Written by Halima Phelps, Staff Writer. Compared to those taking placebo, patients taking Rhodiola rosea experienced less side effects and had 1.4 times the odds of improvement in depression by week 12 of treatment, while patients on sertraline had 1.9 times the odds of improvement in depression.
Sertraline is a pharmacological agent that is known for its use in antidepressant cases. Many know the drug by its brand name, Zoloft, but sertraline hydrochloride has had implications in many other conditions including “depressive disorders, anxiety disorders, substance abuse, eating disorders, somatoform disorders, and chronic fatigue syndrome”1.The mechanism of action (MOA) by which sertraline works is as an SSRI, or selective serotonin reuptake inhibitor; which is the MOA of many antidepressant medications. It increases the time that the neurological synapses have exposure to serotonin, thereby increasing mood 1. Although many have found sertraline helpful, it does not come without side effects, which could include various distresses of the gastrointestinal system, nervous system, sleep and reproductive dysfunction such as diarrhea and nausea, akathisia, insomnia, and delayed seminal release.1 Since many patients find the side effects disturbing, it is worthwhile to find alternatives to the medication, and Rhodiola rosea (R. rosea), also known as roseroot or goldenroot, of the Crassulaceae family was chosen as a candidate for this study. The authors hypothesize that R. rosea would have similar therapeutic effects but less adverse events than sertraline 2.
In this randomized, double-blind, placebo-controlled 12 week study2, 57 study participants 18 years of age or older, were randomized into three groups [R. rosea (n=20), sertraline (n=19) and placebo (n=18)]. They were given identically-appearing capsules of either 340 mg of pharmaceutical grade R. rosea or sertraline 50 mg HCl, or a placebo in escalating doses of one capsule per day the first two weeks, followed by 2 capsules per day in weeks 3 and 4, and 3 capsules per day for 5th and 6th week. Changes in Hamilton Depression Rating (HAM- D), Beck Depression Inventory (BDI), and Clinical Global Impression Change (CGI/C) scores were used to detect changes in depression during the 12-week study.
Results revealed no statistically significant differences in the HAM-D 17 score in participants during this 12-week study (p=0.79). Compared to R. rosea and placebo, sertraline had a greater but non-significant decrease in the HAM-D 17 score (-8.2, 95% confidence interval (CI), -12.7 to -3.6), R. rosea (-5.1, 95% CI: -8.8 to -1.3) and placebo (-4.6, 95% CI: -8.6 to -0.6). While there was a clinically important change in improvement by week 12 with sertraline and R. rosea vs. placebo at 1.90 (0.44-8.20) and 1.39 (0.38-5.04) respectively, there were also more accounts of adverse events with the ingestion of sertraline vs. R. rosea, (63.2% vs. 30.0% respectively, and 16.7% with placebo).
Future studies of larger sample size and longer duration are warranted. Although sertraline was more effective in the treatment of depression, R. rosea, can be considered as a viable natural alternative for those desiring an unconventional and less symptomatic treatment for depression.2
Source: Mao, Jun J., Sharon X. Xie, Jarcy Zee, Irene Soeller, Qing S. Li, Kenneth Rockwell, and Jay D. Amsterdam. “Rhodiola rosea versus sertraline for major depressive disorder: A randomized placebo-controlled trial.” Phytomedicine 22, no. 3 (2015): 394-399.
© 2015 Elsevier GmbH. All rights reserved.
Posted August 22, 2018.
References:
- Khouzam HR, Emes R, Gill T, Raroque R. The antidepressant sertraline: a review of its uses in a range of psychiatric and medical conditions. Comprehensive therapy. 2003;29(1):47-53.
- Mao JJ, Xie SX, Zee J, et al. Rhodiola rosea versus sertraline for major depressive disorder: A randomized placebo-controlled trial. Phytomedicine. 2015;22(3):394-399.
