Objectives: To assess the beneficial and adverse effects of Xiaoyaosan for depression. Inclusion Criteria: We included randomized clinical trials testing Xiaoyaosan against placebo, antidepressants, or combined with antidepressants against antidepressants alone. Data analyses were conducted according to the Cochrane standards. Results: 26 randomized trials (involving 1837 patients) were included and the methodological quality was evaluated as generally low. The pooled results showed that Xiaoyaosan combined with antidepressants was more effective in comprehensive effect, the score of Hamilton Rating Scale for Depression (HAMD) and the score of Self-Rating Depression Scale (SDS) compared with antidepressants alone. Xiaoyaosan was superior to antidepressants for the score of HAMD. However, Xiaoyaosan was not different from placebo for the score of SDS. There was no adverse effect reported in the trials from Xiaoyaosan. Conclusions: Xiaoyaosan appears to be effective on improving symptoms in patients with depression.
Zhang Y, et al.: Evid Based Complement Alternat Med. 2012;2012:931636.


Xiao Yao San is a classical Chinese herbal formula published in 1087 in Imperial Grace Formulary of the Tai Ping Era (Tai Ping Hui Min He Ji Ju Fang). Traditionally, it is used for Liver Qi stagnation with Blood deficiency. Clinically, it is used mostly in depression-related diseases in Chinese medicine. A recent systematic review of 26 randomized clinical trials (involving 1837 patients) of Xiao Yao San revealed its effectiveness on depression (see below).

Jia Wei Xiao Yao San (JWXYS) is a modified version of Xiao Yao San recorded in 1602 in Rules of Conformation and Therapy (Zheng Zhi Zhun Sheng). Recently, it has been studied for its usage in functional dyspepsia (FD), a gastrointestinal disorder that affects an estimated 20% of Americans. One of the conventional treatments of FD is low dose anti-depressant drugs. A randomized clinical trial funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is currently underway to examine the effectiveness and mechanisms of the tricyclic antidepressant amitriptyline and the selective serotonin-reuptake inhibitor (SSRI) escitalopram in functional dyspepsia. Interestingly, many studies already conducted in the Chinese medicine field have shown that JWXYS, a commonly used herbal formula for depression-related disorders, may have beneficial roles in FD. A meta-analysis of multiple clinical trials showed that JWXYS is more effective compared to prokinetic drugs in the treatment of FD. A clinical study of 20 patients with FD indicated that the formula improved the symptoms as well as electrogastrography (EGG). Please read on below for details of the studies.