Anxiety disorders are the most prevalent mental health conditions in the world, affecting approximately 284 million people globally. First-line pharmacologic options — selective serotonin reuptake inhibitors, benzodiazepines, buspirone — have significant limitations: slow onset of action, dependence, side effects, and high relapse rates after suspension. A meta-analysis published in the Journal of Clinical Psychology by Jang and colleagues synthesizes the evidence accumulated from 20 randomized clinical trials (RCTs) to evaluate the efficacy of manual acupuncture in the treatment of anxiety — one of the most frequent clinical questions received by medical acupuncturists.
SCALE OF THE META-ANALYSIS
Study design and comparators
The systematic search covered six databases — AMED, CINAHL, CENTRAL, Embase, Ovid MEDLINE, and PubMed — including RCTs published in English through January 2025. Studies that compared manual acupuncture with sham acupuncture (needles at false points or retractable needles) or with usual care and waiting list, using validated anxiety scales as primary outcome, were eligible. Heterogeneity was evaluated by I² and a random-effects model (REML). The protocol was pre-registered on PROSPERO.
Results: post-treatment efficacy and at follow-up
Manual acupuncture was significantly superior to sham both at the end of treatment (SMD = -1.06; 95% CI: -1.74 to -0.39; p = 0.0005) and at follow-up (SMD = -0.78; 95% CI: -1.21 to -0.35; p < 0.00001). Compared with usual care or waiting list, the post-treatment benefit was even more expressive (SMD = -1.35; 95% CI: -2.26 to -0.44; p = 0.00006), although the effect did not reach statistical significance at late follow-up (SMD = -0.60; p = 0.12). This pattern is clinically informative: acupuncture produces robust benefits during active treatment, and effects on the placebo control persist beyond the intervention period.
Safety profile
Seventy-nine adverse events were recorded in the studies that reported safety data. All were classified as mild and transient: local discomfort during needling, small bleeding or punctate hematomas, transient pain at the insertion site. No serious adverse events were attributed to acupuncture. This profile contrasts favorably with the side effects of conventional antidepressants and anxiolytics, which include sexual dysfunction, weight gain, withdrawal syndrome, and risk of dependence.
Frequently Asked Questions
The meta-analysis included studies with different anxiety diagnoses — generalized anxiety disorder, situational anxiety, preoperative anxiety, and anxiety comorbid with other clinical conditions. The benefits were consistent in subgroups, although the number of RCTs per specific subtype is still limited. The medical acupuncturist should individually assess the diagnosis, severity, and comorbidities to define the most appropriate protocol.
Protocols varied between studies, with typical cycles of 8 to 12 sessions performed over 4 to 8 weeks. The most common frequency was 2 sessions per week. There is still no consensus on the optimal protocol; individualization based on clinical response is the recommended approach in medical practice.
Fonte Original
Journal of Clinical Psychology(em inglês)Founded in 1989 by physicians trained at the University of São Paulo (USP) and specialized in China, CEIMEC is a Brazilian national reference in the teaching and practice of medical acupuncture. With more than 3,000 physicians trained over 35 years, it collaborates with HC-FMUSP and is recognized by the Brazilian Medical College of Acupuncture (CMBA/AMB).
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