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5 points, 95 CI 2. 96 to 14. 03, p 0. 002, ETCD only mean difference, 5. 9 points, 95 CI, 0. 36 to 11. 43, p 0. 03 and placebosham ETCD mean difference, 11. 5 points, 95 CI, 6. 03 to 17. 10; P 0. 001. The analysis of ETCD versus sertraline showed comparable efficacies difference 2. 6 points, 95 CI -2. 90 to 8. 13, p 0. The use of ETCD alone but not sertraline alone was superior to placebosham ETCD. The most frequent adverse effects did not differ between the interventions, with the exception of skin redness on the scalp for the active ETCD regimen P 0.