Outcome
    Limited

    Rhodiola Rosea for Mood Stabilization

    Rhodiola trials for depressive symptoms are few and small. One trial found it inferior to sertraline on efficacy but better tolerated. Evidence does not support it as a treatment for a mood disorder.

    Overview

    Rhodiola trials for depressive symptoms are few and small. One trial found it inferior to sertraline on efficacy but better tolerated. Evidence does not support it as a treatment for a mood disorder.

    Verdict

    Insufficient evidence

    How It Works

    Rhodiola rosea contains rosavins and salidroside, which inhibit monoamine oxidase in vitro and appear to slow the breakdown of serotonin, dopamine and noradrenaline. This is the standard explanation for its classification as a mood-supporting adaptogen. It also modulates the HPA axis, with animal work showing attenuated corticosterone responses to stress, and influences heat shock proteins and cellular stress-response pathways. The mechanism suggests an effect on stress-related low mood rather than on the neurobiology of major depression.

    Dosing & Protocol

    Typical dose

    Recommended dose
    Studied at 340-680 mg/day in depression trials; mood stabilization has not been studied and rhodiola may destabilise mood
    Expected timeframe
    Not established

    Protocol

    form
    Rhodiola rosea root extract standardised to 3% rosavins and 1% salidroside
    duration
    Trials in depression ran 6-12 weeks
    co factor
    Evidence is insufficient and there is a specific safety concern. Mood stabilization in clinical usage refers to preventing the mood episodes of bipolar disorder, and no trial has studied rhodiola for this. What exists is a small trial in mild to moderate unipolar depression at 340-680 mg/day showing modest improvement over placebo, and a comparison with sertraline in which rhodiola was less effective but better tolerated. Rhodiola is activating, and case reports and reviews describe agitation, irritability and possible precipitation of hypomania or mania - the opposite of mood stabilisation in the population where the term applies.
    titration
    Not applicable
    starting dose
    Not recommended for this outcome. Depression trials used 340-680 mg/day of standardised extract

    Evidence

    What the studies say

    A randomised trial comparing Rhodiola rosea extract with sertraline and placebo in adults with mild-to-moderate major depressive disorder found that both active treatments reduced Hamilton Depression Rating Scale scores more than placebo, with sertraline producing the larger reduction and rhodiola causing significantly fewer adverse events. A separate Scandinavian trial reported improvement in depressive symptoms with standardised extract over six weeks. Systematic reviews judge the evidence base too small and too heterogeneous to support clinical recommendations, noting high risk of bias and short follow-up. Rhodiola should not be used in place of treatment for a diagnosed mood disorder, and it has theoretical interaction potential with serotonergic medications.

    Rhodiola rosea versus sertraline for major depressive disorder: a randomized placebo-controlled trial

    Score: 8/10
    2015
    rct
    n=57

    Mao JJ, Xie SX, Zee J +4 more

    Modest, albeit statistically non-significant, reductions were observed for HAM-D, BDI, and CGI/C scores for all treatment conditions with no significant difference between groups.

    View source

    Clinical trial of Rhodiola rosea L. extract SHR-5 in the treatment of mild to moderate depression

    Score: 6/10
    2007
    rct
    n=89

    Darbinyan V, Aslanyan G, Amroyan E +3 more

    For individuals in groups A and B, overall depression, together with insomnia, emotional instability and somatization, but not self-esteem, improved significantly following medication, whilst the placebo group showed no improvement.

    View source

    The effects of Rhodiola rosea L. extract on anxiety, stress, cognition and other mood symptoms

    Score: 5/10
    2015
    rct
    n=80

    Cropley M, Banks AP, Boyle J

    Relative to the controls, the experimental group demonstrated a significant reduction in self-reported, anxiety, stress, anger, confusion and depression at 14 days.

    View source

    Safety

    Caveats

    The best-designed depression trial (Mao 2015, n=57, NIH-funded) found no statistically significant separation from placebo; earlier positive results come from manufacturer-affiliated trials.

    Less likely to help if

    Anyone with bipolar disorder - rhodiola may worsen rather than stabilise mood.

    Medical Disclaimer

    The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.

    Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.