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

Wing Fai Yeung, Ka Fai Chung, Ka Yan Ng, Yee Man Yu, Eric Tat Chi Ziea, Bacon Fung Leung Ng

Research output: Journal article publicationJournal articleAcademic researchpeer-review

65 Citations (Scopus)


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.
Original languageEnglish
Pages (from-to)165-175
Number of pages11
JournalJournal of Psychiatric Research
Issue number1
Publication statusPublished - 1 Jan 2014
Externally publishedYes


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

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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