Shuganjieyu capsule for major depressive disorder (MDD) in adults: a systematic review.
OBJECTIVE
Shuganjieyu capsule is a pure herbal pharmaceutical product for depression. Our objective was to explore the effectiveness and safety of Shuganjieyu capsule for the treatment of major depressive disorder in adults.


METHODS
Eight computerized databases were searched. In addition, randomized controlled trials (RCTs) on Shuganjieyu capsule were hand-searched on seven key Chinese journals. Data were extracted and evaluated by two reviewers independently. Analysis was performed by intention-to-treat where possible. Prespecified subgroup analyses were different-dose regimens, patient spectrum, publication status, and treatment duration.


RESULTS
Seven RCTs with 595 participants were included. Shuganjieyu capsule was superior than placebo in terms of response rate (RR = 2.42, 95% CI: 1.55-3.79; P = 0.0001), remission rate (RR = 4.29, 95% CI: 1.61-11.45; P = 0.004), the scores of the mean change from baseline of the HAM-D17 (MD = -4.17, 95% CI: -5.61 to -2.73; P < 0.00001) and from baseline of traditional Chinese medicine (TCM) syndrome score scale scores (MD = -6.00, 95% CI: -8.25 to -3.75; P < 0.00001). In addition, Shuganjieyu plus venlafaxine had a significantly higher response rate (RR = 1.56, 95% CI: 1.29-1.88; P < 0.00001) and was superior in terms of the scores of the mean change from baseline of the treatment emergent symptoms scale scores (MD = -0.74, 95% CI:-1.12 to -0.35; P = 0.0002) than venlafaxine alone.


CONCLUSIONS
Shuganjieyu capsule is superior to placebo in terms of overall treatment effectiveness and safety. Both response rate and remission rate among patients treated with the combination of Shuganjieyu plus venlafaxine were significantly higher than those treated with venlafaxine alone. Due to the considerable risk of bias in majority of trials, recommendations for practice should be cautious, and additional, well-designed RCTs are needed in next step.
a Evidence-based Medicine and Clinical Epidemiology Department, West China Hospital , Sichuan University , Chengdu , China.
Xin
X
Zhang
Deying
D
Kang
Lan
L
Zhang
Le
L
Peng
D003865:Major Depressive Disorder / Q000188:drug therapy*; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage / Q000494:pharmacology*; D028001:Eleutherococcus; D006801:Humans; D020902:Hypericum; D008517:Phytotherapy; D028321:Plant Preparations / Q000008:administration & dosage / Q000494:pharmacology*; D016032:Randomized Controlled Trials as Topic
D004338:Drug Combinations; D004365:Drugs, Chinese Herbal; D028321:Plant Preparations
Shuganjieyu capsule; depression; major depressive disorder; meta-analysis; systematic review