A systematic review and meta-analysis found that auriculotherapy (AA) may be an effective complementary therapeutic strategy for anxiety. These findings were published in the European Journal of Integrative Medicine.

The investigators at the University of Porto in Portugal searched publication databases through June 2021 for randomized controlled trials of AA for the treatment of anxiety. A total of 13 trials were included in this analysis.

The patients received AA (n=386) or placebo (n=382) for preoperative anxiety (n=7), school-related anxiety (n=3), anxiety due to first-trimester abortion (n=1), anxiety after in vitro fertilization (n=1), and generalized anxiety disorder (n=1). The AA interventions included auricular acupuncture (n=8) and acupressure (n=5).

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Outcomes were measured using the State-Trait Anxiety Inventory (n=8), visual analog scale for anxiety (n=4), vital signs (n=3), cortisol (n=1), and neurovegetative status of the tongue according to the principles of Traditional Chinese Medicine (n=1). Most trials (n=10) evaluated outcomes after 1 session and did not report adverse effects (n=10).

Overall, AA was favored for the treatment of anxiety compared with placebo (standardized mean difference [SMD], -0.44; 95% CI, -0.60 to -0.28; P <.00001; I2, 16%). Similar results were found in studies using waitlist as the comparator (SMD, -0.55; 95% CI, -0.70 to -0.41; P <.00001; I2, 0%).

Similarly, auricular acupuncture was favored for treating preoperative anxiety (SMD, -0.49; 95% CI, -0.92 to -0.06; P =.03; I2, 65%). The effect was stronger after removing the study responsible for the heterogeneity (SMD, -0.70; 95% CI, -1.05 to -0.36; P <.0001; I2, 0%).

For school-related anxiety, AA was not favored (mean difference [MD], -2.44; 95% CI, -5.67 to 0.79; P =.14; I2, 0%).

The major limitation of this analysis was the short follow-up duration in the majority of trial designs.

Study authors concluded, “There is evidence that AA may reduce anxiety levels as measured by psychometrically robust scales of anxiety symptoms. Clinicians may consider AA as an adjunct or alternative when concerns about anxiety drug side effects are severe, contraindicated, or previously ineffective. [..] There is still a gap of reporting the AA adverse events and lack of research in anxiety disorders following appropriate diagnosis.”


Vierira A, Moreira A, Machado JP, Robinson N, Hu XY. Is auriculotherapy effective and safe for the treatment of anxiety disorders? – A systematic review and meta-analysis. Eur J Integr Med. 2022;102157. doi:10.1016/j.eujim.2022.102157

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