The effect of acupoint stimulation as an adjuvant therapy for obsessive-compulsive disorder: a systematic review and...

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric condition associated with significant functional impairment. Acupoint stimulation (AS), encompassing techniques such as electroacupuncture, acupuncture, and transcutaneous electrical acupoint stimulation, is a widely used therapeutic approach. However, a comprehensive synthesis of evidence regarding its efficacy and safety as an adjunctive therapy for OCD is needed.

This systematic review and meta-analysis aimed to evaluate the efficacy and safety of AS as an adjunctive treatment for OCD.

A comprehensive literature search was conducted across seven electronic databases from their inception to February 2026. Randomized controlled trials (RCTs) investigating AS for OCD were included. Two reviewers independently screened records, extracted data, and assessed methodological quality using the Cochrane Risk of Bias tool (ROB 2.0). Statistical analyses were performed using Review Manager 5.4.

This review included 23 RCTs involving 1,713 participants. Compared with the controls, AS was associated with greater improvement in OCD. It was associated with a statistically significant reduction in obsessive-compulsive symptoms as measured by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) (MD = -3.14, 95% CI [-4.46, -1.81], p < 0.00001) and also associated with improvements in anxiety and Clinical Global Impression (CGI) scores, and other secondary outcomes. The combination of AS with both pharmacotherapy and CBT yielded the largest Y-BOCS reduction among subgroups examined (3 studies; MD -3.50, 95% CI [-4.34, -2.66]; p < 0.00001). Regarding safety, the AS group had fewer reported adverse events than medication controls (RR = 0.17, 95% CI [0.06, 0.51], p < 0.0001). Subgroup analyses suggested that acupoint prescriptions containing PC6 and a treatment frequency of 20-40 times may be associated with the largest point estimate, though this comparison is exploratory.

This meta-analysis found that AS, whether used alone or as an adjunct to pharmacotherapy or CBT, was associated with a mean reduction of approximately 3.14 points on the Y-BOCS. On a 0-40 scale, with substantial heterogeneity across studies, variable control conditions, and inconsistent methodological quality, this reduction is statistically significant but of uncertain clinical relevance. The evidence does not support a firm conclusion that AS is clinically effective, and the safety data are insufficient to establish AS as safe. Further high-quality trials with standardized protocols are needed.

CRD420251070503.