Original Paper

Drugs and Acupuncture: The Energetic Impact

of Antidepressant Medications

Michael T. Greenwood, MD (MB)

ABSTRACT

Many patients seeking acupuncture are taking antidepressants, yet rarely do they appreciate the impact such
drugs might have on the acupuncture process. In this paper, the author explores the energetic effect of antide-
pressants, using side-effect profiles and the impressions of other practitioners. The argument is made that an-
tidepressants can interfere with acupuncture and can even prevent patients from getting to the root of their ill-
ness.

Key Words: Depression, Drugs, Antidepressants, Acupuncture, Pulse Diagnosis, Five Elements

INTRODUCTION larly serotonin and norepinephrine. This in turn has given

rise to the idea, albeit heavily supported by drug advertis-
ing, that depression is simply a biochemical disorder.4,5 In-
I N THE EARLY TO MID-20TH century, several pivotal books
foretold the evolution of thought-controlled, drug-influ-
enced societies: Brave New World1 and 1984.2 The former
deed, so pervasive is this explanation that most patients tak-
ing antidepressants are under the impression they have a
described a society dominated by people who took happy chemical imbalance that is being corrected by the drugs.
pills rather than face the pain of their existence, while the However, the neurotransmitter theory has been widely cri-
latter illustrated a society in which the state controlled what tiqued for being, at best, simplistic, and at worst, wrong,
people could think and do. This article is about the ener- since it completely ignores the psychosocial context in
getic effects of those “happy pills” and the consequences of which depression arises.6 Yet it remains popular, perhaps
relying on them. because it simultaneously provides a simple explanation for
Antidepressants are some of the most commonly used a complex disorder, gives the physician a rationale for a
pharmaceuticals. Many people use them long-term, some quick prescription, and allows patients to dismiss or ignore
taking 2 or even 3 different brands simultaneously, all in the personal responsibility for their health. In short, perhaps its
pursuit of the elusive goal of happiness. In a previous pa- popularity is based on convenience rather than truth.
per, I discussed antihypertensives, using inferences arising Curiously, whether antidepressants even work at all is a
from drug adverse effects listed in the compendium.3 Al- matter of some debate.7 Thomas J. Moore, an investigative
though a similar approach could be used here, the fact that journalist, reviewed the scientific evidence on some selec-
other authors have written on the subject makes the exer- tive serotonin reuptake inhibitors (SSRIs) and concluded
cise easier. that the popularity of antidepressants is largely manufac-
The biochemistry of antidepressants is centered around tured hyperbole.8 Medical researchers, too, have written
their modulating effect on brain neurotransmitters, particu- about their limited effectiveness, pointing out that the

Victoria Pain Clinic, Victoria, BC, Canada.

35
36 GREENWOOD

SSRIs are little better than placebo, and that unethical mar- ness, and acupuncture demands a fair commitment in terms
keting practices (such as the withholding of negative re- of time and responsibility.
search results) were used to get them launched.9,10 In the
words of Ioannidis:
CATEGORIES
Perhaps most people given antidepressants for de-
Antidepressants are generally classified as:
pressive symptoms would just need some attention
from their physician and people to talk to and take
Tricyclics (TCAs), e.g., amitriptyline
some care of them. Antidepressants may be covering
Selective serotonin reuptake inhibitors (SSRIs):
largely the lost placebo of human interaction and pa-
a) Pure SSRIs, e.g., citalopram
tient-physician interaction that has become so sparse
b) Atypical (SNRIs), e.g., venlafaxine
in modern society . . . even if one feels a bit depressed
Monoamine oxidase inhibitors (MAOIs), e.g.,
by this state of affairs, there is no reason to take an-
phenelzine
tidepressants, they probably won’t work.11

