Electro-acupuncture improves psychiatric symptoms, anxiety and depression in methamphetamine addicts during abstinence: A randomized controlled trial

This randomized controlled clinical trial investigated the effects of electroacupuncture in methamphetamine-dependent men during the abstinence period at a rehabilitation center in Shanghai. Methamphetamine dependence represents a growing global public health problem, characterized by induction of psychotic symptoms similar to paranoid schizophrenia, along with anxiety, depression, and sleep disturbances during withdrawal. Currently, pharmacologic treatment for this type of dependence has limited efficacy and considerable adverse effects, creating a need for effective adjunctive therapies.

The study enrolled 68 adult men diagnosed with methamphetamine dependence per DSM-V criteria, randomized into two groups: electroacupuncture (EA) and sham electroacupuncture (sham-EA). Participants received treatment three times per week for four weeks, totaling 12 sessions. The electroacupuncture protocol used bilateral Jiaji points at T5 and L2 with 2 Hz electrical stimulation, supplemented by Neiguan (PC-6), Shenmen (HT-7), Zusanli (ST-36), and Sanyinjiao (SP-6). The control group received superficial acupuncture at points near the true ones, without electrical stimulation.

Outcomes were assessed using standardized scales: PANSS for psychotic symptoms, HAMA for anxiety, and HAMD for depression. Measurements were performed before treatment and weekly during the four weeks of intervention. Of the 68 initial participants, 64 completed the study (31 in the EA group and 33 in the sham-EA group), with only four dropouts due to minor adverse events.

Results demonstrated significant superiority of electroacupuncture over sham treatment. On the PANSS scale, the EA group showed a more pronounced reduction in total score (51.52 vs 58.36 points at week 4, p < 0.001), with clear improvements in positive symptoms, negative symptoms, and general psychopathology. Anxiety, measured by the HAMA scale, showed substantial reduction in the EA group (5.77 vs 8.79 points at week 4, p = 0.002), particularly in psychic anxiety components. Depressive symptoms showed more modest improvement, becoming significant only at the fourth week of treatment, especially in the anxiety/somatization and sleep disturbance domains.

The proposed mechanisms for these effects involve acupuncture's capacity to modulate central neurotransmitters, particularly the dopaminergic system affected by methamphetamine use. Specific point selection was based on traditional Chinese medicine, where Jiaji T5 and L2 have a calming function, while the combination of the remaining points aims to regulate the mind and promote neurologic balance. Low-frequency electrical stimulation potentiates these effects through modulation of the autonomic nervous system.

The clinical implications are important, suggesting that electroacupuncture may serve as a valuable adjunctive therapy in the treatment of methamphetamine dependence. The absence of significant adverse effects and the progressive improvement of symptoms throughout treatment indicate good tolerability and increasing efficacy. This is particularly relevant given the limitations of current pharmacologic treatments and the need for integrated approaches in the rehabilitation of substance-dependent patients.