Meta-analysis of Chinese herbal Xiaoyao formula as an adjuvant treatment in relieving depression in Chinese patients

Chinese herbal Xiaoyao formula (XYF) has been widely used as an adjuvant treatment for depression in China. The objective of this meta-analysis was to assess the efficacy and safety of XYF in relieving depression in Chinese patients. Systematic literature searches were carried out on the Pubmed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang database (prior to June 2013). Only randomized controlled trials (RCTs) comparing XYF plus antidepressants with antidepressants alone for patients with depression were selected. The main outcomes were changes in weighted mean difference (WMD) and 95% confidence interval (CI) of the Hamilton depression scale (HAMD) and risk ratios (RRs) and 95% CI for adverse events. Ten RCTs involving 735 patients were identified and analyzed. All of the included RCTs were associated with a moderate to high risk of bias. In the meta-analysis, XYF plus antidepressants reduced the HAMD scores compared with antidepressants alone (WMD −2.15; 95% CI −3.56 to −0.74) in a random effect model. In subgroup analysis, XYF plus antidepressants reduced WMD was not observed in the treatment duration less than 8 weeks’ subgroup (WMD −1.37; 95% CI −2.92 to 0.19) and XYF powder subgroup (WMD −2.87; 95% CI −7.40 to 1.66). The adverse events included hyperhidrosis, dry mouth, nausea, and constipation. No serious adverse events were reported in any of the included trials. XYF as an adjuvant treatment appeared to have benefits on depressive patients. In addition, XYP appeared to reduce insomnia and constipation related to antidepressants.