TCAs
Moore noted that SSRIs are highly addicting and although
initial studies showed an increase in the suicide rate, they Tricyclics have been around for many years and in addi-
were marketed as if this were not the case. Now, after many tion to depression, they are used for panic disorders, pain
years pretending otherwise, drug makers have been forced syndromes, and anxiety states. Their mode of action is on
to concede the suicide question and that, in young people at presynaptic reuptake of both serotonin and norepinephrine,
least, there is indeed an increased mortality in those taking and they have anticholinergic effects.17 Side effects include
the newer antidepressants.12 Regardless of the truth or un- dry mouth, sedation, urinary blockage in patients with pro-
truth of these troublesome issues, it is clear that antidepres- static hypertrophy, orthostatic hypotension, arrhythmias,
sants remain a dubious approach to a common condition.13,14 erectile dysfunction, delirium, and agitation.18
With this in mind, it is difficult to understand why any- A perusal of side effects reveals that TCAs promote the
one would want to take antidepressants at all, especially be- rising of Liver Yang,19 but they also have been noted to dis-
cause there are other less risky ways to approach the prob- perse the Qi, stagnate the Blood, and deplete the Yin.20 The
lem. In particular, acupuncture has been shown to be quite well-known side effects of urinary inhibition, impotence,
effective for depression,15 as have other interactive energetic constipation, and dry mouth are clearly signs of Yin defi-
therapies.16 Yet most people prefer the easy road to happi- ciency21 (Table 1).

TABLE 1. ENERGETIC EFFECTS OF ANTIDEPRESSANTS

Inferred Chinese
System Potential Side Effects Medicine Effect

Tricyclic antidepressants Dry mouth, blurred vision, constipation, sedation, urinary retention, Disperse the Qi
orthostatic hypotension, arrhythmias, erectile dysfunction, delirium, ↑Liver Yang
agitation, nausea, and black tongue Stagnate the Blood
Deplete Yin
Heat in the Yang Ming
Selective serotonin reuptake Headache, nausea, tinnitus, insomnia, anxiety, akathisia, extrapyramidal ↑Liver Yang, ↑Wind,
inhibitors (SSRIs) symptoms, constipation, sexual dysfunction, and serotonin syndrome ↓Liver Yin
Agitate the Hun/Shen
↓Kidney/Heart Yin;
↓Kidney Qi, Stagnation
fluids in Kidney/Brain
Long-term: ↓Kidney
Yang & Jing
SSRI withdrawal syndrome Dysphoria, agitation, flu-like state (chills, fatigue, myalgias, sweating, Qi deficiency/stagnation
nausea/diarrhea), vertigo, emotional lability, tremor Liver Blood deficiency,
Wind
Damp
Monoamine oxidase Orthostatic hypotension, and sympathomimetic effects such as ↑Liver Yang, ↑Wind,
inhibitors (MAOIs) tachycardia, sweating and tremor, nausea, constipation, insomnia, ↑Heart Yang
sexual dysfunction, agitation, and toxic psychosis agitation Hun/Shen
Heat in the Yang Ming
MAOIs  tyramine Hypertensive crisis Heart Yang excess
ANTIDEPRESSANTS AND ACUPUNCTURE 37

