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Regular Research Article| Volume 21, ISSUE 11, P1082-1085, November 2013

Yokukansan Treatment of Chronic Renal Failure Patients Receiving Hemodialysis, with Behavioral and Psychological Symptoms of Dementia: An Open-Label Study

Published:March 13, 2013DOI:https://doi.org/10.1016/j.jagp.2011.06.001

      Objective

      The efficacy and safety of yokukansan (YKS) for chronic renal failure (CRF) patients receiving hemodialysis with behavioral and psychological symptoms of dementia (BPSD) was evaluated.

      Methods

      Twelve CRF patients receiving hemodialysis with BPSD were recruited and 7.5 g of YKS powder was added to ongoing therapy with antipsychotics. Neuropsychiatric Inventory (NPI) criteria and Barthel Index before and after 4-week YKS treatment were compared.

      Results

      Analysis of the mean score for NPI revealed a significant improvement during the period of YKS administration (25.3 ± 17.6 versus 8.36 ± 4.46; p = 0.0069). The mean score for the Barthel Index showed no significant difference during the period of YKS administration. Mean level of serum potassium was still within the normal range. No subjects had severe adverse reactions necessitating discontinuation from the study.

      Conclusion

      Yokukansan significantly improved the symptoms of BPSD in CRF patients receiving hemodialysis without critical side effects.

      Key Words

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      References

        • Fukunishi I.
        • Kitaoka T.
        • Shirai T.
        • et al.
        Psychiatric disorders among patients undergoing hemodialysis therapy.
        Nephron. 2002; 91: 344-347
        • Griva K.
        • Stygall J.
        • Hankins M.
        • et al.
        Cognitive impairment and 7-year mortality in dialysis patients.
        Am J Kidney Dis. 2010; 56: 693-703
        • Shinno H.
        • Inami Y.
        • Inagaki T.
        • et al.
        Effect of Yi-Gan San on psychiatric symptoms and sleep structure at patients with behavioral and psychological symptoms of dementia.
        Prog Neuropsychopharmacol Biol Psychiatry. 2008; 32: 881-885
        • Sanga M.
        • Shigemura J.
        Pharmacokinetics of haloperidol in patients on hemodialysis.
        Nihon Shinkei Seishin Yakurigaku Zasshi. 1998; 18: 45-47
        • Kamo T.
        • Horikawa N.
        • Tsuruta Y.
        • et al.
        Efficacy and pharmacokinetics of fluvoxamine maleate in patients with mild depression undergoing hemodialysis.
        Psychiatry Clin Neurosci. 2004; 58: 133-137
        • Berlyne G.M.
        • Janabi K.
        • Shaw A.B.
        Dangers of resonium A in the treatment of hyperkalemia in renal failure.
        Lancet. 1966; 1: 167
        • Iwasaki K.
        • Maruyama M.
        • Tomita N.
        • et al.
        Effects of the traditional Chinese herbal medicine Yi-Gan San for cholinesterase inhibitor-resistant visual hallucinations and neuropsychiatric symptoms in patients with dementia with Lewy bodies.
        J Clin Psychiatry. 2005; 66: 1612-1613
        • Miyaoka T.
        • Furuya M.
        • Yasuda H.
        • et al.
        Yi-gan san for the treatment of borderline personality disorder: an open-label study.
        Prog Neuropsychopharmacol Biol Psychiatry. 2008; 32: 150-154
        • Miyaoka T.
        • Furuya M.
        • Yasuda H.
        • et al.
        Yi-gan san for the treatment of neuroleptic-induced tardive dyskinesia: an open-label study.
        Prog Neuropsychopharmacol Biol Psychiatry. 2008; 32: 761-764
        • Hayashi Y.
        • Ishida Y.
        • Inoe T.
        • et al.
        Treatment of behavioral and psychological symptoms of Alzheimer-type dementia with Yokukansan in clinical practice.
        Prog Neuropsychopharmacol Biol Psychiatry. 2010; 34: 541-545
        • Takeda A.
        • Itoh H.
        • Tamano H.
        • et al.
        Suppressive effect of Yokukansan on excessive release of glutamate and aspartate in the hippocampus of zinc-deficient rats.
        Nutr Neurosci. 2008; 11: 41-46
        • Mizoguchi K.
        • Tanaka Y.
        • Tabira T.
        Anxiolytic effect of a herbal medicine, yokukansan, in aged rats: involvement of serotonergic and dopaminergic transmissions in the prefrontal cortex.
        J Ethnopharmacol. 2010; 127: 70-76
        • Turnamian S.G.
        • Binder H.J.
        Regulation of active sodium and potassium transport in the distal colon of the rat. Role of the aldosterone and glucocorticoid receptors.
        J Clin Invest. 1989; 84: 1924
        • Ishida S.
        • Sakiya Y.
        • Ichikawa T.
        • et al.
        Binding of glycyrrhizin to human serum and human serum albumin.
        Chem Pharm Bull (Tokyo). 1989; 37: 226
        • Carlat L.E.
        • Margraf H.W.
        • Weathers H.H.
        • et al.
        Human metabolism of orally ingested glycyrrhetinic acid and monoammonium glycyrrhizinate.
        Proc Soc Exp Biol Med. 1959; 102: 245
        • Khedr E.
        • Abdelwhab S.
        • El-Sharkawy M.
        • et al.
        Prevalence of hyperkalemia among hemodialysis patients in Egypt.
        Ren Fail. 2009; 31: 891-898