Table 3 Summary of findings and quality of evidence table

 Depression, number of treatment responders

18 RCTs, N = 2922

RR 1.53 (1.19, 1.97), favors SJW

Moderate^a

 Depression scale score

16 RCTs, N = 2888

SMD 0.49 (0.23, 0.74), favors SJW

Moderate^a

 Depression remission

9 RCTs, N = 1419

RR 1.69 (0.63, 4.55), n.s.

Low^a,b

 Depression relapse

1 RCT, N = 426

RR 0.70 (0.49, 1.02), n.s.

Very low^a,b

 Quality of life—mental

2 RCTs, N = 358

SMD 0.48 (0.24, 0.73), favors SJW

Low^b

 Quality of life—physical

2 RCTs, N = 358

SMD 0.28 (−1.03, 0.47), n.s.

Very low^a,b

 Number of patients with adverse events

13 RCTs, N = 2600

OR 0.83 (0.62, 1.13), n.s.

Moderate^b

 Serious adverse events

6 RCTs, N = 1358

OR 0.26 (0.04, 1.23), n.s.

Moderate^a

 Gastrointestinal/metabolic/nutritional adverse events

16 RCTs, N = 2490

OR 1.06 (0.83, 1.41), n.s.

Low^a,b

 Neurologic/nervous system adverse events

14 RCTs, N = 2404

OR 1.56 (1.08, 3.32) SJW more AE

Low^a,b

 Skin/musculoskeletal adverse events

10 RCTs, N = 1978

OR 1.47 (0.98, 2.21), n.s.

Very low^a,b

 Photosensitivity

4 RCTs, N = 1054

OR 1.10 (0.36, 3.56), n.s.

Low^a,b

 Respiratory/infectious adverse events

7 RCTs, N = 1081

OR 1.48 (0.95, 2.33), n.s.

Low^a,b

 Other organ system (eye, ear, liver, renal, reproductive) adverse events

5 RCTs, N = 1054

OR 1.87 (1.08, 3.32), SJW more AE

Low^a,b

 Cardiovascular adverse events

4 RCTs, N = 759

OR 6.81 (0.92, 304.08), n.s.

Very low^a,b,d

 Psychiatric adverse events

3 RCTs, N = 608

OR 1.61 (0.34, 10.21), n.s.

Very low^a,b,d

 Sexual dysfunction adverse events

2 RCTs, N = 428

OR 1.92 (0.94, 4.00), n.s.

Very low^a,b,d

 Depression, number of treatment responders

17 RCTs, N = 2776

RR 1.01 (0.90, 1.14), n.s.

Moderate^b

 Depression scale score

14 RCTs, N = 2248

SMD 0.03 (−0.15, 0.21), n.s.

Moderate^b

 Depression remission

7 RCTs, N = 787

RR 1.17 (0.84, 1.62), n.s.

Low^b

 Depression relapse

1 RCT, N = 241

RR 4.17 (0.47, 33.33), n.s.

Very low^a,b

 Quality of life—mental

1 RCT, N = 216

SMD −0.11 (−0.15, 0.38), n.s.

Very low^a,b

 Quality of life—physical

1 RCT, N = 153

SMD 0.35 (0.01, 0.70), favors SJW

Very low^a,b

 Number of patients with adverse events

11 RCTs, N = 1946

OR 0.67 (0.56, 0.81), favors SJW

Moderate^a

 Serious adverse events

4 RCTs, N = 805

OR 0.62 (0.05, 5.46) n.s.

Low^a,b

 Gastrointestinal/metabolic/nutritional adverse events

15 RCTs, N = 2491

OR 0.43 (0.34, 0.55) favors SJW

Low^a,b

 Neurologic/nervous system adverse events

15 RCTs, N = 2492

OR 0.29 (0.24, 0.36) favors SJW

Low^a,b

 Skin/musculoskeletal adverse events

10 RCTs, N = 1587

OR 1.18 (0.79, 1.78) n.s.

Low^a,b

 Respiratory/infectious adverse events

2 RCTs, N = 352

OR 1.25 (0.70, 2.25) n.s.

Very low^a,b

 Other organ system (eye, ear, liver, renal, reproductive) adverse events

4 RCTs, N = 761

OR 0.85 (0.52, 1.38), n.s.

Low^a,b

 Cardiovascular adverse events

5 RCTs, N = 750

OR 0.55 (0.26, 1.16), n.s.

Low^a,b

 Psychiatric adverse events

4 RCTs, N = 552

OR 0.41 (0.19, 0.87) favors SJW

Very low^a,b

 Sexual dysfunction adverse events

2 RCTs, N = 301

OR 0.51 (0.30, 0.88) favors SJW

Low^a,b

 Depression, treatment responders

18 RCTs, N = 2922

Meta-regression did not suggest differences between patient subgroups

(p = 0.798)

Very low^a,c

 Depression scale score

16 RCTs, N = 2888

Meta-regression did not suggest differences between patient subgroups

(p = 0.365)

Very low^a,c

 Depression remission

9 RCTs, N = 1507

Meta-regression did not suggest differences between patient subgroups

(p = 0.159)

Very low^a,c

 Number of patients with adverse events

13 RCTs, N = 2600

Meta-regression did not suggest differences between patient subgroups

(p = 0.480)

Very low^a,c