Improvement in delusions and hallucinations in patients with dementia with Lewy bodies upon administration of yokukansan, A traditional Japanese medicine

Department of Traditional Asian Medicine, Graduate School of Medicine, Tohoku University, Sendai Center for Traditional Asian Medicine, Nishitaga National Hospital, Sendai, Miyagi Medical Care Court Clinic, Yokohama Department of Neurology, Juntendo University Koshigaya Hospital, Koshigaya Department of Geriatrics and Gerontology, Institute of Development, Aging and Cancer, Tohoku University, Sendai Okehazama Hospital, Fujita Kokoro Care Center, Toyoake, Aichi Department of Neurology and Neurobiology of Aging, Kanazawa University Graduate School of Medical Science, Kanazawa Department of Psychiatry, Fujita Health University, Toyoake Department of Neurology, Mie University Graduate School of Medicine, Tsu Department of Neurology, Tottori University, Yonago Department of Psychiatry, Shimane University School of Medicine, Izumo Department of Internal Medicine III, Shimane University School of Medicine, Izumo Department of Neuropsychiatry, Neuroscience, Ehime University Graduate School of Medicine, Toon Department of Neurology, Fukuoka University Faculty of Medicine, Fukuoka Houei Clinic, Miyakonojo Department of Psychiatry and Neuropathobiology, Kumamoto University, Kumamoto Kodama Clinic, Tokyo, Japan.
Psychogeriatrics (Impact Factor: 0.99). 12/2012; 12(4):235-241. DOI: 10.1111/j.1479-8301.2012.00413.x
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This multicentre open-label trial examined the efficacy and safety of the traditional Japanese medicine, or Kampo medicine, yokukansan (YKS), for behavioural and psychological symptoms of dementia (BPSD) in patients with dementia with Lewy bodies.

Sixty-three dementia with Lewy bodies patients with probable BPSD (M:W, 30:33; mean age, 78.2±5.8 years) were enrolled and treated with YKS for 4 weeks.

Significant improvements in Neuropsychiatric Inventory scores (mean decrease, 12.5 points; P<0.001) and Zarit Burden Interview-Japanese edition tests (mean decrease, 3.6 points; P=0.024) were observed. In patients who consented to an assessment after 2 weeks of treatment, a time-dependent significant improvement was observed in the Neuropsychiatric Inventory score (n=23; mean decrease, 14.4; P<0.001), each subscale, including delusions and hallucinations, the Zarit Burden Interview-Japanese edition (n=22; mean decrease, 8.2; P<0.01) and the behavioural pathology in Alzheimer's disease insomnia subscale. The Mini-Mental State Examination and the Disability Assessment for Dementia (DAD) showed no significant change. Adverse events were observed in 11 (18%) patients. Three patients (5%) discontinued YKS due to adverse reactions, namely, spasticity and exacerbation of BPSD, edema, and nausea. Hypokalaemia (<3.5 mEq/L) was present in four patients (6%) at the study endpoint. Worsening of extrapyramidal symptoms was not observed.

YKS improved BPSD in dementia with Lewy bodies patients and caregiver burden scores without deterioration in cognitive function. YKS is useful for the treatment of delusions and hallucinations in BPSD.

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Available from: Koh Iwasaki, Oct 10, 2015
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    • "The same group that conducted the original controlled trial in dementia subsequently reported the efficacy of YKS in treating cholinesterase inhibitor-resistant visual hallucinations and neuropsychiatric symptoms of DLB.3 Since that time (late 2005), YKS has become the second-line treatment for DLB in Japan. The efficacy of YKS in DLB was further validated in a larger population (54 patients) by the same group in 2012.11 "
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