Acupuncture is being increasingly used in psychiatric disorders. The effect of acupuncture on depression (including depressive neurosis and depression following stroke) has been documented repeatedly in controlled studies (189-194). Acupuncture is comparable with amitriptyline in the treatment of depression but has fewer side-effects. In addition, acupuncture has been found to be more effective in depressive patients with decreased excretion of 3-methyl-4-hydroxy-phenylglycol (the principal metabolite of the central neurotransmitter norepinephrine), while amitriptyline is more effective for those with inhibition in the dexamethasone suppression test (192). This suggests that these two therapies work through different mechanisms.