Peony-Glycyrrhiza Decoction for Antipsychotic-Related Hyperprolactinemia in Women With Schizophrenia

Man, Sui Cheung; Li, Xian Bin; Wang, Huai Hai; Yuan, Hai Ning; Wang, Hua Ning; Zhang, Rui Guo; Tan, Qing Rong; Wong, Hai Ming; McAlonan, Gráinne; Wang, Chuanyue; Zhang, Zhang Jin

doi:10.1097/jcp.0000000000000607

Cited by 15 publications

(19 citation statements)

References 32 publications

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“…It appears that, while JYP had comparable efficacy in improving estrogen deprivation-induced psychiatric symptoms, JYP may possess a better safety profile than estrogen therapy. Such therapeutic advantages also have been observed in several herbal medicines that contain JYP individual materials in OVX+CUMS mice ( 16 , 17 ) and patients with menopause syndrome and hyperprolactinemia ( 35 , 36 ).…”

Section: Discussionmentioning

confidence: 69%

Jie-Yu Pill, A Proprietary Herbal Medicine, Ameliorates Mood Disorder-Like Behavior and Cognitive Impairment in Estrogen-Deprived Mice Exposed to Chronic Unpredictable Mild Stress: Implication for a Potential Therapy of Menopause Syndrome

et al. 2020

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Jie-Yu Pill (JYP) is a proprietary herbal medicine initially developed to treat menstrual mood disorders. This study sought to determine whether JYP could alleviate menopausal psychiatric symptoms in ovariectomized (OVX) mice, an animal model of estrogen deprivation, exposed to chronic unpredictable mild stress (CUMS) and the underlying mechanisms in comparison with estrogen therapy. The OVX+CUMS mice were treated with 0.3 mg/kg estradiol (E 2), 2.5 g/kg or 5 g/kg JYP for 36 days, and tested in multiple behavioral paradigms. Serum, uterus, and brain tissues were collected for the measurement of hypothalamus-pituitary-ovarian axis (HPO) and hypothalamus-pituitary-adrenal (HPA) axis hormones, γ-aminobutyric acid (GABA), glutamate, neurotrophins, and estrogen receptors. JYP and E 2 had comparable efficacy in reducing anxiety-and depression-like behavior and cognitive impairment of the OVX+CUMS mice. E 2 strikingly increased ratio of uterus to body weight of the OVX+CUMS mice, but JYP did not. Both agents suppressed HPO-axis upstream hormones, inhibited HPA-axis hyperactivity by reinstating hypothalamic GABA, restored hippocampal and prefrontal glutamate contents and its receptor expression in the OVX+CUMS mice. While JYP and E 2 protected against decreases in hippocampal and prefrontal neurotrophins and estrogen receptors of the OVX+CUMS mice, unlike E 2 , JYP had no significant effects on these biomarkers in the uterus. These results suggest that JYP has comparable efficacy in ameliorating mood disorder-like behavior and cognitive impairment induced by a combination of estrogen deprivation and chronic stress in association with certain differential Zhou et al. JYP for Menopause uterus-brain mechanisms compared to estrogen therapy. JYP may be a potential therapy for menopause-associated psychiatric disorders.

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Section: Discussionmentioning

confidence: 69%

Jie-Yu Pill, A Proprietary Herbal Medicine, Ameliorates Mood Disorder-Like Behavior and Cognitive Impairment in Estrogen-Deprived Mice Exposed to Chronic Unpredictable Mild Stress: Implication for a Potential Therapy of Menopause Syndrome

et al. 2020

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“…Previous studies in cultured cells and animals suggested that PGD, a famous traditional Chinese decoction, would be effective in reducing the symptoms of antipsychotics-related hyperprolactinemia [ 16 , 26 , 27 ]. At present, clinical trials have successfully proved that the PGD can significantly reduce the symptoms of hyperprolactinemia caused by antipsychotic drugs [ 19 ]. However, the majority of the studies focused on the hyperprolactinemia induced by Risperidone, Sulpiride, and Olanzapine [ 28 – 30 ]; the data describing the Amisulpride-induced hyperprolactinemia were rare, which may be associated with its infrequent use in clinic.…”

