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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Feb 19, 2026; 16(2): 113049
Published online Feb 19, 2026. doi: 10.5498/wjp.v16.i2.113049
Published online Feb 19, 2026. doi: 10.5498/wjp.v16.i2.113049
Acupuncture on 5-hydroxytryptamine levels and clinical outcomes in depression: A systematic review and meta-analysis of randomized controlled trials
Yi Wang, Zhi-Hai Hu, Department of Acupuncture and Moxibusion, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China
Peng-Tao Wu, Department of Traditional Chinese Medicine, Puxing Community Health Service Center in Pudong New District, Shanghai 200129, China
Ittipalanukul Penpat, International Education College, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Fei-Cui Zeng, Department of Traditional Chinese Medicine, Community Health Service Center of Beiwaitan Street in Hongkou District, Shanghai 200080, China
Qun Lu, Department of Clinical Laboratory, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200082, China
Co-first authors: Yi Wang and Peng-Tao Wu.
Co-corresponding authors: Qun Lu and Zhi-Hai Hu.
Author contributions: Wang Y and Wu PT contributed equally to this work as co-first authors; Hu ZH and Lu Q contributed equally to this work as co-corresponding authors; Wang Y and Hu ZH designed and conducted the research and participated in drafting the manuscript; Wu PT participated in drafting the manuscript, co-designed the research, and provided clinical advice; Lu Q co-designed the research and supervised the report; Penpat I and Zeng FC co-designed the research and contributed to data analysis.
Supported by Outstanding Young Medical Talents Training Program of the Health System in Pudong New District, Shanghai, No. PWRq2023-37.
Conflict-of-interest statement: The authors report no conflicts of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Hai Hu, Associate Professor, Department of Acupuncture and Moxibusion, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, No. 230 Baoding Road, Hongkou District, Shanghai 200082, China.
Received: September 12, 2025
Revised: October 27, 2025
Accepted: November 18, 2025
Published online: February 19, 2026
Processing time: 139 Days and 23.2 Hours
Revised: October 27, 2025
Accepted: November 18, 2025
Published online: February 19, 2026
Processing time: 139 Days and 23.2 Hours
Core Tip
Core Tip: This meta-analysis focused exclusively on traditional manual acupuncture, excluding electroacupuncture, to determine its independent therapeutic effect on depression. Twenty randomized controlled trials were included. The findings reveal that acupuncture significantly improves depressive symptoms, anxiety, sleep quality, and serum 5-hydroxytryptamine levels, while reducing antidepressant-related side effects. By eliminating heterogeneity caused by different acupuncture modalities, this study provides stronger evidence for the clinical application of acupuncture as an effective adjunctive therapy for depression.