not feel confident telling my patients that acupuncture would definitely relieve their depression. However, I do not think that pharmacists should hesitate to inform their patients of acupuncture’s potential to help treat their depression as long as they counsel patients not to discontinue their usual course of depression treatment.

As health-care providers, pharmacists should be willing to learn and accept new forms of treatment outside the standard of care when provided with sufficient evidence to do so. Though research has not definitively determined the merit of acupuncture in treating depression, research has show St. John’s Wort to be an effective form of alternative therapy for patients suffering from mild to moderate depression.6 Unfortunately, because St. John’s Wart interacts with numerous medications, including drugs often prescribed for depression such as paroxetine (Paxil®) and sertraline (Zoloft®), the pharmacist must be cautious in recommending it to a patient.6 For patients seeking a more “natural” approach to tradition antidepressant medications, however, St. John’s Wart may be a viable treatment option as long as the pharmacist ensures the patient is not taking any medications that would may interact with this natural product

While one would need to conduct a more thorough review of published literature regarding acupuncture and depression to form a truly authoritative position regarding the use of acupuncture in treating depression, discussing the place of acupuncture and other nontraditional forms of care such as St. John’s Wart in the treatment of depression nevertheless requires pharmacists to take a closer look at alternative methods of medical practice and self-care, respectively. While the pharmacist should certainly evaluate such modes of treatment critically, he or she must constantly accompany this evaluation with the following question: “Am I allowing the evidence to guide my recommendations, or am I letting my preconceived notions of alternative methods of care, whether positive or negative, unduly influence my thoughts?” While providing an honest answer to this question may prove convicting, evaluating all treatment options with as little bias as possible will ultimately result in the best possible patient outcomes.

 

References

  1. Smith C, Hay P, MacPherson H. Acupuncture for depression. Cochrane Database Of Systematic Reviews [serial online]. November 11, 2009;(1)Available from: Cochrane Database of Systematic Reviews, Ipswich, MA. Accessed November 6, 2013.
  2. Milne, Laura. Acupuncture offers new hope in treating depression and anxiety. Express Web site. Available from http://www.express.co.uk/life-style/health/435324/Acupuncture-offers-new-hope-in-treating-depression-and-anxiety. Published October 9, 2013. Accessed November 5, 2013.
  3. Home page. British Acupuncture Council Web site. http://www.acupuncture.org.uk. Accessed November 19, 2013.
  4. Depression: Intro. British Acupuncture Council Web site. Available from http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/depression.html. Last modified December 2, 2013. Accessed November 6, 2013.
  5. Depression: The evidence. British Acupuncture Council Web site. Available from http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/depression.html. Last modified December 2, 2011. Accessed November 6, 2013.
  6. Krinsky D et al. Handbook of Prescription Drugs: An Interactive Approach to Self-Care. 17th ed. Washington, DC: American Pharmacists Association; 2012.