SynthesisFrontiers in pharmacology2026
Inflammation-neurotrophin synergy of Xiao-yao-san-type botanical drug formulations in depressive disorders: a qualitative synthesis of recent human studies with taxonomic and compositional characterisation.
Synthesis in Frontiers in pharmacology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Depressive disorders represent a major contributor to the global burden of disease, with persistently rising prevalence rates posing significant challenges to individual quality of life and public health systems. Existing first-line medications such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) typically require 2-4 weeks to take effect, with complete remission rates below 60%. Approximately one-third of patients discontinue treatment within 90 days due to adverse reactions including gastrointestinal discomfort, weight changes, or sexual dysfunction. Consequently, exploring interventions with faster onset and improved tolerability holds significant clinical importance. Methods: A systematic search of seven databases-PubMed, Embase, Web of Science, Cochrane CENTRAL, CNKI, AMED, and Scopus-identified randomised controlled trials (RCTs) and mechanism studies published between 2010 and 2025. A qualitative synthesis method analysed clinical efficacy and adverse reactions, integrating evidence from metabolomics, epigenetics, and network pharmacology. Botanical drug identification was performed in accordance with ConPhYMP guidelines, with all species names validated taxonomically against the Medicinal Plant Names Services (MPNS) and Plants of the World Online (POWO) databases. Results: Twenty-one RCTs (n = 2,766) and three mechanistic studies were included. Findings indicated that Xiaoyao Formula Conclusion: Existing evidence preliminarily supports potential advantages of Xiaoyao Formula in treating depressive disorders, including possibly earlier onset of action, good tolerability, and potential additional benefits in female subgroups. However, given limitations such as small sample sizes, short intervention durations (6-12 weeks), and predominantly combination therapy rather than monotherapy comparisons, these conclusions should be regarded as suggestive or indicative findings rather than definitive efficacy. Long-term efficacy and generalisability across populations require further validation. Future studies should conduct multicentre, large-sample clinical trials with ≥24-week follow-up, incorporating wearable digital phenotyping technologies to confirm its application value in precision psychiatry.
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