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Aim: Transcutaneous electrical cranial‐auricular acupoint stimulation (TECAS) is a novel non‐invasive therapy that stimulates acupoints innervated by the trigeminal and auricular vagus nerves. An assessor‐blinded, randomized, non‐inferiority trial was designed to compare the efficacy of TECAS and escitalopram in mild‐to‐moderate major depressive disorder. Methods: 468 participants received two TECAS sessions per day at home (n = 233) or approximately 10–13 mg/day escitalopram (n = 235) for 8 weeks plus 4‐week follow‐up. The primary outcome was clinical response, defined as a baseline‐to‐endpoint ≥50% reduction in Montgomery‐Åsberg Depression Rating Scale (MADRS) score. Secondary outcomes included remission rate, changes in the severity of depression, anxiety, sleep and life quality. Results: The response rate was 66.4% on TECAS and 63.2% on escitalopram with a 3.2% difference (95% confidence interval [CI], −5.9% to 12.9%) in intention‐to‐treat analysis, and 68.5% versus 66.2% with a 2.3% difference (95% CI, −6.9% to 11.4%) in per‐protocol analysis. The lower limit of 95% CI of the differences fell within the prespecified non‐inferiority margin of −10% (P ≤ 0.004 for non‐inferiority). Most secondary outcomes did not differ between the two groups. TECAS‐treated participants who experienced psychological trauma displayed a markedly greater response than those without traumatic experience (81.3% vs 62.1%, P = 0.013). TECAS caused much fewer adverse events than escitalopram. Conclusions: TECAS was comparable to escitalopram in improving depression and related symptoms, with high acceptability, better safety profile, and particular efficacy in reducing trauma‐associated depression. It could serve an effective portable therapy for mild‐to‐moderate depression. [ABSTRACT FROM AUTHOR]

Aim: Acupuncture has benefits in the rehabilitation of neuropsychiatric sequelae of stroke. This study was aimed to evaluate the effectiveness of dense cranial electroacupuncture stimulation plus body acupuncture (DCEAS+BA) in treating poststroke depression (PSD), functional disability, and cognitive deterioration. Methods: In this assessor‐ and participant‐blinded, randomized controlled trial, 91 stroke patients who initially had PSD were randomly assigned to either DCEAS+BA (n = 45) or minimum acupuncture stimulation as controls (n = 46) for three sessions per week over 8 consecutive weeks. The primary outcome was baseline‐to‐end‐point change in score of the 17‐item Hamilton Depression Rating Scale. Secondary outcomes included the Montgomery–Åsberg Depression Rating Scale for depressive symptoms, the Barthel Index for functional disability, and the Montreal Cognitive Assessment for cognitive function. Results: DCEAS+BA‐treated patients showed strikingly greater end‐point reduction than MAS‐treated patients in scores of the three symptom domains. The clinical response rate, defined as an at least 50% baseline‐to‐end‐point reduction in 17‐item Hamilton Depression Rating Scale score, was markedly higher in the DCEAS+BA‐treated group than that of controls (40.0% vs 17.4%, P = 0.031). Incidence of adverse events was not different in the two groups. Subgroup analysis revealed that DCEAS+BA with electrical stimulation on forehead acupoints was more apparent in reducing Barthel‐Index‐measured disability than that without electrical stimulation. Conclusion: DCEAS+BA, particularly with electrical stimulation on forehead acupoints, reduces PSD, functional disability, and cognitive deterioration of stroke patients. It can serve as an effective rehabilitation therapy for neuropsychiatric sequelae of stroke. [ABSTRACT FROM AUTHOR]