Treatment of depression with Chai Hu Shu Gan San: a systematic review and meta-analysis of 42 randomized controlled trials

Abstract

BackgroundDepression is a common mental disorder. Chai Hu Shu Gan San, a traditional Chinese medicine, is used to treat depression empirically. We present a systematic review and meta-analysis of the therapeutic efficacy and safety of Chai Hu Shu Gan San in treating depression.MethodsSeveral databases, including PubMed, China National Knowledge Internet, Wanfang, Chongqing VIP, and the Cochrane library, were systematically searched from their date of foundation to January 1, 2017. In this review, wehave included randomized control trials that compared Chai Hu Shu Gan San (or its combination with a regular Western medicine) with a regular Western medicine alone for the treatment of depression. Two investigators independently extracted and analyzed the data using RevMan 5.2.0 software. Mean difference (with a 95% confidence interval) was used as efficacy indices for outcomes.ResultsWe included 42 studies involving 3234 patients with depression in 15 different types of diseases. Meta analyses showed better effect of Chai Hu Shu Gan San than fluoxetine for pure depression (MD = − 1.59, from − 2.82 to − 0.37, 4 trials, I2 = 26%), for post-stroke depression (MD = − 4.20, from − 6.20 to − 2.19, 7 trials, I2 = 96%), and for postpartum depression (MD = − 4.10, from − 7.48 to − 0.72 7 trials, I2 = 86%). None of the articles reported severe adverse events of oral administration of Chai Hu Shu Gan San. Furthermore, any adverse effects of using Chai Hu Shu Gan San alone were fewer than those of regular Western medicines.ConclusionsThis review found that Chai Hu Shu Gan San has some advantages in treating depression, especially post-stroke depression and post-partum depression. A meticulously designed and conducted randomized control trial is needed for further evaluation.

Antidepressant-Like Effects and Cognitive Enhancement of Coadministration of Chaihu Shugan San and Fluoxetine: Dependent on the BDNF-ERK-CREB Signaling Pathway in the Hippocampus and Frontal Cortex

“…It is estimated that up to 80% of the population in developing countries use traditional herbs for primary health care [15]. CSS or coadministration of CSS and FLU is commonly used to enhance antidepressant effect and reduce side effects in Chinese clinics [16], which was confirmed by multiple studies [17][18][19]. Chaihu Shugan San (CSS) is a classic and effective antidepressant Chinese herbal medicine that has been used in China for thousands of years.…”

Gut Microbiota Is the Key to the Antidepressant Effect of Chaihu-Shu-Gan-San

“…Although the antidepressant mechanism of different responses to CSGS treatment has been extensively investigated, these studies are mainly focused on hippocampal 5-HT receptor and brain-derived neurotrophic factor (BDNF) either at pre-or post-treated CSGS that correlates with therapeutic outcomes [16][17][18]. Herein, we paid more attention to the overall hippocampal metabolism after CGSG and the combined oral administration broad-spectrum antibiotic treatment and then conducted analyses by the UPLC-Q-TOF/MS-based metabolomics approach.…”

Spirit-Quieting Traditional Chinese Medicine May Improve Survival in Prostate Cancer Patients with Depression

“…However, we also found that TCM physicians did not use some antidepressant TCM formulae that have proven useful in clinical trials. For example, a systematic review and meta-analysis study found that Chai-Hu-Shu-Gan-San can effectively reduce the severity and frequency of depression [26]. However, Taiwanese TCM physicians rarely use it to treat patients with depressive prostate cancer.…”