Systematic Review and Meta-Analysis of Effectiveness Comparison of Acupuncture Combined with Chinese Herbal Medicine Versus Antidepressants in Treatment of Adolescent Patients with Depression in China

Background Adolescent-onset depression (ages 12–18) presents similarly to adult depression but with a higher likelihood of physical symptoms, agitation, impulsivity, hostility, and non-suicidal self-injury (NSSI). This systematic review and meta-analysis compares the effectiveness of acupuncture combined with Chinese herbal medicine (CHM) versus antidepressants in treating adolescent depression in China. Methods Chinese and English literature comparing acupuncture plus CHM to antidepressants for adolescent depression was searched across multiple databases (CBM, CNKI, WANFANG, CSSCI, MEDLINE, EMBASE) up to December 31, 2025. Non-randomized studies, reviews, and case reports were excluded. Depression scores, anxiety scores, and treatment effectiveness rates were synthesized. Study quality was assessed using the Joanna Briggs Institute criteria. Statistical analysis was performed using SAS software, with a random- or fixed-effects model applied based on heterogeneity ( I 2 ). Result Five controlled Chinese studies were included. Compared with antidepressants, the combination of acupuncture and CHM resulted in significantly lower depression and anxiety scores, higher effective and remission rates, and a lower ineffective rate at the end of treatment (8–12 weeks). All differences were statistically significant ( P < 0.05). In the five studies, the commonly used acupoints were Baihui (100%), Taichong (80%), Hegu (60%), Shenmen (60%), Sishenchong (60%), Xinshu (60%), Yintang (40%), Sanyinjiao (40%), and Danzhong (40%). Conclusion The combination of acupuncture and CHM appears more effective than antidepressant monotherapy in reducing depressive and anxiety symptoms and improving response rates among adolescents with depression. These findings support the potential role of integrated non-pharmacological approaches as a first-line treatment option, aligning with guidelines that prioritize non-drug therapies for mild to moderate adolescent depression.