A meta-analysis was performed to reevaluate the effectiveness of Hypericum perforatum as an antidepressant. Funnel plot analysis and meta-regression to assess the impact of publication bias, small-study effects and variation in trial characteristics were performed. The authors conducted two analyses: a reproduction of a recent meta-analysis including 15 studies (Meta-15) and a meta-analysis extended by the three studies published since then (Meta-18). For both meta-analyses, the authors compared funnel plots, Begg’s rank correlation, Egger’s regression, trim and fill method, and meta-regression. In both analyses, effect sizes in recent studies were smaller than those reported in earlier studies; the addition of more recent studies into the analyses resulted in reduced effect size. In Meta-15, H. perforatum was significantly more effective than placebo with a RR of 1.97 (CI = 1.54 to 2.53). In Meta-18, the RR was reduced to 1.73 (CI = 1.40 to 2.14). On funnel plot analysis, the Meta-18 plot proved to be much more skewed than the Meta-15 plot. Meta-regression showed that increase in effect size was associated with smaller sample size only. The impact of baseline severity of depression could not be evaluated as the studies used different versions of the Hamilton Rating Scale for Depression.