Supplement
Chaihu Longgu Muli Decoction is a traditional East Asian herbal formula that, in rodent studies, helped keep the body's stress-hormone feedback working normally. People mostly look at it for depression, and meta-analyses found scores fell more with it, alone or added to SSRIs, than with antidepressants alone, including after a stroke, and the evidence is moderate. Evidence for anxiety and blood pressure is only limited, and the stress findings are mostly from animals.
Sources: PMID 37808199; PMID 34457030
- Updated
- How we grade
- 10 studies cited
- Best evidence
- Grade B
- Conditions studied
- 1
- Outcomes
- 5
- Graded outcomes
- 0221
Evidence by condition
- Strong
- Moderate
- Limited
- Very limited
General
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Sleep Quality Two meta-analyses of RCTs (22 studies, n=2029; 10 studies, n=842) found CLMLD alone or combined with conventional medications significantly improved Pittsburgh Sleep Quality Index scores (MD −2.80 and WMD −2.21 respectively) and increased total sleep time (+1.01 hours) compared to conventional medication alone, with fewer adverse events. However, included studies had significant risk of bias and lacked adequate blinding. | Improves (the measure goes up) | Moderate effect | 3 studies | 2,871 people | ||
Studies that measured sleep quality
| ||||||
| Depression Symptoms A meta-analysis of 24 RCTs (n=2,382) found CLMLD alone or combined with SSRIs significantly reduced Hamilton Depression Rating Scale scores versus antidepressants alone (SMD = −1.94 for combination therapy). A separate meta-analysis of 13 RCTs in post-stroke depression (n=1,665) confirmed superior efficacy and safety versus antidepressants alone. Quality of evidence was generally rated low due to risk of bias in included Chinese-language trials. | Improves (the measure goes down) | Moderate effect | 3 studies | 4,047 people | ||
Studies that measured depression symptoms
| ||||||
| Blood Pressure A systematic review and meta-analysis of 7 RCTs (n=711) found the formula significantly lowered systolic BP by 8.84 mmHg and diastolic BP by 9.11 mmHg versus placebo, with no serious adverse events. Quality of evidence was rated 'low' with unclear risk of bias in most included studies. | Improves (the measure goes down) | Moderate effect | 1 study | 711 people | ||
Studies that measured blood pressure | ||||||
| Stress Response In rodent models, CLMLD prevented chronic stress-induced HPA axis dysfunction and glucocorticoid negative feedback disruption in a dose-dependent manner. Microdialysis studies showed the formula prevented stress-induced decreases in prefrontal cortex dopamine and serotonin, and attenuated stress-induced monoamine surges in the thalamus, hypothalamus, and amygdala. A single-dose mouse study showed rapid BDNF upregulation in the hippocampus within 30 minutes. | Improves (the measure goes down) | Moderate effect | 4 studies | |||
Studies that measured stress response
| ||||||
| Grade | Outcome | Effect | Size | Studies | People | Studies list |
|---|---|---|---|---|---|---|
| Anxiety Symptoms Anxiety improvement has been reported as a secondary outcome in multiple depression and insomnia meta-analyses, and the hypertension meta-analysis (7 RCTs, n=711) showed significant depression/mood score improvements (PHQ-9 −3.52). However, no dedicated anxiety-focused RCTs or meta-analyses exist. A clinical trial (NCT06725771) combining CLMLD with sertraline for generalized anxiety disorder is ongoing. | Improves (the measure goes down) | Small effect | 2 studies | 711 people | ||
Studies that measured anxiety symptoms | ||||||
Key findings
- Sleep QualityImproves (the measure goes up)
- Depression SymptomsImproves (the measure goes down)
- Anxiety SymptomsImproves (the measure goes down)
Safety notes in the studies
- Two meta-analyses of RCTs (22 studies, n=2029; 10 studies, n=842) found CLMLD alone or combined with conventional medications significantly improved Pittsburgh Sleep Quality Index scores (MD −2.80 and WMD −2.21 respectively) and increased total sleep time (+1.01 hours) compared to conventional medication alone, with fewer adverse events.
- However, included studies had significant risk of bias and lacked adequate blinding.
- Quality of evidence was generally rated low due to risk of bias in included Chinese-language trials.
Shop the evidence-backed picks
Third-party tested Chaihu Longgu Muli Decoction products, in the forms the graded studies used where we can match them.
- Grade B
Links to Fullscript, iHerb or Thorne carry our referral, so we may earn a commission at no extra cost to you. Grades come from the research and never change based on what we earn. Fullscript asks for a free account before it shows its catalog and prices. Full disclosure
Studies cited
10 studies from PubMed
- Efficacy and safety of Chaihu plus Longgu Muli decoction combined with Estazolam in the treatment of insomnia: a meta-analysis
- The pharmacological mechanism of chaihu-jia-longgu-muli-tang for treating depression: integrated meta-analysis and network pharmacology analysis
- Chaihu-Longgu-Muli decoction improves sleep disorders by restoring orexin-A function in CKD mice
- Efficacy and Safety of Chaihu Jia Longgu Muli Decoction in the Treatment of Poststroke Depression: A Systematic Review and Meta-Analysis
- Chaihu Longgu Muli decoction, a Chinese herbal formula, for the treatment of insomnia: A systematic review and meta-analysis
- Herbal Medicine (Sihogayonggolmoryeo-Tang or Chai-Hu-Jia-Long-Gu-Mu-Li-Tang) for Treating Hypertension: A Systematic Review and Meta-Analysis
- Immediate and persistent antidepressant-like effects of Chaihu-jia-Longgu-Muli-tang are associated with instantly up-regulated BDNF in the hippocampus of mice
- Saiko-ka-ryukotsu-borei-to, a herbal medicine, ameliorates chronic stress-induced depressive state in rotarod performance
- Saiko-ka-ryukotsu-borei-to, an herbal medicine, prevents chronic stress-induced disruption of glucocorticoid negative feedback in rats
- Increase in monoamine levels caused by emotional stress in mice brain regions is attenuated by Saiko-ka-ryukotsu-borei-to