SSRIs and Atypical Antidepressants (SNRIs) Liver Yang energies with associated Qi deficiency/stagna-
tion, Blood stagnation, Damp accumulation, and possibly,
The SSRIs and their related atypical antidepressants
Wind. Dharmanada attributes these syndromes to Spleen Qi
(SNRIs) have the advantage of not causing significant car-
and Liver Blood deficiency, and suggests that a conventional
diovascular or anticholinergic side effects, but they have a
interpretation of the same pattern might be a relative defi-
wide variety of other energetic effects. By and large, their
ciency in serotonin availability or an imbalance of neuro-
mode of action is to block the reuptake of serotonin, while
transmitters that occurs when the drugs are removed25
the SNRIs do the same while also having additional ef-
(Table 1).
fects.17 For example, venlafaxine blocks both serotonin and
norepinephrine reuptake, nefazodone blocks serotonin and
inhibits 5-HT2 postsynaptic receptors, and mirtazapine se- Monoamine Oxidase Inhibitors (MAOIs)
lectively blocks presynaptic 2-adrenergic receptors and en- The MAOIs are generally used as third-line drugs after
hances both noradrenergic and serotonergic transmission. failure of TCAs or SSRIs.17 Common side effects include
Side effects of SSRIs include headache, nausea, tinnitus, in- orthostatic hypotension and sympathomimetic effects such
somnia, anxiety, akathisia, extrapyramidal symptoms, sex- as tachycardia, sweating, and tremor. Other side effects in-
ual dysfunction, and serotonin syndrome. There can also be clude nausea, insomnia, sexual dysfunction, agitation, and
withdrawal symptoms such as dysphoria, agitation, and a toxic psychosis, and if tyramine-containing foods are eaten,
flu-like state.18 hypertensive crisis can occur.18
Rosenberg says that neurotransmitters can be identified A perusal of side effects reveals that, given their predilec-
with Kidney Yin, Yang, and Jing.21 Hence, inhibition and tion for hypertensive crisis, MAOIs are potent stimulants of
accumulation of serotonin might lead to stagnation of flu- Liver Yang rising, but, they too are capable of stirring up
ids in the kidneys and brain. Beyond that, a perusal of side Liver Wind and depleting the Kidneys (Table 1).
effects reveals a complex variety of effects on Yin/Yang bal-
ance. For example, headaches indicate Liver Yang rising;
nervousness and tremor indicate Wind and Yang; insomnia
relates to agitation of the Hun/Shen, Kidney, and Heart Yin CHINESE MEDICINE AND DEPRESSION
vacuity; reduced concentration indicates depletion of Kid-
ney Qi, and the gradual development of anxiety points to Depression is known as Yu Zheng in Chinese Medicine
consumption of Liver Yin. In addition, the effectiveness of (CM), in which the term Yu has the double meaning of de-
SSRIs as anxiolytics is often perhaps at the cost of an in- pression or stagnation. Thus, in the usual CM classification,
terference with the life force/Will (Hun, Po, Yi, Zhi). Hun depression is thought to begin with stagnation of Liver Qi
disturbance leads to abnormal dreams, hot flashes, and pal- which, in time, spreads to other organ systems, primarily the
pitations, while reduction in Will leads to chronic under- Heart, Spleen, and Kidneys.26,27 Maciocia projects this idea
performance. into the psychic/mental realm by positing that depression is
Hammer straightforwardly says that SSRIs tonify Kidney a disharmony between the Hun (Spirit of the Wood Element)
Yang.22 Rosenberg says they are warm, pungent, stimulate and the Shen (Spirit of the Fire Element).28 Such stagnation
and release Kidney Yang, open the orifices, and disperse the or “binding depression of Liver Qi” can give rise to
Qi.23 Flaws, in his unique jargon, opines that SSRIs are hypochondriacal or precordial discomfort along the course
windy-natured, Yang-upbearing medicinals similar to pow- of the Liver meridian. This situation was once recognized
erful exterior-resolving and Qi-rectifying medicinals.24 Be- in medicine as hypochondriasis, although the term has ac-
cause of this, while they may increase a sense of energy and quired a more pejorative connotation.29 Liver Qi stagnation
mental alertness and elevate the mood, they also tend to en- can also progress to Blood stagnation, Phlegm accumula-
gender Wind, consume Yin, and eventually deplete Yang. tion, or Phlegm Fire. If the Heart is involved, then Heart Qi
He points out that the side effects typically group themselves and Blood deficiency can occur; and, if the Liver energy in-
around in vacuity-Fire effulgence/Yin vacuity-Yang hyper- vades the Spleen, then Heart and Spleen can become defi-
activity symptoms. cient. Eventually, the Kidney may be stressed, giving rise
In summary, SSRIs might be said to stagnate fluids in the to Kidney/Spleen Yang deficiency or Kidney Yin defi-
brain, raise Liver Yang, aggravate Liver Wind, disperse Kid- ciency. A detailed exploration of these syndromes is beyond
ney Yang upward and outward, disturb the Hun and Shen, the scope of this paper but can be found elsewhere.30
deplete Heart Yin, deplete Kidney Qi and Yin, and eventu- If endogenous depression were due to a deficiency of Kid-
ally, the Kidney Yang.23 ney Yang and Jing, as Hammer has suggested,22(p550) and
neurotransmitters are actually Kidney Yin/Yang and Jing,
as Rosenberg has suggested, then it would perhaps be con-
SSRI Withdrawal Syndrome
ceptually satisfying to consider norepinephrine as Kidney
Since SSRIs strongly stimulate Liver Yang, the with- Yang and serotonin as Kidney Yin. But such one-to-one
drawal symptoms might be understood as a collapse of the cross-referencing between different paradigmatic concepts
38 GREENWOOD

