Comparative efficacy and acceptability of non-invasive brain stimulation and acupuncture for depression: protocol for a systematic review and network meta-analysis.

If you or someone you love struggles with depression, you may have heard about treatments beyond medication — things like acupuncture or brain stimulation therapies. A new research project is underway that aims to help us better understand how well these options actually work.

Researchers are conducting what's called a systematic review and network meta-analysis, which means they're gathering and comparing data from many existing studies at once. Their goal is to compare two types of non-drug treatments for depression: acupuncture (the traditional practice of inserting fine needles at specific points on the body) and non-invasive brain stimulation (NIBS), which includes techniques like transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) that use magnetic fields or mild electrical currents to influence brain activity.

This matters because depression affects more than 300 million people worldwide, and antidepressant medications don't work for everyone. Some people experience unpleasant side effects, while others simply don't respond well to drug-based treatments. Non-pharmacological options like acupuncture and NIBS have been growing in popularity, but until now, there hasn't been a thorough head-to-head comparison of the two approaches.

The research team will search 14 major medical databases, reviewing randomised controlled trials — the gold standard of clinical research — to assess how well each treatment reduces depression symptoms and how acceptable patients find each option. They will also look at response rates and any adverse effects reported.

While this study is still in progress and hasn't yet produced results, its findings are expected to provide clearer guidance for patients and doctors choosing between these treatments.

If you're interested in exploring acupuncture for depression, speak with your doctor and seek care from a licensed, qualified acupuncture practitioner in your area.

This protocol paper published in BMJ Open outlines a forthcoming Bayesian network meta-analysis (NMA) designed to compare the efficacy and acceptability of non-invasive brain stimulation (NIBS) modalities — including rTMS and tDCS — against acupuncture interventions for the treatment of depression. The review will incorporate RCTs sourced from 14 databases (including PubMed, Cochrane, Embase, CNKI, and ClinicalTrials.gov) from inception to May 2025. Primary outcomes are depressive symptom severity and all-cause discontinuation as a proxy for acceptability. Secondary outcomes include response rate and adverse events. Risk of bias will be assessed using the Cochrane RoB 2 tool, and evidence certainty rated via the CINeMA framework. The GeMTC package in R will facilitate Bayesian NMA modelling. No efficacy data are yet available at protocol stage. This analysis is anticipated to provide clinically actionable rankings of NIBS and acupuncture protocols, informing integrative treatment decisions for patients with inadequate pharmacological response.