KMCRIC

A systematic review on the efficacy safety and types of Chinese herbal medicine for depression.

Yeung WF, Chung KF, Ng KY, Yu YM, Ziea ET, Ng BF.

J Psychiatr Res. 

2014

57

165-175.

10.1016/j.jpsychires.2014.05.016.

24974002

http://www.ncbi.nlm.nih.gov/pubmed/24974002

Adult
Antidepressive Agents/adverse effects*
Antidepressive Agents/therapeutic use*
Depressive Disorder, Major/drug therapy*
Depressive Disorder, Major/psychology
Female
Humans
Male
Medicine, Chinese Traditional/adverse effects*
Medicine, Chinese Traditional/methods
Middle Aged
Plant Preparations/adverse effects*
Plant Preparations/therapeutic use
Randomized Controlled Trials as Topic
Treatment Outcome

Chinese herbal medicine; Depression; Meta-analysis; Systematic review; TCM

중약학; 우울증; 메타분석; 체계적 문헌고찰; 중의학

KMCRIC 비평 보기 +

Chinese herbal medicine (CHM) is one of the commonly used complementary and alternative medicine therapies for major depressive disorder. The objective of this study was to review the efficacy, safety and types of CHM for depression. We systematically searched key databases (9 Chinese and 7 English) up until May 2013 for randomized controlled trials (RCTs) and examined 7 systematic reviews for additional articles. Methodological quality was assessed by modified Jadad scale and Cochrane's risk of bias assessment. Only studies with moderate methodological quality, defined as modified Jadad scale score ≥3, were included in meta-analysis for efficacy. Of the 296 RCTs that were assessed in details, 278 (93.9%) had modified Jadad scale score < 3, and only 21 scored ≥ 3. The frequently used formulas were Xiao Yao decoction, Chaihu Shugan decoction and Ganmai Dazao decoction; while Chaihu, Bai Shao and Fu Ling were the frequently used single herb. Meta-analyses showed that CHM monotherapy was better than placebo and as effective as antidepressants in reducing Hamilton Depression Rating Scale (HDRS) score (CHM vs. placebo: mean difference: -7.97, 95% CI: -10.25 to -5.70, P < 0.00001, 2 studies; CHM vs. antidepressants: mean difference: 0.01, 95% CI: -0.28 to 0.30, P = 0.95, 7 studies). CHM were associated with less adverse events than antidepressants, and adding CHM to antidepressants reduced adverse events. Despite the overall positive results, due to the small number of studies with sufficient methodological quality, it is premature to accurately conclude the benefits and risks of CHM for depression.

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