title: Improvement in delusions and hallucinations in patients with dementia with Lewy bodies upon administration of yokukansan, a traditional Japanese medicine.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Traditional Asian Medicine, Graduate School of Medicine, Tohoku University, Sendai Center for Traditional Asian Medicine, Nishitaga National Hospital, Sendai, Japan.
authors.forename: Koh
authors.initials: K
authors.lastname: Iwasaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Kosaka
authors.forename: Hideo
authors.initials: H
authors.lastname: Mori
authors.forename: Reina
authors.initials: R
authors.lastname: Okitsu
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Furukawa
authors.forename: Yuta
authors.initials: Y
authors.lastname: Manabe
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yoshita
authors.forename: Aya
authors.initials: A
authors.lastname: Kanamori
authors.forename: Nobuo
authors.initials: N
authors.lastname: Ito
authors.forename: Kenji
authors.initials: K
authors.lastname: Wada
authors.forename: Michio
authors.initials: M
authors.lastname: Kitayama
authors.forename: Jun
authors.initials: J
authors.lastname: Horiguchi
authors.forename: Shuhei
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Shin
authors.initials: S
authors.lastname: Takayama
authors.forename: Ryuji
authors.initials: R
authors.lastname: Fukuhara
authors.forename: Shinji
authors.initials: S
authors.lastname: Ouma
authors.forename: Seigo
authors.initials: S
authors.lastname: Nakano
authors.forename: Mamoru
authors.initials: M
authors.lastname: Hashimoto
authors.forename: Toru
authors.initials: T
authors.lastname: Kinoshita
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003702:Delusions / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D004185:Disability Evaluation; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006212:Hallucinations / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D006801:Humans; D020961:Lewy Body Disease / Q000150:complications* / Q000523:psychology*; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D010936:Plant Extracts / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D004365:Drugs, Chinese Herbal; D010936:Plant Extracts; C524644:Yi-Gan San