Yokukansan Treatment of Chronic Renal Failure Patients Receiving Hemodialysis, with Behavioral and Psychological Symptoms of Dementia: An Open-Label Study

Sumiyoshi, Hidenori; Mantani, Akio; Nishiyama, Satoshi; Fujiwaki, Soh; Masuda, Yoshikazu; Tomita, Youhei; Tarumoto, Naofumi; Yamawaki, Shigeto

doi:10.1016/j.jagp.2011.06.001

Cited by 12 publications

(17 citation statements)

References 15 publications

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“…YKS has also been found to exert significant therapeutic effects without severe adverse effects on the behavioral symptoms of dementia among chronic renal failure patients receiving hemodialysis three times per week 13. To the best of the authors’ knowledge, the most recent controlled clinical trial was carried out in 2013 in a well-structured study, in which patients were randomized by the trial investigator to preserve rater blinding to a flexible oral dosing regimen of either YKS, risperidone, or fluvoxamine, and demonstrated that YKS improved NPI scores without causing extrapyramidal symptoms and with no significant between-group differences 14…”

Section: Controlled Human Studiesmentioning

confidence: 99%

“…YKS infrequently evoked tiredness13 and oversedation (or drowsiness)2,3,5,7,35 among the elderly and children and adolescents, and more infrequently caused tiredness in other generations 18,19…”

Section: Adverse Effectsmentioning

confidence: 99%

“…Gastrointestinal complaints have been reported in the elderly5,11,13 and the non-elderly;17–19,33,34 however, these complaints are mild and transient. Mild elevation of blood liver enzymes was observed in one case 9…”

Section: Adverse Effectsmentioning

confidence: 99%

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Yokukan-san: a review of the evidence for use of this Kampo herbal formula in dementia and psychiatric conditions

Okamoto¹,

Iyo²,

Ueda³

et al. 2014

NDT

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Japanese traditional herbal medicine (Kampo) has its origins in traditional Chinese medicine (TCM). It was introduced to Japan in the middle of the sixth century and has evolved over the past 1,400 years after combining with Japan’s original folk remedies. While it retains some similarities to TCM, Kampo has evolved in Japan, resulting in a system of medicine that has many differences from TCM. Kampo medicine is considered to be very safe; in Japan, Kampo herbal formulas are manufactured by licensed pharmaceutical companies, prescribed by Western-trained medical doctors (usually as a freeze-dried extract), and have quality control standards similar to those of prescription drugs. The present study examined Yokukan-san (Yi-Gan San in TCM), a Kampo formula that has been used empirically in Japan for more than 400 years. Accumulating clinical trials have demonstrated Yokukan-san’s efficacy in treating patients with behavioral and psychological symptoms of dementia, which has resulted in the Japanese Society of Neurology listing it in the Japanese Guidelines for the Management of Dementia 2010. Efficacy in other diseases and conditions, such as sleep disorders, tardive dyskinesia, aggression, and impulsivity has also been reported. This article reviews both clinical and basic studies of Yokukan-san, with the goal of clarifying its clinical indications.

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Section: Controlled Human Studiesmentioning

confidence: 99%

Section: Adverse Effectsmentioning

confidence: 99%

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Yokukan-san: a review of the evidence for use of this Kampo herbal formula in dementia and psychiatric conditions

Okamoto¹,

Iyo²,

Ueda³

et al. 2014

NDT

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show abstract

“…Moreover, they did not demonstrate any obvious toxic side effects . Yokukansan significantly improved the behavioral and psychological symptoms of dementia in chronic renal failure (CRF) patients receiving HD without critical side effects . Neuronal glutaminase is a potential component of neurotoxicity during inflammation, and modulation of glutaminase may provide therapeutic avenues for neurodegenerative diseases .…”

Section: Interventions For Ckd Frailty and Cognitive Impairmentmentioning

confidence: 99%

“…155 Yokukansan significantly improved the behavioral and psychological symptoms of dementia in chronic renal failure (CRF) patients receiving HD without critical side effects. 156 Neuronal glutaminase is a potential component of neurotoxicity during inflammation, and modulation of glutaminase may provide therapeutic avenues for neurodegenerative diseases. 157 MK-801, which is an N-methyl-D-aspartate receptor antagonist, blocked glutamate production by IL-1 and/or TNF-and alleviated the neurotoxicity associated with these cytokines.…”

Section: Interventions For Ckd and Cognitive Impairmentmentioning

confidence: 99%

Chronic kidney disease‐related physical frailty and cognitive impairment: a systemic review

Shen

Ruan

et al. 2016

Geriatrics Gerontology Int

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Chronic kidney disease is a potential cause of frailty and cognitive impairment. Vascular and non-vascular factors are the possible causes. The mechanism of chronic kidney disease-induced physical frailty and cognitive impairment suggests that multidimensional interventions may be effective therapeutic strategies in the early stage of chronic kidney disease. Geriatr Gerontol Int 2017; 17: 529-544.

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Characteristics of psychiatric patients with hypokalemia after yokukansan administration: A retrospective study

et al. 2023

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Aim: Yokukansan is a Japanese herbal medicine used in psychiatry to treat behavioral and psychological symptoms of dementia and other psychiatric symptoms. However, the glycyrrhizic acid included in this medicine can cause pseudoaldosteronism and hypokalemia. We aimed to identify the risk factors for hypokalemia due to yokukansan.Methods: A retrospective cohort study was conducted on patients previously treated with yokukansan. The risk factors were determined by comparing the hypokalemia group with the non-hypokalemia group for each parameter.Results: This study included 304 patients who received yokukansan treatment between April 2009 and March 2019. We found that 17.4% (n = 53) of the patients experienced yokukansan-induced hypokalemia. Risk factors detected as significantly different between patients with and without yokukansan-associated hypokalemia were low serum potassium concentration before yokukansan administration, dose 7.5 g /day or more, and dementia. Hypokalemia occurred earlier in patients with low albumin, low potassium, and dementia. Conclusion:It is necessary to pay attention to hypokalemia onset when administering yokukansan at 7.5 g or more to patients with low potassium levels and dementia. Our findings suggest that potassium levels must be checked early after yokukansan administration, especially in patients with low albumin, low potassium, and dementia.

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Yokukansan Treatment of Chronic Renal Failure Patients Receiving Hemodialysis, with Behavioral and Psychological Symptoms of Dementia: An Open-Label Study

Cited by 12 publications

References 15 publications

Yokukan-san: a review of the evidence for use of this Kampo herbal formula in dementia and psychiatric conditions

Yokukan-san: a review of the evidence for use of this Kampo herbal formula in dementia and psychiatric conditions

Chronic kidney disease‐related physical frailty and cognitive impairment: a systemic review

Characteristics of psychiatric patients with hypokalemia after yokukansan administration: A retrospective study

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