Efficacy and safety of Chinese patent medicine Wuling capsule combined with antidepressant drugs in the treatment of major depressive disorder: A systematic review with meta-analysis

Abstract

Background

Major depressive disorder is a public health problem covering the world. Medical therapy is one of the main treatment for Major depressive disorder. However, antidepressants often have delayed efficacy and many side effects, which seriously affect the quality of life of patients. To systematically evaluate the efficacy and safety of Chinese patent medicine Wuling capsule combined with antidepressant drug in the treatment of patients with Major depressive disorder. Wuling capsule is a traditional Chinese medicine in China consisting of Wuling mycelia of Xylaria nigripes Sacc (a rare type of fungus).

Methods

Relevant documents published before December 1st, 2023 were retrieved from China national knowledge infrastructure, WANFANG DATA, SinoMed, Vip Journal Integration Platform, Chinese Bio Medical Literature Database, Web of Science, Pubmed, Embase, PsycINFO, International Clinical Trials Registry Platform, Scopus, CINAHL, ProQuest, Wiley Online Library and Clinicaltrials.gov. Randomized controlled trials that meet the inclusion criteria were selected. Their qualities were evaluated and classified. The meta-analysis was performed using RevMan 5.4, and heterogeneity test and publication bias evaluation were performed.

Results

This review includes 2148 patients from 24 studies. In this study, the intervention group chose Wuling capsule combined with Antidepressant, and the control group used antidepressants alone. The results show that compared with using antidepressant drug alone, using Wuling capsule combined with antidepressant drug displays statistical significance in reduction of patients’ Hamilton Depression Scale score [mean difference= -3.08, 95 %CI (-3.58,-2.57), P < 0.001], Treatment Emergent Symptom Scale score [mean difference= -3.00, 95 %CI (-4.24, −1.75), P < 0.001], and the effective rate [risk ratio= 1.18, 95 %CI (1.13, 1.23), P < 0.001].

Conclusions

Compared with antidepressants alone, the Wuling capsule has an advantage in improving the Hamilton Depression score of patients with major depressive disorder. Through this study, we believe that the Wuling capsule can be used as a safe and effective adjunctive drug for the treatment of Chinese patients with major depressive disorder. However, the quality of the evidence still needs to be further improved, and more high-quality clinical trials from different regions are needed to enhance the credibility of the evidence.