We should consider several limitations before accepting the findings of this paper. First, the quality of the included studies is generally moderate according to the quality assessment tool for quantitative Studies (Effective Public Health Practice Project 2007) which was recommended on the Cochrane Handbook. It also indicated that there are moderate risk of bias in most of the trials. Due to inadequate reporting of the allocation sequence, allocation concealment, blinding, intention to treat analysis and drop outs account in the majority of trials, it was possible that there was performance bias and detection bias due to patients and researchers being aware of the therapeutic interventions for the subjective outcome measures. Most of the trials provided limited descriptions of study design, randomization were mentioned but without further details after randomly assignment of patients which do not allow a proper judgment of the conduct of the trials. Therefore, we canot draw a confident conclusion that there are significant beneficial effects in patients with depression on combined groups or xiaoyaosan prescriptions using alone comparing to antidepressants. The number of trials identified limits us to perform meaningful subgroup or sensitivity analyses to illuminate robustness of the results in the review. Sixteen out of twenty-seven trials didnot described the blinding in details, only two trials [12, 15] used double-dummy in their study design.