Every year, an estimated 19 million Americans suffer from depression but about 70% who seek treatment don’t get effective relief using conventional treatments that usually include prescription-required antidepressants such as sertraline (marketed under the brand name Zoloft). Some people just don’t respond well to pharmaceutical therapies, others discontinue treatment due to the sometimes harsh side effects antidepressants produce, and others simply cannot afford conventional therapies.

When conventional therapies fail, for whatever reason, many people experiencing depression turn to alternative or integrative therapies which include herbal remedies. Herbal remedies haven’t been as systematically tested as pharmaceuticals for depression or any ailment, leaving many physicians reluctant to discuss them. One recent study, however, does systematically test an herbal remedy — Rhodiola Rosea (R. rosea), or roseroot — against Zoloft and a placebo.

The results of the study, conducted by Dr. Jun J. Mao, an associate professor of Family Medicine, Community Health, and Epidemiology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, found roseroot to be almost as effective in treating mild to moderate major depressive disorder (MDD) but with far fewer adverse side effects that turn patients away.

Rhodiola Rosea

Mao was not working with extract of ornamental roses (Rosaceae) that adorn so many yards and public spaces in temperate climates. Her study involved a succulent flowering plant native to cold regions such as Alaska, the Arctic, and the northernmost regions of Europe and Asia.

Roseroot has been used for thousands of years to prevent altitude sickness, increase stamina, and improve physical endurance in cold, stress-filled climates.

Mao’s Study

Mao and her research team recruited 57 adult volunteers to undergo a 12-week study in which each would be randomly assigned roseroot, sertraline, or a powdered milk-sugar placebo, all of which were presented in look-alike capsules. Each study participant was otherwise healthy except for diagnosis with MDD based on results of three commonly used diagnostic tests. None were taking any antidepressants, mood stabilizers, or any other drugs commonly prescribed for MDD.

For the first two weeks of study, each participant took one assigned capsule per day. At the 2-week mark, patients again took the depression evaluation tests and those who scored no higher than 50% improvement from their baseline scores had dosage doubled to two capsules per day. Assessment and dosage adjustments continued every two weeks until week 6, after which dosages remained the same for the remaining six weeks of study.

By week 8, thirteen participants withdrew from the study:

  • 2 discontinued because of adverse events (both were in the Zoloft group).
  • 1 withdrew consent.
  • 6 simply dropped out, no reason given.
  • 4 discontinued because their assigned treatment proved ineffective.

Improvement of Symptoms

The participants taking Zoloft did improve their test scores more than those in the roseroot and placebo groups but not by a margin considered statistically significant. When compared at week 12 with the placebo group:

  • The Zoloft group exhibited 1.9 times the likelihood for improvement of symptoms.
  • The roseroot group exhibited 1.4 times the likelihood for improvement.

Rate of Adverse Events

Adverse events were reported in all three study groups although no adverse events were serious enough to require medical interventions:

  • 63.2% in the Zoloft group reported adverse side effects.
  • 30.0% in the roseroot group reported adverse events.
  • 16.7% in the placebo group reported adverse events.

No participants in the roseroot or placebo groups left the study because of adverse events. The two participants who withdrew from the study after taking Zoloft did so due to undesirable side effects which included palpitations, headache, insomnia, and sexual dysfunction.


  1. Mao, Jun J. "Rhodiola rosea versus sertraline for major depressive disorder: A randomized placebo-controlled trial." Phytomedicine 22.3 (2015): 394-99. Science Direct / Elsevier BV. Web. 7 Apr. 2015.
  2. "Sertraline." MedlinePlus. National Institutes of Health, 15 Nov. 2014. US National Library of Medicine. Web. 7 Apr. 2015.
  3. "Diseases & Conditions: Alternative Therapies for Depression." Cleveland Clinic. The Cleveland Clinic Foundation, n.d. Web. 7 Apr. 2015.