Effect of yokukansan on the behavioral and psychological symptoms of dementia in elderly patients with Alzheimer's disease.
OBJECTIVE
The aim of this study was to investigate the effects of yokukansan (YKS) on the behavioral and psychological symptoms of dementia (BPSD) in elderly patients with Alzheimer's disease (AD).


METHODS
Fifteen patients with AD (mean age: 80.2+/-4.0 years) participated in the study. The Mini-Mental State Examination (MMSE) was used for the assessment of cognitive function. BPSD were evaluated using the Neuropsychiatric Inventory (NPI). The Barthel Index was used for the assessment for the activities of daily living (ADL). The treatment with YKS along with sulpiride, a dopamine D(2) selective antipsychotic, was performed for 12 weeks.


RESULTS
Fourteen patients completed the trial. After the 12 weeks of treatment with YKS, significant improvement of the mean NPI score was observed while no significant improvement was observed in the control group. The average dose of sulpiride at the end of the present study was less in the YKS group than in the control group. The MMSE results did not change either in the YKS group or in the control group. The Barthel Index did not significantly change either in the YKS group or in the control group. No serious adverse effects were noted.


CONCLUSIONS
Twelve weeks of the YKS treatment significantly improved BPSD with less antipsychotics in elderly patients with AD. The YKS treatment did not cause any cognitive decline or ADL decline and no serious adverse effects were noted. The present study suggests that YKS is beneficial for the treatment of BPSD and that it can possibly reduce the doses of antipsychotics required for the treatment of BPSD. Further studies with larger patient populations using a double-blind placebo-controlled design should be performed.
Monji
Akira
A
Department of Neuropsychiatry, Graduate School of Medical Sciences, Kysushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. amonji@hf.rim.or.jp
Takita
Masashi
M
Samejima
Takaaki
T
Takaishi
Toshihiro
T
Hashimoto
Kazuhito
K
Matsunaga
Hiroyuki
H
Oda
Mariko
M
Sumida
Yasuhisa
Y
Mizoguchi
Yoshito
Y
Kato
Takahiro
T
Horikawa
Hideki
H
Kanba
Shigenobu
S
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy* / Q000523:psychology*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001519:Behavior / Q000187:drug effects*; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D013469:Sulpiride / Q000627:therapeutic use
D014150:Antipsychotic Agents; D004365:Drugs, Chinese Herbal; C524644:Yi-Gan San; D013469:Sulpiride