is notoriously fickle. Such biochemistry cannot explain de- probably the one that gives rise to the cotton pulse. And
pression, and Kidney Jing is not truly a neuropeptide. while SSRIs might temporarily mitigate such a pulse through
Yet Hammer’s view makes several useful cross-refer- mobilizing Kidney Yang, they simultaneously block patients
ences between conventional diagnostic categories and CM from discovering the innate power that resides at the root of
patterns. For example, besides attributing endogenous de- their existential angst. Such blocking, together with the as-
pression to a deficiency of Kidney Yang and Jing, he relates sociated deferral of the deeper work of self-enquiry, fre-
agitated depression to Liver and Heart excess, manic de- quently results in long-term drug dependence and chronic
pression to disruption of the Heart-Kidney axis, and dys- underperformance.
thymia or flat affect to Heart Qi deficiency.
Wood
The Wood sector is responsible for controlling the flow
PULSE FINDINGS of Qi through appropriate judgment, planning, and decision
making. Imbalance tends to give rise to anger. For Wood
Hammer notes in general that prescription medications types, the existential issue is letting go of judgment so that
often make the pulse more uniform, or tense and subtly anger can be transformed into healthy creativity, i.e., a force
suppressed, obliterating both gross and subtle mes- for construction rather than destruction. This is not an easy
sages.22(pp57,96,474) They also tend to strain and, in time, ex- task; Wood energy is often expressed through the dual poles
haust the Liver, Heart, and Kidneys, leading to sequential of implosion and explosion. Since explosion tends to be so-
lack of control over Yang energies and eventually, to the Qi cially unacceptable, many people opt for implosion, which
Wild condition.22(p131) Elsewhere, he points out that am- then masquerades as apathy and depression. If antidepres-
phetamines which, like antidepressants, tonify the Yang, sants are prescribed, Liver Yang tonification may inadver-
lead initially to tense, robust, pounding, and even flood- tently revert the implosion to explosion, giving rise to vio-
ing/excess qualities in the left middle position. The Fire im- lent acting out, self-destructive actions, and/or even
pacts the Heart, giving rise to a tight quality in the Peri- suicide.31 Books have been written on this subject.32
cardium position. Later, when the fire burns out, both left
middle and distal positions (Liver and Heart) become wiry, Fire
signifying extreme Yin deficiency.22(p45)
The key existential issue for Fire constitutional types is
With specific regard to endogenous depression, Hammer
the challenge of being fully present in the moment despite
notes that it is often associated with a cotton pulse.22(p237)
a deep sense of betrayal that characterizes their lives. They
This pulse is felt above the Qi depth and conveys a spongy,
often try to escape this pain through avoidance and a pre-
amorphous, formless resistance that is without structure and
tense of happiness, with a bipolar oscillation around a po-
wave form. As gentle pressure is exerted from the surface
tential center of calm located in the Heart. While antide-
to the Qi depth, this shapeless entity feels like pushing one’s
pressants in this situation may reduce mood swings and
finger through cotton. Also known as a sad pulse, it reflects
stabilize ego functioning, the price paid is a continued de-
a sense of oppression, resignation, and hopelessness based
nial of full presence as the drug creates a wall of protection
on the felt inability to change specific onerous conditions of
around the Heart. In this way, the individual is effectively
one’s life. Hammer claims that SSRIs can eliminate a cot-
banished from a psychospiritual center which, if found,
ton pulse in people with Kidney Yang deficiency through
would return him/her to the theme of existence. By locking
their action of tonifying the Kidney Yang.22(pp67.238)
the door to the Heart-center, such patients perpetuate the
original wound of betrayal and in so doing, further deplete
their already fragile Heart Yin.
FIVE ELEMENTS AND DEPRESSION
Earth
One of the great strengths of the hidden tradition of CM
is its ability to reach beyond the psychosomatic levels of ill- The key existential issue for Earth types is the transfor-
ness to intuit a patient’s likely core issue, based on Five El- mation of selfishness into altruism, through an appropriate
ement constitutional typing. Each of the Five Elements man- balance between giving and receiving. Earth constitutional
ifests its own particular form of depression. types often have a curious inability to receive anything nour-
ishing, whether it be material as food or mental as new ideas
or thoughts. As a result, they often develop caretaking strate-
Water
gies that they carry out until they are exhausted while si-
The key existential issue for Water constitutional types multaneously wondering when it will be their turn to re-
is the manifestation of inner potential, their relationship with ceive. If antidepressants are prescribed for such people, the
fear, and the transformation of that fear into wisdom (zhi). temporary boost to Yang energies will often give them more
If fear becomes overwhelming, then the Water type can be- reason to carry on, exhausting themselves and further de-
come paralyzed into inaction. This energetic situation is plete their Spleen and Kidney energies.
ANTIDEPRESSANTS AND ACUPUNCTURE 39

