Four trials [9, 17, 19, 23] reported no side effect in the herbal medicine group compared to the antidepressants 10 Evidence-Based Complementary and Alternative Medicine group. Three trials reported side effect in xiaoyaosan group including headache, dizziness, and slightly diarrhea [15, 18, 30] . Fifteen out of eighteen trials reported the combination group has less side effect compare to the antidepressants group. Twelve trials [7, 15-19, 21, 25, 29-31] mentioned the side effect are significant reduced in intervention group compared to control group. Seven trials [7, 16, 18, 21, 25, 30, 31] used treatment-emergent symptom side effect (TESS) scale scores, one trial [15] used asberg side effect scale scores, the rest three trials [17, 19, 29] did not mentioned the tools they used to evaluate the side effect.