Can electroacupuncture improve symptoms of mild to moderate postnatal depression?

ISRCTN ISRCTN49447857
DOI https://doi.org/10.1186/ISRCTN49447857
Secondary identifying numbers None
Submission date
28/04/2019
Registration date
23/05/2019
Last edited
15/03/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Mental and Behavioural Disorders
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
Postpartum (postnatal) depression can start in parents before or after the birth of a baby. It is a serious problem because it can affect bonding between the parents and baby and childcare routines. If a mother is breastfeeding, it might not be safe to take antidepressant tablets, because breast milk can contain some of the drug. There is a new drug called Zulresso that is taken through a vein using a drip. It is safe to use during breastfeeding but is expensive.
Electroacupuncture involves very fine needles being inserted into the skin at certain points and electric current being passed through them. Electroacupuncture is cheap and does not affect breastfeeding. This study aims to investigate whether electroacupuncture can help with postpartum depression symptoms.

Who can participate?
Women who have postpartum depression within one year of their baby's birth.

What does the study involve?
Participants will be randomly allocated to one of two groups. They will not know which group they are in. Both groups will receive supportive psychotherapy. One group will receive electroacupuncture twice a week for 6 weeks. The other group will have sham electroacupuncture, where the needles are not put in the correct places and the current is not turned on.

What are the possible benefits and risks of participating?
Both groups will receive treatment in the form of supportive psychotherapy. There are some potential side effects of electroacupuncture, including bleeding, bruising and pain, but these are generally mild and will stop quickly.

Where is the study run from?
China Academy of Chinese Medical Sciences (China)

When is the study starting and how long is it expected to run for?
January 2018 to December 2022.

Who is funding the study?
The Ministry of Science and Technology of the People's Republic of China

Who is the main contact?
Mrs Hong Zhao, hongzhao2005@aliyun.com

Contact information

Mrs Hong Zhao
Scientific

China Academy of Chinese Medical Sciences
16 Nanxiaojie
Dongzhimennei
Dongcheng District
Beijing
100700
China

Phone 13911132103
Email hongzhao2005@aliyun.com

Study information

Study designTwo-armed single-blind randomized controlled interventional trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet No participant information sheet available.
Scientific titleThe effect of electroacupuncture on mild to moderate postpartum depression: a randomized controlled single-blind study.
Study objectivesThe morbidity of mild to moderate postpartum depression is increasingly rising. However, the need of lactation prevents the use of regular oral antidepressants. The new antidepressant Zulresso (brexanolone), which has been approved by the FDA for postpartum depression, costs USD 34,000 dollars per treatment course per person. Acupuncture might offer an advantage in mild to moderate postpartum depression because it does not affect breastfeeding. However, the supporting evidence is weak. This trial is designed to provide high-level evidence regarding whether electroacupuncture is effective in relieving the symptoms of mild to moderate postpartum. We hypothesize that the effect of electroacupuncture on mild to moderate postpartum depression will be better than that of sham electroacupuncture.
Ethics approval(s)1. Approved 26/07/2018, Acupuncture and Moxibustion Hospital, China Academy of Chinese Medical Science (No.16, Nanxiaojie, Dongzhimennei, Beijing; +86 010-64060868; yuxc@acutimes.com), ref: 2018-05-25-3-2
2. Approved 10/09/2018, Beijing Obstetrics and Gynecology Hospital, Capital Medical University (17 Qihelou St, Dongcheng District, Beijing; +86 010-85968407; fcyylunli@163.com), ref: 2018-KY-053-01
Health condition(s) or problem(s) studiedPostpartum depression
InterventionEligible patients will be randomly assigned into treatment group or control group using SAS software. Group assignment information will be kept in sealed envelopes. According to their group assignment, patients will receive either electroacupuncture plus supportive psychotherapy or sham electroacupuncture plus supportive psychotherapy. Both groups will receive treatment twice a week for 6 weeks, and the whole treatment course is 12 sessions.
The treatment group will receive the electroacupuncture and the selected acupoints are as follows: Ophryon (EX-HN 3), Xinshu (BL 15), Geshu (BL 17), Ganshu (BL 18), Shenshu (BL 23), Hegu (LI 4), Sanyinjiao (Sp 6), Zhongwan (CV 12) and Baihui (GV 20).
The control group will receive sham electroacupuncture. The practitioner will needle locations beside the acupoints at superficial layers and use the electroacupuncture device without current output as the sham acupuncture.
Intervention typeOther
Primary outcome measureSeverity of depression using the first 17 answers on Hamilton Depression Rating Scale (HAM-D). The 17-HAMD will be measured by a professional psychiatrist at baseline and weeks 2, 4 and 6
Secondary outcome measures1. Severity of depression using the Montgomery–Åsberg Depression Rating Scale (MADRS) at baseline and weeks 2, 4 and 6
2. Postpartum depression assessed using the Edinburgh Postnatal Depression Scale at baseline, weeks 2, 4 and 6 and week 10 (4 weeks after treatment end)
3. Alertness assessed using the Stanford Sleepiness Scale at baseline and weeks 2, 4 and 6
4. Maternal functional status assessed using the Barkin Index of Maternal Functioning at baseline, weeks 2, 4 and 6 and week 10 (4 weeks after treatment end)
5. Severity of depression using the first 17 answers on Hamilton Depression Rating Scale (HAM-D) at week 10 (4 weeks after treatment end)
6. Participant assessment of depression assessed using the Patient Health Questionnaire(PHQ-9) at baseline and weeks 2, 4 and 6
Overall study start date20/01/2018
Completion date30/12/2022