Metal istential split.34 The existential split leads to the erroneous

assumption that humans are separate and alienated beings,
The key existential issue for Metal types lies in their re-
somehow divorced from the whole, an assumption that en-
solving an inner emptiness, by letting go of their angst and
courages the ego to make decisions that interfere with the
contacting the transcendent. Because this is such a difficult
natural flow of Qi. Without such alienation, there would be
task, they often attempt to fill the void with material “things,”
no tendency to engage in inhibition, Qi stagnation would not
which are inevitably transient and thus do not ultimately sat-
arise, and there would be no such thing as depression.
isfy. As a result, they can become chronically depressed and
Thus, beyond the habitual prescription for a chemical
morose, as everything they acquire fails to fill the void. While
quick-fix, any lasting solution to depression must involve a
antidepressants may place a functional cover over their doom
thorough scrubbing of the most stubborn of illusions, some-
and gloom, the price is a compromised ability to find the
thing that drugs can never achieve. Indeed, a diagnosis of
transcendent, since drug dependency blocks their ability to
depression and its associated drug therapy deliberately
fully let go. Thus, they become physically, mentally, and spir-
strengthens the illusion by confirming the aberrant notion of
itually obstructed, forever blocked from true inspiration. (It
a separation between illness and patient. The point is that
is perhaps notable that all 3 classes of antidepressants com-
when it comes to dealing with existential issues, bio-medi-
monly give rise to constipation.)
cine somehow misses the mark.35 Here is perhaps the most
compelling reason of all to caution against indiscriminate
The Missing Metallic Link use of drugs for depression. Certainly, antidepressants may
The standard TCM classifications of depression are listed help the ego to function better in the short term, but in do-
in Table 2, relating them to those of Hammer and the likely ing so, they inadvertently support the mental state which it-
Five Element constitutional factors. self is the root of depression.
There is no TCM classification that reflects the depres-
sion characteristic of the Metal element (Table 2). This is
unusual, considering that from a Five Element perspective,
depression is one of the Element’s defining characteristics. CASE STUDIES
Perhaps in this omission lies the key to a true holistic un-
derstanding of depression. By attributing depression pri- An 80-year-old woman with a Metal constitutional type
marily to Liver Qi stagnation, TCM accurately describes a presented with ongoing pain in the right hip and leg after
common enough energetic pattern, but fails to identify the a right hip replacement that she said made her life impos-
psychospiritual state from which Liver Qi stagnation itself sible. She blamed the surgeon for a botched job and com-
arises. That state is archetypically described in the Metal plained continuously even though comparatively speaking,
constitution as a profound existential despair which itself is she was in good physical shape for her age. Medications
rooted in the feeling of disconnection from the Tao. included mirtazepine, clonazepam, and various analgesics.
However, TCM is not CM, but rather a fairly recent adap- Acupuncture treatments included points to move the Liver
tation which, like conventional medicine, categorizes dis- Qi such as LV 3 (Taichong), PC 6 (Neiguan), and CV 17
ease and treatment in dualistic ways.33 As such, it ignores (Danzhong), and periodic Yang Ming balancing. Treatment
the philosophical root of acupuncture which lies in non-du- also included encouragement to help her better understand
alism and the Tao. the existential question. Over a period of a year, the patient
discontinued all medication. Once drug-free, her pain and
mood disturbance dramatically improved.
The Existential Split
A 54-year-old woman with a Fire constitutional type and
The conundrum of depression invites us to dig deeper, long-standing depression gradually discontinued her med-
down to the root of Liver Qi stagnation itself, an exploration ications in order to face her existential angst. Previously, she
that reveals the source of stagnation to be in the primary ex- had treated her depression with SSRIs including venlafax-

