Acupuncture may be effective in the treatment of chronic stress symptoms . The main investigative findings concerning the effects of acupuncture on stress are outlined in Table 2.Table 2Acupuncture as a stress management strategy: randomized controlled trialsWu, Y, Yuan, J, Feng, X. (2011) Acupuncture as an adjunct to anesthesia was found to help maintain stable hemodynamics and reduce stress responses during laparoscopic cholecystectomy surgery.Kwong E, Yiu E. A. (2010) Acupuncture did not reduce salivary cortisol concentrations (and therefore could not reduce emotional stress) in female patients with dysphonia.Middlekauff H, Hui K, Yu J. (2002) Acute acupuncture appeared to control excessive sympathetic arousal during mental stress in individuals with advanced heart failure.Balk J, Catov J, Horn B. (2009) Acupuncture is associated with reduced stress during embryo transfer and increased pregnancy rates in women receiving in vitro fertilization.Hui K, Marina O, Liu J et al. (2010) Acupuncture affects areas of the brain known to reduce sensitivity to pain and stress, promotes relaxation, and deactivates the analytical brain, which is responsible for anxiety.Erickson K, Voss M, Prakash R et al. (2011) Kim H, Park H, Shim H et al. (2011) Acupuncture improves stress-induced memory impairment and increases acetylcholinesterase reactivity in the hippocampus.Park H, Kim H, Hahm D. (2010) Acupuncture reduces serum levels of corticosterone and the number of tyrosine hydroxylase-immunoreactive cells.Lee A, Fan L. (2009) Cheng K. (2009) Acupuncture regulates levels of neurotransmitters and hormones such as serotonin, noradrenaline, dopamine, neuropeptide Y and ACTH, thus altering the mood chemistry of the brain to help combat negative affective states.Arranz L, Guayerbas N, Siboni L et al. (2007) Acupuncture reverses pathological changes in levels of inflammatory cytokines that are associated with stress reactions.Kavoussi B, Ross B. (2007) Acupuncture reduces inflammation by promoting the release of vascular and immunomodulatory factors.