Key result
Shugan Jieyu Capsule shows ~2-point worse depression reduction and higher cardiac risk vs. conventional antidepressants.
Why the study?
Although Shugan Jieyu Capsule has been prescribed for depression, whether it benefits depression in patients with coronary heart disease remains controversial.
Does Shugan Jieyu Capsule improve depressive symptoms and is it safe in patients with coronary heart disease?
Meta-Analysis (n=644)
Does Shugan Jieyu Capsule improve depressive symptoms and is it safe in patients with coronary heart disease?
Mean Difference: 2.12 (95% CI 0.73–3.5)
p-value: p=0.003
Shugan Jieyu Capsule is less effective than conventional antidepressants for treating depression in CHD patients and carries a higher risk of adverse cardiac events.
Shugan Jieyu Capsule should not replace antidepressants in CHD patients with depression; extends RCT evidence of inferior efficacy and higher cardiac risk.
INTRODUCTION: Shugan Jieyu Capsule (SGJYC) has been prescribed to treat primary and secondary depression; however, whether it can benefit depression of patients with coronary heart disease (CHD) remains controversial. This meta-analysis aimed to evaluate the efficacy and safety of SGJYC in treating depression in patients with CHD. PATIENT CONCERNS: A total of 644 CHD patients with depression were selected from China National Knowledge Infrastructure, Wanfang, China Biomedical Database, MEDLINE, the Cochrane library from their inceptions until June, 2021. DIAGNOSIS: All patients with CHD or coronary artery disease were confirmed to suffer from depression based on recognized criteria. INTERVENTION: Patients were assigned randomly to receive SGJYC-based regimens or conventional antidepressants alone. OUTCOMES: Meta-analysis of 6 studies showed that antidepressants (MD, 2.12; 95% confidence interval [CI], 0.73~3.50) or sertraline (MD, 2.15; 95%CI, 0.61~3.68) significantly alleviated depression level compared to SGJYC; however, SGJYC plus antihypertensive drugs (AHD) (MD, -8.33; 95%CI, -13.90 ~ -2.75) significantly improved depression symptoms compared to AHD. A significant difference in risk of adverse cardiac events (risk ratios [RR], 2.72; 95%CI, 1.07~6.94) between SGJYC and sertraline was detected in patients with simple CHD. CONCLUSIONS: SGJYC has a poor effect on depressive symptoms, and the effect of combination with AHD is better than AHD but its efficacy and cardiac safety are inferior to antidepressants.
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Liu et al. (2023) conducted a meta-analysis in Coronary heart disease complicated by depression (n=644). Shugan Jieyu Capsule vs. Conventional antidepressants (sertraline, fluoxetine) or antihypertensive drugs alone was evaluated on Anti-depressive effect assessed by changes in Hamilton Depression Scale (HAMD) score (antidepressants vs SGJYC) (MD 2.12, 95% CI 0.73-3.50, p=0.003). Shugan Jieyu Capsule was significantly inferior to conventional antidepressants for alleviating depressive symptoms (MD 2.12) and was associated with a higher risk of adverse cardiac events.
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