TABLE 2. CHINESE MEDICINE CATEGORIZATIONS OF DEPRESSION

Constitutional
TCM Hammer25 Factors

Liver Qi stagnation Agitated depression Wood

Blood stagnation Wood
Phlegm accumulation Wood/Earth
Phlegm Fire Liver and Heart Excess Earth/Fire
Heart Qi/Blood deficiency Heart Qi stagnation Fire
Heart/Spleen deficiency Heart Qi stagnation Fire/Earth
Spleen/Kidney Yang deficiency Endogenous depression Water
Kidney Yin deficiency Disruption of Heart-Kidney axis Water/Fire
40 GREENWOOD

ine and paroxetine, her insomnia with TCAs such as Points and herbs can facilitate the movement of at-
amitriptyline and trazodone, and her anxiety with occasional tention from the wounded ego to the authentic self.
lorazepam. As the withdrawal progressed, she was increas- But it is who the practitioner is that creates the moti-
ingly faced with a sense of impending doom, located for the vating force of such change.36
most part in the upper Jiao, which she admitted had been
there all her life. Acupuncture focused on balancing the Jue Perhaps the art of medicine involves delivering the mes-
Yin–Shao Yang circuits, opening the Heart with points like sage without appearing confrontational or judgmental. One
PC 6 (Neiguan), TH 5 (Waiguan), and CV 17 (Danzhong), useful strategy involves simply asking patients whether their
and opening the upper Chakras with points like CV 22 drugs help. Some will say the medications keep them bal-
(Tiantu), GV 24.5 (Yintang), and GV 20 (Baihui). As the anced and they have no intention of changing anything. For
patient sank deeper into her existential angst, she gradually such people, perhaps the issue of antidepressants should be
developed an extraordinary intuitive ability, hitherto hidden, postponed. Others answer that the drugs do little and that
in which she was able to “see” quite directly into other peo- they would like to discontinue them if they only knew how.
ple’s life issues. Developing this gift and learning to artic- Patients often need some gentle coaxing to leave the
ulate it eventually became the creative expression of her life. safety of a biochemical perspective to embrace an energetic
A 29-year-old woman with a Wood constitutional type un- world-view. To the degree that the energy perspective is in-
dergoing inpatient treatment for depression fractured her ternalized, so the will to discontinue drugs is galvanized.
right humerus when she had a seizure and fell across the Acupuncture can assist this transition if it is intentionally
nursing station desk. After a failed pin and plating, her only used to mobilize original energy; and that is a matter of iden-
other option was a cadaveric shoulder replacement, a proce- tifying the constitutional type, then repeatedly stimulating
dure the surgeons were reluctant to perform. Past history in- the primary constitutional circuit involved in a context in
cluded endometriosis and ovarian cystectomy. Medications which it is possible for the patient to allow full spontaneous
included paroxetine, amitriptyline, and morphine. Acupunc- expression.37
ture treatment for the patient focused on the Shao Yang–Jue
Yin circuit to mobilize Wood energy, together with local
points in the shoulder area such as LI 15 (Jianyu), SI 10 CONCLUSIONS
(Naoshu), SI 11 (Tianzong), and Jianneiling (EM). During
several sessions, what began as apparent seizure activity de- If the fundamental energetic reason for depression is
veloped into loud verbal expressions and punching shoulder Liver Qi stagnation, then clearly the goal of acupuncture
movements (that she would never have allowed without an will be to smooth out the flow of Liver Qi. As physicians
appropriately safe context). After these sessions, she was are well aware, the temporary reprieve achieved through
temporarily pain-free and had full shoulder range-of-motion. such an approach frequently leads to a dependency. Whether
With repeated acupuncture experiences, her depression grad- that dependency is to drugs or acupuncture ultimately makes
ually lifted and she discontinued all medications. little difference because such dependency is itself patho-
logical.
A more permanent solution to the problem of depression
DISCUSSION needs to involve patients themselves making the inner ef-
fort necessary to transcend their alienated ego. Such an ap-
The above scenarios highlight a fundamental dissonance proach not only allows the Qi to flow, which is the funda-
between the biochemical view of depression with its asso- mental goal of the acupuncture ritual, but also engenders an
ciated drug therapy and energetic healing, which requires attitudinal transformation as patients traverse the mythical
that people face and deal with their existential despair. Golden Gate located between the Metal and Water Sectors.37
There is no doubt a place for drugs. Indeed, in situations The difficulty is that antidepressants tend to block this all-
of deep despair, antidepressants can sometimes be life-sav- important transition. Since drugs and acupuncture have op-
ing. But the long-term use of antidepressants as a strategy posite intentional vectors, trying to move the Qi while pa-
for living is a different matter. Depression asks people to tients continue taking drugs is much like pulling a rope at
rediscover their original energy and anything that interferes both ends. It tends to be a self-defeating exercise.
with that process will prolong the depression. Moreover, the What then is the physician-acupuncturist to do? One al-
longer antidepressants are taken, the more dependence be- ternative is to encourage patients to read the pertinent liter-
comes an issue, and the more difficult it becomes to ever ature on antidepressants, with particular emphasis on the
discontinue them. conflicting studies that show little benefit over placebo and
Some acupuncture practitioners believe this issue should the tendency to develop a life-long drug dependency. The
be tackled head-on. Jarrett, for example, has suggested that sooner patients can muster sufficient internal fortitude to re-
patients be challenged to live up to their authentic self from linquish their crutch, the sooner they may come to have
the first interaction, and points out this is best done through enough contact with original energy to initiate a sustained
the practitioner’s example: transformation.
ANTIDEPRESSANTS AND ACUPUNCTURE 41

