title: Effectiveness and safety of Wuling capsule for post stroke depression: a systematic review.
abstract: OBJECTIVE
  To review the effectiveness and safety of Wuling capsule for post stroke depression (PSD) systematically.
  
  
  METHODS
  We searched electronic databases for randomized controlled trials (RCTs) that compared either Wuling capsule with placebo, no treatment or Wuling capsule plus conventional treatment with conventional treatment alone in adults with post stroke depression. Relevant resources were also retrieved. Two reviewers screened the citations, assessed the risk of bias and extracted data independently.
  
  
  RESULTS
  A total of 16 studies involving 1378 patients were identified for this review. There were 3 trials comparing Wuling capsule with no treatment control and 13 trials comparing Wuling capsule plus conventional treatment (Deanxit, Fluoxetine, Sertraline, Paroxetine or Citalopram) with conventional treatment alone. Meta-analyses indicated Wuling capsule used alone or integrated with conventional treatment was effective for PSD in terms of HAMD (Hamilton depression scale) scores, response rate and with less adverse effects, of which, HAMD scores decreased significantly in favor of Wuling capsule from onset time to 1 week (SMD = 1.27, 95%CI: 0.71-1.83, P < 0.00001), 2 weeks (SMD = 1.45, 95%CI: 0.57-2.33, P = 0.001), 4 weeks (SMD = 2.84, 95%CI: 2.15-3.52, P < 0.00001), 6 weeks (SMD = 2.70, 95%CI: 2.15-3.24, P < 0.00001), and 8 weeks (SMD = 4.53, 95%CI: 3.55-5.50, P < 0.00001) and overall effect (SMD = 2.40, 95%CI: 1.75-3.05, P < 0.00001) (SMD = standardized mean difference).
  
  
  CONCLUSIONS
  Wuling capsule appeared to present certain antidepressant effect compared to no treatment control. With a combination of several Western medicines, Wuling capsule could be helpful in strengthening efficacy and reducing the incidence of adverse events as an alternative choice in the treatment of PSD. However, due to the limited number of included trials and relatively moderate methodological quality in the majority of studies, further large scale and rigorously designed trials are warranted to confirm the effectiveness and safety of Wuling capsule for post stroke depression.
authors.affiliation: Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Le
authors.initials: L
authors.lastname: Peng
authors.affiliation: Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu 610041, China. Electronic address: deyingkang@126.com.
authors.forename: De-Ying
authors.initials: DY
authors.lastname: Kang
authors.affiliation: Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Xue-Ting
authors.initials: XT
authors.lastname: Liu
authors.affiliation: Department of Evidence-based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu 610041, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Hong
mesh_terms: D000328:Adult; D003863:Depression / Q000188:drug therapy*; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D020521:Stroke
chemical_list: D004365:Drugs, Chinese Herbal; C533472:wuling
keywords: Conventional treatment; Meta-analysis; Post stroke depression (PSD); Systematic review; Wuling capsule