Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C


OBJECTIVE: The objective of this systematic review is to determine is Black Cohosh effective for reducing anxiety/depression symptoms in postmenopausal women?

DESIGN: Review of three English language primary randomized controlled studies published from 2005-2009.

DATA SOURCES: Randomized, double blind, placebo-controlled trials comparing Black Cohosh to placebo or hormonal therapies were found using PubMed and Cochrane databases.

OUTCOMES MEASURED: Each of the three trials assessed the efficacy and clinical improvement in anxiety symptoms with the use of Black Cohosh. Studies utilized to measure change in anxiety symptoms included Harrison Anxiety Rating (HAM), Symptom Rating Test (SRT), and Kupperman Test.

RESULTS: Two double-blind randomized controlled trials were included in this review. Results from the Amsterdam et al study indicates that Black Cohosh use had little vasomotor or anxiolytic activity, however the sample size in this study was small. The second study by Nappi et al concluded that after the use of Black Cohosh reduced anxiety/depression as well as vasomotor symptoms in postmenopausal women to the same degree as hormone therapy. The third study by Vermes et al showed a reduction in anxiety/ depression symptoms. The Kupperman index scores also decreased over the duration of the study. All three trials demonstrated that Black Cohosh does contribute reduction in anxiety/depression in menopausal women.

CONCLUSIONS: All of the RCT and Clinical Trial demonstrate that Black Cohosh use is effective at reducing anxiety/depression. Black Cohosh seems to be the same effectiveness as Hormonal therapy available for anxiety/depression in postmenopausal women.