Such an approach can be very rewarding. It may take 18. Compendium of Pharmaceuticals and Specialties – The Cana-
some time and patience in the beginning, but in the long run, dian Drug Reference for Health Professionals. Toronto, ON,
such patience pays off. I have seen many people relinquish Canada: Webcom Ltd; 2006.
their dependence on antidepressants, acquire a sense of free- 19. MacPherson H, Blackwell R. Tired out: approaches to tired-
ness and fatigue. J Chin Med. 1992;40:13–20.
dom, and begin to enjoy a life more in tune with their in-
20. Flaws B. Prednisone: it’s TCM functions, indications and con-
nate constitutional destiny.
traindications. J Chin Med. 1990;33:14–17.
21. Rosenberg ZA. Traditional medical view of pharmaceutical
drugs. Oriental Med. 1994;3(4):33–38.
DISCLOSURE STATEMENT 22. Hammer L. Chinese Pulse Diagnosis: A Contemporary Ap-
proach. Vista, CA: Eastland Press; 2001.
No competing financial interests exist. 23. Rosenberg Z. Treating patients on prescription drugs with Tra-
ditional Chinese Medicine. Oriental Med. 1994;3(3):41–46.
24. Flaws B. Thoughts on the Integration of Chinese Medicine and
REFERENCES Western Psychiatry. Boulder, CO: Blue Poppy Press; 2000.
25. Dharmananda S. SSRI withdrawal procedure: getting off an-
1. Huxley A. Brave New World. New York, NY: Harper Collins tidepressants may be made easier. http://www.itmonline.org/
Publishers; 1932. arts/ssri.htm.
2. Orwell G. Nineteen Eighty Four. New York, NY: Harcourt, 26. Flaws B, Lake J. Chinese Medical Psychiatry: A Textbook and
Brace & Co; 1949. Clinical Manual. Boulder, CO: Blue Poppy Press; 2001.
3. Greenwood MT. Drugs and acupuncture: the energetic impact 27. Yin Yang House. Acupuncture treatment for depression.
of antihypertensives. Medical Acupuncture. 2007;19(1):5–12. http://www.yinyanghouse.com/chinesetheory/treatments/
4. Metzl JM. Prozac on the Couch. Durham, NC: Duke Univer- treatment-depression.html.
sity Press; 2003. 28. Maciocia G. The treatment of mental and emotional illness:
5. Currie J. The Marketization of Depression: The Prescribing of the psyche in Chinese Medicine. Proceedings of the Canadian
Antidepressants to Women. Women and Health Protection. Oriental Medical Symposium, pre-symposium workshop. Van-
May 2005. http://www.whp-apsf.ca/pdf/SSRIs.pdf. couver, BC, Canada; March 5, 2008.
6. Moynihan R, Cassels A. Selling Sickness: How the World’s 29. Jennes F. Melancholia and the hypochondrium: a curious cul-
Biggest Pharmaceutical Companies Are Turning Us All Into tural convergence. J Chin Med. 2007;83:33–38.
Patients. Vancouver, BC, Canada: Greystone Books; 2005. 30. Reid T. Mood disorders and TCM, Focus on Depression, Part 2.
7. Oken BS. Complementary Therapies in Neurology, and Evi- Chinese Medicine Times. 2007;2(6). http://www.chinesemed-