Section: Discussionmentioning

confidence: 99%

“…It suggested that the level of PRL may be related to the regulation of hormones, and the PGD may inhibit the secretion of PRL by regulating the hormones level [ 26 ]. However, some scholars said that although the PGD can improve the symptoms of hyperprolactinemia caused by antipsychotics, the level of PRL did not change significantly [ 19 ]. The possible reason may be related to normalization of sex hormone dysfunction via dopaminergic action upon the hypothalamic-pituitary-gonadal axis [ 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…In recent years, the intervention of Chinese herbs in hyperprolactinemia caused by antipsychotic drugs has been studied. The results showed that Peony-Glycyrrhiza Decoction (PGD) could increase the binding capacity of dopamine receptor, inhibit the secretion of PRL [ 18 ], and significantly reduce the level of Risperidone-induced PRL [ 19 ]. Therefore, in this study, we aimed to observe the clinical effect of PGD on Amisulpride-induced hyperprolactinemia in female schizophrenia patient, then detect the changes of levels of PRL and other related hormones, and assess whether it is safe and reliable or not.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Peony‐Glycyrrhiza Decoction on Amisulpride‐Induced Hyperprolactinemia in Women with Schizophrenia: A Preliminary Study

Yang¹,

Yang³

et al. 2017

Evidence-Based Complementary and Alternative Medicine

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Objective The aim of this study is to observe the effect of Peony-Glycyrrhiza Decoction (PGD) on hyperprolactinemia in women with schizophrenia induced by Amisulpride. Material and Methods A total of 41 female schizophrenia patients receiving Amisulpride were randomly divided into placebo (n = 20) and PGD groups (n = 21). Maintaining the original Amisulpride dose, the two groups were given placebo and PGD, respectively. The levels of Prolactin (PRL) and other hormones were measured on the initial day and at weeks 4 and 8 after treatment. Changes of clinical symptoms in patients with hyperprolactinemia were observed. The PANSS scores were recorded to assess the psychotic symptoms. Results Compared with placebo group, level of PRL decreased while Progesterone increased remarkably in the PGD group at weeks 4 and 8 (p < 0.01), and level of Estradiol in the PGD group increased significantly at week 8 (p < 0.05). There were no differences in PANSS scores and biochemical indexes between two groups at weeks 4 and 8. Conclusion PGD can improve symptoms of hyperprolactinemia and hormone levels in women with schizophrenia caused by Amisulpride, without affecting their mental symptoms and biochemical indexes.

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“…Numerous studies have suggested the existence of therapeutic benefits of TCM for persistent negative symptoms, cognitive impairment, and adverse side effects in schizophrenic patients 31 . It also could alleviate hyperprolactinemia in schizophrenic patients too 32 . However, it is also commonly observed that herbal medicines are accompanied by their own risks, side-effect profile, and in some cases may inadvertently induce psychosis in schizophrenia along with unknown herb-drug interactions 33 .…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Traditional Chinese Medicineas as an Adjunct Therapy for Refractory Schizophrenia: A Systematic Review and Meta Analysis

Wei

Lin

Zhang

et al. 2018

Sci Rep

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Although recent studies focused on traditional Chinese medicine (TCM) for the treatment of refractory schizophrenia have reported that it may be beneficial, there is still lack of convincing evidence and critical meta-analytic work regarding its effectiveness as an adjunctive therapy. Therefore, we performed a meta-analysis to investigate the effectiveness of TCM in combination with antipsychotics for refractory schizophrenia. Fourteen articles involving 1725 patients published as of December 2016 were included which compared antipsychotic therapies to either TCM alone, or TCM as an adjunctive therapy. TCM was observed to have beneficial effects on aspects of the Positive and Negative Syndrome Scale (PANSS) including total score changes and negative score changes, as well as clinical effects estimated with PANSS or the Brief Psychiatric Rating Scale (BPRS). The changes in extrapyramidal side effects (RSESE) scores from baseline to the end of the treatment period were similar in two groups of related trials. TCM was also reported to mitigate some anti-psychotic related side-effects and overall, TCM adjuvant therapy was generally safe and well tolerated. While, the results indicated the potential utility of TCM as an alternative adjunctive therapeutic for refractory schizophrenia treatment, there remains a need for further high-quality studies.

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Peony-Glycyrrhiza Decoction for Antipsychotic-Related Hyperprolactinemia in Women With Schizophrenia

Cited by 15 publications

References 32 publications

Jie-Yu Pill, A Proprietary Herbal Medicine, Ameliorates Mood Disorder-Like Behavior and Cognitive Impairment in Estrogen-Deprived Mice Exposed to Chronic Unpredictable Mild Stress: Implication for a Potential Therapy of Menopause Syndrome

Jie-Yu Pill, A Proprietary Herbal Medicine, Ameliorates Mood Disorder-Like Behavior and Cognitive Impairment in Estrogen-Deprived Mice Exposed to Chronic Unpredictable Mild Stress: Implication for a Potential Therapy of Menopause Syndrome

Effect of Peony‐Glycyrrhiza Decoction on Amisulpride‐Induced Hyperprolactinemia in Women with Schizophrenia: A Preliminary Study

Effectiveness of Traditional Chinese Medicineas as an Adjunct Therapy for Refractory Schizophrenia: A Systematic Review and Meta Analysis

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