Do Japanese herbal remedy help in dementia?Hum Psychopharmacol. 2013 Jan

27.03.2013

Yokukansan (Tsumura TJ-54) is a traditional Japanese medicine. Several studies found that it has a therapeutic role in treating the behavioral and psychological symptoms (BSPD)of dementia. It is thought that it has neuroprotective effect in that it improves glutamate uptake and inhibits glutamate-induced neuronal death . It might also have partial agonistic effect on serotonin (5-HT) 1A receptors.

Yuki Matsuda, Taro Kishi, Hiroto Shibayama and Nakao Iwata from the Department of Psychiatry, Fujita Health University School of Medicine, Japan performed a meta-analysis of Yokukansan for BPSD in patients with dementia. They included 4 RCTs with a total of 236 patients that met the inclusion criteria.The primary measure of efficacy was the change in total NPI (Neuropsychiatric Inventory) score. Sample sizes ranged from 15 to 106 participants. The mean age of the study population was 77 years. Studies included different kinds of dementia.

Findings:

Yokukansan was more efficacious than Usual Care in reducing NPI total scores . Results were not significantly different in trials that were permitted to receive co-treatment. They also found that the active treatment improved the ADL. No differences in discontinuation due to any cause between the Yokukansan and usual care treatment groups .Yokukansan was efficacious in treating symptoms of BPSD including delusions, hallucinations, and agitation/aggression.The funnel plot suggested that publication bias was unlikely (  data  not given ). It is important to note that all trials included in this meta-analysis were  of short duration (4–12 weeks).

Comments: Given the harmful side effects of antipsychotics, investigation in to other remedies is becoming more important.There should be more coordinated global research in to similar agents/products once they are shown to be beneficial in trials.

Summary of the article:

Yokukansan in the treatment of behavioral and psychological symptoms of dementia: a systematic review and meta-analysis ofrandomized controlled trials.

Matsuda Y, Kishi T, Shibayama H, Iwata N. Hum Psychopharmacol. 2013 Jan;28(1):80-6

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