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Acupuncture for Combat-Related Posttraumatic Stress Disorder: A Randomized Clinical Trial
Michael Hollifield1,2, An-Fu Hsiao1,3, Tyler Smith4
1Tibor Rubin VA Medical Center, Long Beach, California.
JAMA Psychiatry
|February 21, 2024
Summary
Verum acupuncture significantly reduced posttraumatic stress disorder (PTSD) symptoms and improved fear extinction in combat veterans compared to sham acupuncture. This study supports acupuncture as a viable treatment option for PTSD.
Area of Science:
- Integrative medicine and psychiatry
- Neuroscience and behavioral science
- Clinical psychology and psychotherapy
Background:
- Current posttraumatic stress disorder (PTSD) treatments face limitations due to adverse effects and high withdrawal rates.
- Acupuncture presents a promising alternative, with preliminary studies indicating potential benefits for PTSD symptom management.
Purpose of the Study:
- To compare the efficacy of verum acupuncture against sham acupuncture (minimal needling) in treating PTSD.
- To evaluate the impact of acupuncture on both clinical and physiological outcomes in combat veterans with PTSD.
Main Methods:
- A 2-arm, parallel-group, prospective blinded randomized clinical trial was conducted.
- 93 treatment-seeking combat veterans with PTSD were randomized to receive verum or sham acupuncture twice weekly for 15 weeks.
- Primary outcome: change in PTSD symptom severity (CAPS-5); Secondary outcome: change in fear-conditioned extinction (fear-potentiated startle response).
Main Results:
- Verum acupuncture demonstrated a large treatment effect (Cohen d, 1.17) on PTSD symptoms, significantly outperforming sham acupuncture (Cohen d, 0.67).
- A significant reduction in fear-potentiated startle during extinction was observed in the verum group, indicating improved fear extinction.
- Low withdrawal rates were reported, suggesting good tolerability of the acupuncture intervention.
Conclusions:
- Acupuncture intervention proved clinically efficacious in reducing PTSD symptoms and favorably impacting the psychobiology of the disorder in combat veterans.
- The findings support the clinical implementation of acupuncture for PTSD and warrant further research into its comparative efficacy, durability, and underlying mechanisms.