Eligibility

Participant type(s)Patient
Age groupAdult
SexFemale
Target number of participants60
Total final enrolment60
Key inclusion criteria1. Diagnosed with postpartum depression according to The Diagnostic and Statistical Manual of Mental Disorders (DSM) by psychiatrists
2. Conceived naturally or artificially
3. Aged 20–50 years
4. Overall score of ≥9 on the Edinburgh Postnatal Depression Scale (EPDS)
5. Diagnosed with mild to moderate postpartum depression according to the 17-item Hamilton Depression Scale (17-HAMD)
6. Postpartum depression onset time within 1 year after delivery
7. Can accept electroacupuncture treatment and complete the prescribed course of treatment
8. Agrees to participate in the study willingly and voluntarily and signs the informed consent form
Key exclusion criteria1. Brain disease or mental retardation, or have difficulty understanding the contents of questionnaires or are unable to communicate effectively
2. History of epilepsy, bipolar disorder, schizophrenia or schizoaffective disorder
3. History of suicide attempts
4. Diagnosed with non-depressive psychosis by psychiatrists
5. Addicted to alcohol or drugs
6. Received antidepressant therapy within the past month
7. Hemorrhagic diseases or infectious diseases or otherwise unable to receive acupuncture therapy
Date of first enrolment01/10/2018
Date of final enrolment30/10/2022

Locations

Countries of recruitment

  • China

Study participating centres

Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences
16 Nanxiaojie
Dongzhimennei
Dongcheng District
Beijing
100700
China
Beijing Obstetrics and Gynecology Hospital
17 Qihelou St
Dongcheng District
Beijing
100020
China
Shenzhen Traditional Chinese Medicine Hospital
1 Fuhua Road
Shenzhen
518033
China

Sponsor information

China Academy of Chinese Medical Sciences
Government

16 Nanxiao St
DongZhimen
Dongcheng District
Beijing
100000
China

Phone +86 010-64089307
Email kychzhen@163.com
ROR logo "ROR" https://ror.org/042pgcv68

Funders

Funder type

Government

Ministry of Science and Technology of the People's Republic of China
Government organisation / National government
Alternative name(s)
Chinese Ministry of Science and Technology, Ministry of Science & Technology, People Republic of China, 中华人民共和国科学技术部, Ministry of Science and Technology (China), State Science and Technology Commission, MOST
Location
China

Results and Publications

Intention to publish date30/09/2023
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryOther
Publication and dissemination planCurrent publication and dissemination plan as of 07/06/2021:
We tend to publish the protocol before December 2021. We plan to publish results in February 2022.

Previous publication and dissemination plan:
We tend to publish the protocol before February 2020. We plan to publish results in December 2020.
IPD sharing planThe datasets generated and/or analysed during the current study during this study will be included in the subsequent results publication.

Editorial Notes

15/03/2023: the intention to publish date was changed from 29/03/2023 to 30/09/2023.
08/12/2022: The intention to publish date was changed from 30/12/2022 to 29/03/2023. Total final enrolment added.
18/08/2022: The intention to publish date was changed from 01/02/2022 to 30/12/2022.
05/10/2021: The following changes have been made:
1. The recruitment end date has been changed from 30/10/2021 ​to 30/10/2022.
2. The overall trial end date has been changed from 30/12/2021 to 30/12/2022 and the plain English summary has been updated to reflect this change.
09/06/2021: IPD sharing statement added.
07/06/2021: The publication and dissemination plan was updated and the intention to publish date was changed from 30/12/2020 to 01/02/2022.
03/06/2021: The following changes have been made:
1. The recruitment end date has been changed from 01/01/2019 to 30/10/2021.
2. The overall trial end date has been changed from 20/01/2020 to 30/12/2021 and the plain English summary has been updated to reflect this change.
09/05/2019: Trial's existence confirmed by the ethics committee of the Institute of Acupuncture, China Academy of Chinese Medical Sciences.