Glob Adv Health Med. 2014 Jul;3(4):35-9. doi: 10.7453/gahmj.2014.034.
Scalp acupuncture treatment protocol for anxiety disorders: a case report.
He Y1, Chen J2, Pan Z3, Ying Z4.
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Anxiety disorders are among the most common psychiatric illnesses, and acupuncture treatment is widely accepted in the clinic without the side effects seen from various medications. We designed a scalp acupuncture treatment protocol by locating two new stimulation areas. The area one is between Yintang (M-HN-3) and Shangxing (DU-23) and Shenting (DU-24), and the area two is between Taiyang (M-HN-9) and Tianchong (GB-9) and Shuaigu (GB-8). By stimulating these two areas with high-frequency continuous electric waves, remarkable immediate and long-term effects for anxiety disorders have been observed in our practice. The first case was a 70-year-old male with general anxiety disorder (GAD) and panic attacks at night. The scalp acupuncture treatment protocol was applied with electric stimulation for 45 minutes once every week. After four sessions of acupuncture treatments, the patient reported that he did not have panic attacks at night and he had no feelings of anxiety during the day. Follow-up 4 weeks later confirmed that he did not have any episodes of panic attacks and he had no anxiety during the day since his last acupuncture treatment. The second case was a 35-year-old male who was diagnosed with posttraumatic stress disorder (PTSD) with a history of providing frontline trauma care as a Combat Medics from the Iraq combat field. He also had 21 broken bones and multiple concussions from his time in the battlefield. He had symptoms of severe anxiety, insomnia, nightmares with flashbacks, irritability, and bad temper. He also had chest pain, back pain, and joint pain due to injuries. The above treatment protocol was performed with 30 minutes of electric stimulation each time in combination with body acupuncture for pain management. After weekly acupuncture treatment for the first two visits, the patient reported that he felt less anxious and that his sleep was getting better with fewer nightmares. After six sessions of acupuncture treatments, the patient completely recovered from PTSD, went back to work, and now lives a healthy and happy family life. The above cases and clinical observation show that the scalp acupuncture treatment protocol with electric stimulation has a significant clinic outcome for GAD, panic disorder and PTSD. The possible mechanism of action of scalp acupuncture on anxiety disorder may be related to overlapping modulatory effects on the cortical structures (orbitofrontal cortex [OFC]) and medial prefrontal cortex [mPFC]) and subcortical/limbic regions (amygdala and hippocampus), and biochemical effect of acupuncture through immunohistochemistry (norepinephrine, serotonin) performed directly to the brain tissue for anxiety disorders.

Acupunct Med. 2015 Jan 16. pii: acupmed-2014-010524. doi: 10.1136/acupmed-2014-010524. [Epub ahead of print]
Randomised controlled trial on the use of acupuncture in adults with chronic, non-responding anxiety symptoms.
Errington-Evans N.
A group of adults can be identified with chronic non-responding anxiety symptoms who have repeatedly accessed treatments through their GP, such as cognitive behaviour therapy, bibliotherapy and medication, but with no effect. These patients make heavy use of health service resources with no beneficial outcome. This study aims to test the effect of an acupuncture formula of three specific acupuncture points, suggested in a previous pilot study.
40 participants from a psychiatry waiting list were randomised into one of two groups: group 1 (n=25) received 10 weeks of acupuncture at PC6, HT7 and LR3, and group 2 was a waiting list control group. The waiting list group (n=15) then received acupuncture. Both groups were followed up for 10 weeks after treatment. The outcome measure was the State and Trait Anxiety Inventory.
36 patients completed the study, with two dropouts in each group. State anxiety scores in the acupuncture group decreased from 57.7 (SD 13.1) to 38.8 (12.0); scores in the waiting list control group decreased from 61.5 (11.6) to 60.6 (11.7). The difference was highly significant (p<0.0001). Similar changes were seen for trait anxiety scores. The control group showed similar statistically significant improvements when they received acupuncture. The improvements were maintained after 10 weeks of follow-up in each group.
Acupuncture is a promising intervention for patients with chronic anxiety symptoms that have proven resistant to other forms of treatment.
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Neurosci Lett. 2015 Apr 30. pii: S0304-3940(15)00344-4. doi: 10.1016/j.neulet.2015.04.045. [Epub ahead of print]
The tegmental-accumbal dopaminergic system mediates the anxiolytic effect of acupuncture during ethanol withdrawal.
Zhao Z1, Kim SC2, Zhao R3, Wu Y1, Zhang J1, Liu H1, Kim YW2, Zhu X1, Gu C1, Lee CW2, Lee BH2, Jang EY2, Ko HL2, Yang CH2.
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This study investigated the involvement of the mesolimbic dopamine (DA) system in the anxiolytic effects of acupuncture during ethanol withdrawal (EW). Rats were intraperitoneally treated with 3g/kg/day of ethanol for 28 days and experienced 3 days of withdrawal. During EW, the rats were bilaterally treated with acupuncture at acupoints HT7 (Shenmen) or PC6 (Neiguan) or at a non-acupoint (tail) once daily for 1min over 3 days. High-performance liquid chromatographic (HPLC) analysis showed that EW significantly decreased both DA and 3, 4-dihydroxyphenylacetic acid (DOPAC) levels in the nucleus accumbens shell (NaccSh); however, these processes were inhibited by acupuncture at HT7 but not at PC6. Real-time polymerase chain reaction and western blot assays also revealed that acupuncture at HT7 prevented the EW-induced reductions in tyrosine hydroxylase mRNA expression in the ventral tegmental area (VTA) and tyrosine hydroxylase protein expression in the NaccSh. A prior intra-NaccSh infusion of a cocktail of the selective DA1 receptor antagonist SCH23390 and the selective DA2 receptor antagonist eticlopride blocked the anxiolytic effect of acupuncture at HT7 in elevated plus maze tests. In addition, acupuncture at HT7 suppressed EW-induced increased BDNF levels in the VTA. These findings suggest that acupuncture at HT7 improves the VTA-Nacc DAergic function via inhibition of BDNF expression in the VTA, thereby exerting anxiolytic effects during EW.