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Effects of Yokukansan on behavioral and psychological symptoms of dementia in regular treatment for Alzheimer's disease
Authors:Kazunori Okahara  Yasushi Ishida  Yoshihito Hayashi  Teruhiko Inoue  Kazuhito Tsuruta  Kouzou Takeuchi  Hirofumi Yoshimuta  Kouichirou Kiue  Yoshimasa Ninomiya  Jiro Kawano  Kensei Yoshida  Shouji Noda  Seiichiro Tomita  Masumi Fujimoto  Jun Hosomi  Yoshio Mitsuyama
Affiliation:1. Keimei Memorial Hospital, 762 Iwachino, Kunitomi-cho, Higashimorokata, Miyazaki 880-1111, Japan;2. Division of Psychiatry, Department of Clinical Neuroscience, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake-cho, Miyazaki 889-1692, Japan;3. Psychogeriatric Center, Daigo Hospital, 1270 Nagata, Mimata-cho, Kitamorokata, Miyazaki 889-1911, Japan;4. Koga General Hospital, 1749-1 Sudaki, ikeuchi-cho, Miyazaki 880-0041, Japan;5. Fujimoto Hospital, 17-4 Hayasuzu-cho, Miyakonojo, Miyazaki 885-0055, Japan;6. Kyowa Hospital, 1194-3 Zaikohji, Hyuga, Miyazaki 883-0021, Japan;g Yoshida Hospital, 4-8850 Matsubara-machi, Nobeoka, Miyazaki 889-0511, Japan;h Noda Clinic, Wing2-1F, 52 Hagi-machi, Nobeoka, Miyazaki 882-0052, Japan;i Hearty Clinic, 2296-6 Yunokida-machi, Nobeoka, Miyazaki 882-0026, Japan;j Kennan Hospital, 3728 Nishikata, Kusima, Miyazaki 888-0001, Japan;k Heartopia Hosomi Clinic, 1-5-3 Tachibanadoori-nishi, Miyazaki 880-0001, Japan;l Shonan Hospital, 1 Shimokubomachi, oosumi-cho, Soo, Kagoshima 899-8106, Japan
Abstract:Yokukansan (YKS) is used frequently against behavioral and psychological symptoms of dementia (BPSD) together with donepezil in patients with Alzheimer's disease (AD). Here, we investigated the efficacy and safety of YKS in patients with AD in a non-blinded, randomized, parallel-group comparison study. Patients who had at least one symptom score of four or more on the Neuropsychiatric Inventory (NPI) subscales were enrolled in the study. The subjects were randomly assigned to the YKS-treated group (YKS/donepezil combination therapy group) and the non-YKS-treated group (donepezil monotherapy group). TSUMURA Yokukansan (TJ-54, 7.5 g, t.i.d.) was administered in a four-week study treatment period. The subjects were evaluated twice at the start (Week 0) and completion (Week 4) of the study treatment in terms of NPI, Mini-Mental Status Examination (MMSE), Disability Assessment for Dementia (DAD), Zarit Burden Interview, and Self-rating Depression Scale (SDS). The efficacy analysis was performed in 29 patients (YKS-treated group) and 32 patients (non-YKS-treated group). The NPI total score improved significantly more in the YKS-treated group than in the non-YKS-treated group. In the NPI subscales of agitation/aggression and irritability/lability, the YKS-treated group showed significantly greater improvement than the non-YKS-treated group, but no statistically significant improvement was seen with YKS in the other subscales. There were no significant differences between the YKS-treated group and the non-YKS-treated group in MMSE, DAD, Zarit Burden Interview and SDS. No adverse reactions were noted in either group. The results of this study showed that YKS is safe and effective in the treatment of BPSD in AD patients.
Keywords:AD, Alzheimer's disease   ADL, Activities of daily living   BPSD, Behavioral and psychological symptoms of dementia   DAD, Disability Assessment of Dementia   DLB, Dementia with Lewy Bodies   FAST, Functional Assessment Staging   MMSE, Mini-Mental State Examination   NPI, Neuropsychiatric Inventory   SDS, Self-Rating Depression Scale   VaD, Vascular dementia   YKS, Yokukansan
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