dence-Based Approach, New York, NY: Parthenon Publish- icinetimes.com/section/255/1/mood_disorders_in_tcm_foc.
ing Group; 2003. 31. Healy D. Did regulators fail over the selective serotonin re-
8. Moore TJ. Hard to swallow. The Washingtonian. December uptake inhibitors. BMJ. 2006:333:92–95.
1997. http://www.washingtonian.com/health/01/swallow/1.html. 32. Healy D. Let Them Eat Prozac: The Unhealthy Relationship
9. Khan A, Warner HA, Brown WA. Symptom reduction and Between the Pharmaceutical Industry and Depression. New
suicide risk in patients treated with placebo in antidepressant York: New York University Press; 2004.
clinical trials: an analysis of the Food and Drug Administra- 33. Scheid V. Not very traditional, nor exactly Chinese, so what
tion database. Arch Gen Psychiatry. 2000;57(4):311–317. kind of medicine is it? TCM’s discourse on menopause and
10. Kirsch I, Deacon BJ, Huedo-Medina TB, et al. Initial severity its implications for practice, teaching, and research. J Chin
and antidepressant benefits: a meta-analyis of data submitted Med. 2006;82:5–19.
to the Food and Drug Administration. PLoS Med. 2008; 34. Greenwood MT. Splits in Western consciousness, from an
5(2):e45. acupuncture perspective. Medical Acupuncture. 1999;11(2):
11. Ioannidis JPA. Effectiveness of antidepressants: an evidence 11–16.
myth constructed from a thousand randomized trials? Philos 35. Milliken DA. Blame the sickness not the victim: mental ill-
Ethics Humanit Med. 2008;3:14. ness takes a devastating toll on the people it affects and soci-
12. Dubicka B, Hadley S, Roberts C. Suicidal behaviour in youths ety. Victoria Times-Colonist. January 18, 2007:A12.
with depression treated with new-generation antidepressants. 36. Jarrett L. Nourishing Destiny online group. June 11, 2008. Di-
Br J Psychiatry. 2006;189:393–398. gest #2444.
13. Simon GE, Savarino J, Operskalski B, Wang PS. Suicide risk 37. Greenwood MT. Intention—needling without needles. Med-
during antidepressant treatment. Am J Psychiatry. 2006; ical Acupuncture. 1999;11(1):17–23.
163(1):41–47.
14. Webb J. Venlafaxine: troubling toxicity in overdose. BC Med J. Address correspondence to:
2007;49(1):10. Michael T. Greenwood, MD (MB), BCHIR, FCFP,
15. Allen JJB, et al. The efficacy of acupuncture in the treatment CAFCI, FAAMA, FRSA
of major depression in women. Psychol Sci. 1998;9(5). Victoria Pain Clinic
16. Lowen A. Depression and the Body: The Biological Basis of 103-284 Helmcken Road
Faith and Reality. New York, NY: Penguin Books; 1972. Victoria, BC, V9B 1T2
17. Tierney LM, McPhee, SJ, Papadakis MA, ed. Current Med- Canada
ical Diagnosis and Treatment. New York, NY: Lange Med-
ical Books/McGraw-Hill; 2004. E-mail: [email protected]