Holistic/Alternative/Integrative/Complementary Medicine

Acupuncture for Depression in Pregnancy

A randomized controlled trial of acupuncture for depression during pregnancy suggested that symptoms were reduced with a response rate similar to standard depression treatments.  Acupuncture may be a viable treatment option for depression during pregnancy.

150 pregnant women who met criteria for major depression were given either acupuncture specific for depression or one of two active controls: control acupuncture or massage. They received 12 sessions during 8 weeks. The acupuncturists who administered treatment were blinded to treatment assignment. The Hamilton Rating Scale for Depression was used to rate severity. 63% of the women who received depression-specific acupuncture reported a significant reduction in symptoms, compared to 44% of women in the other two groups combined.

Many pregnant women with depression stop taking medications when they become pregnant, due to concerns this may harm their unborn babies.  Women with depression are at increased risk for preterm births, and are at increased risk for post partum depression, so treatment of depression during pregnancy is important. Post partum depression interferes with a woman’s ability to care for her infant, and can have lasting effects; previous studies suggest that children of mothers with postpartum depression perform more poorly in school, become frustrated more easily, and have poorer problem solving.

Acupuncture may be a good option in treating depression in pregnant women; this treatment appears to be more effective than other tested non-pharmacologic treatments. Depression during pregnancy is common; up to 14% of women may have depression when pregnant.

Acupuncture for depression during pregnancy: a randomized controlled trial.

Manber R, Schnyer RN, Lyell D, Chambers AS, Caughey AB, Druzin M, Carlyle E, Celio C, Gress JL, Huang MI, Kalista T, Martin-Okada R, Allen JJ.

Obstet Gynecol. 2010 Mar;115(3):511-20.PMID: 20177281

Use of Nondrug Coping Skills to Help Children With Cancer

There are a number of  current integrative and complementary treatment studies for children and adolescents.

Timothy Culbert is the medical director of the integrative medicine program at Minneapolis-based Children’s Hospitals and Clinics of Minnesota, one of the largest hospital-based, pediatric complementary medicine programs in the country.  Dr. Culbert and his colleagues are about to launch a study at four hospitals in the U.S. and Canada to examine in greater depth the use of nondrug coping skills in kids with cancer.

Several years ago, they developed a “Comfort Kit” designed to teach children coping skills including: deep-breathing relaxation techniques; aromatherapy, in which patients inhale chemicals produced by plant oils; and acupressure, a variant of acupuncture with pressure applied to certain points in the body.

In several pilot studies, Dr. Culbert’s team found that kids can learn such skills and appear to find them helpful. In one study of 150 kids who underwent surgery , 87% said the techniques helped them cope with pain after the procedure. Another study found that a majority of kids with cancer felt relief from their nausea with accupressure.

At the University of Alberta in Edmonton, Canada, Sunita Vohra is running a clinical trial with 80 participants to examine whether a self-calming strategy can help children with a variety of diagnoses, including attention-deficit hyperactivity disorder and opposition-defiant disorder. The aim is to teach children to focus on “their presence in the moment”—by paying attention to breathing and other sensations and blocking out external commotion.

Vohra is beginning an individualized study of the use of probiotics—micro-organisms thought to be healthy for the person that consumes them—with gastrointestinal diseases. Dr. Vohra is also studying whether melatonin aids sleep in kids with attention-deficit hyperactivity disorder.

Wake Forest’s Dr. Kemper has investigated the pediatric use of music therapy, chiropractic care that involves manipulating the body, and “healing touch,” which is based on the premise that the presence of one person’s electromagnetic energy field has an affect on another person.

Dr. Kemper’s research, including one published in the journal Pediatric Research, has shown that music helps soothe kids with cancer. In 2008, she and her colleagues published findings on eight premature infants showing that live harp music can help them gain weight. Previous findings depicting this effect puzzled them, because such babies can’t increase the number of calories they are eating on their own.

To figure out what was going on, Dr. Kemper’s group put devices called actimeters, which measure very small movements, on the legs of the infants and found that those babies who were exposed to the music were alert and paying attention compared to those in a quiet room or getting the usual care. Soothed babies exhibit fewer tiny muscle movements compared with more tense babies, which reduces the amount of calories they burn.

It isn’t always clear from these studies what the active ingredient is that’s responsible for the apparent benefit of the therapy. Recent preliminary findings from Dr. Kemper’s group show that kids with cancer report feeling calmer, less anxious and more comfortable in the presence of someone performing healing touch. Yet the study can’t tease apart whether it is the mere presence of a calm person in the room or the actual healing touch that appears to affect the patient.

A method that is safe can be utilized even if it is not shown to be effective, because it gives children and families a sense that they are doing something. The caution is that if a therapy has side effects,expensive, or is used in place of a therapy known to be effective, then the risks outweigh the benefits.