A review of frequently used Kampo prescriptions. Part 3. Yokukansan

Abstract

BackgroundThe source of yokukansan (YKS) is thought to be Baoying‐Jinjiang (Hoeikinkyōroku in Japanese) by Xue Ji. YKS was originally designed for children and indicated for spasms, clenching of teeth, digestive dysfunction due to mental instability, and insomnia.Key FindingsYKS formula consists of seven types of crude drugs. Clinical studies have revealed that YKS exerts physiological effects including the treatment of behavioral and psychiatric symptoms of dementia (BPSD), preoperative sedation and anxiety, and postoperative delirium. A meta‐analysis showed that YKS could improve BPSD and daily living activities; however, no improvement in cognitive function was observed. Preclinical studies have also reported that YKS modulates neuronal pathways in the central nervous system, including the serotonergic, glutamatergic, GABAergic, and other neurotransmitter pathways. The incidence of adverse events associated with YKS was 5.17%, with the major adverse effect being pseudoaldosteronism. Routine blood sampling is considered for hypokalemia prevention.ConclusionYKS is useful for BPSD and perioperative mental instability. The modulation of the serotonergic and glutamatergic neural pathways is one of mechanisms. Pseudoaldosteronism is one of the side effects.

Conference report: Fourth annual young researcher forum of the Japan Society of Medical and Pharmaceutical Sciences for Traditional Medicine

“…This study aimed to investigate the efficacy of yokukansan in alleviating pain and psychiatric symptoms in patients with cancer undergoing treatment. Yokukansan has inhibitory effects on neuropathic pain and opioid analgesic tolerance in animal experiments and has been reported to improve irritability and sleep disorders in cancer patients [4][5][6]. Although there are reports of its analgesic effects in basic research and case studies, clinical studies validating these effects are scarce.…”

Use of Japanese Herbal Kampo Medicine in Patients With Acute Cardiovascular Disease ― A 12-Year Nationwide Cohort Analysis ―

“…34 Hence, it may be relatively common to use Daikenchuto in patients with cardiovascular disease. Yokukansan is useful for improving behavioral and psychological symptoms of dementia (BPSD), 35 according to previous randomized trials 36,37 and meta-analyses. 38,39 Although the effects of Yokukansan on the occurrence of delirium in patients without a prior diagnosis of dementia remain unknown, physicians' experiences with Yokukansan for BPSD may have led to its use for delirium or BPSDlike symptoms in patients with cardiovascular disease.…”