Department of Sport and Exercise Sciences, Jacksonville University, Jacksonville, Florida 32211, USA; E-mail:
J Integr Med. 2013 Nov;11(6):377-83. doi: 10.3736/jintegrmed2013056.
Due to safety concerns and side effects of many antidepressant medications, herbal psychopharmacology research has increased, and herbal remedies are becoming increasingly popular as alternatives to prescribed medications for the treatment of major depressive disorder (MDD). Of these, accumulating trials reveal positive effects of the spice saffron (Crocus sativus L.) for the treatment of depression. A comprehensive and statistical review of the clinical trials examining the effects of saffron for treatment of MDD is warranted.
The purpose of this study was to conduct a meta-analysis of published randomized controlled trials examining the effects of saffron supplementation on symptoms of depression among participants with MDD.
We conducted electronic and non-electronic searches to identify all relevant randomized, double-blind controlled trials. Reference lists of all retrieved articles were searched for relevant studies.
The criteria for study selection included the following: (1) adults (aged 18 and older) with symptoms of depression, (2) randomized controlled trial, (3) effects of saffron supplementation on depressive symptoms examined, and (4) study had either a placebo control or antidepressant comparison group.
Using random effects modeling procedures, we calculated weighted mean effect sizes separately for the saffron supplementation vs placebo control groups, and for the saffron supplementation vs antidepressant groups. The methodological quality of all studies was assessed using the Jadad score. The computer software Comprehensive Meta-analysis 2 was used to analyze the data.
Based on our pre-specified criteria, five randomized controlled trials (n = 2 placebo controlled trials, n = 3 antidepressant controlled trials) were included in our review. A large effect size was found for saffron supplementation vs placebo control in treating depressive symptoms (M ES = 1.62, P < 0.001), revealing that saffron supplementation significantly reduced depression symptoms compared to the placebo control. A null effect size was evidenced between saffron supplementation and the antidepressant groups (M ES = -0.15) indicating that both treatments were similarly effective in reducing depression symptoms. The mean Jadad score was 5 indicating high quality of trials.
Findings from clinical trials conducted to date indicate that saffron supplementation can improve symptoms of depression in adults with MDD. Larger clinical trials, conducted by research teams outside of Iran, with long-term follow-ups are needed before firm conclusions can be made regarding saffron's efficacy and safety for treating depressive symptoms.
由于许多抗抑郁药物的安全性和副作用问题，草药精神药理学的研究有所增加，草药疗法作为处方药的替代品，治疗重度抑郁症（MDD）的趋势越来越明显。在这些替代方法中，越来越多的试验结果显示，香料藏红花（Crocus sativus L.）对治疗抑郁症有积极作用。有必要对评估藏红花治疗 MDD 的临床试验进行全面和统计学综述。
本研究旨在对评估藏红花补充剂对 MDD 患者抑郁症状影响的已发表随机对照试验进行荟萃分析。
我们进行了电子和非电子搜索，以确定所有相关的随机、双盲对照试验。检索到的所有文章的参考文献列表都被用来查找相关研究。
研究选择的标准包括：（1）有抑郁症状的成年人（年龄在 18 岁及以上），（2）随机对照试验，（3）评估藏红花补充剂对抑郁症状的影响，以及（4）研究有安慰剂对照或抗抑郁药物比较组。
使用随机效应模型程序，我们分别为藏红花补充剂与安慰剂对照组，以及藏红花补充剂与抗抑郁药物组计算加权平均效应大小。使用 Jadad 评分评估所有研究的方法学质量。使用 Comprehensive Meta-analysis 2 计算机软件分析数据。
根据我们预先指定的标准，有五项随机对照试验（2 项安慰剂对照试验，3 项抗抑郁药物对照试验）纳入了我们的综述。藏红花补充剂与安慰剂对照治疗抑郁症状的效果较大（M ES = 1.62，P < 0.001），这表明藏红花补充剂与安慰剂相比显著降低了抑郁症状。藏红花补充剂与抗抑郁药物组之间的效果大小为零（M ES = -0.15），表明两种治疗方法在降低抑郁症状方面同样有效。平均 Jadad 得分为 5 分，表明试验质量较高。
迄今为止进行的临床试验结果表明，藏红花补充剂可以改善 MDD 成人的抑郁症状。需要由伊朗以外的研究团队进行更大规模的临床试验，并进行长期随访，才能对藏红花治疗抑郁症状的疗效和安全性得出更确定的结论。
