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Adjunctive Yokukansan Treatment Improved Cognitive Functions in a Patient With Schizophrenia
Shinji Sakamoto, M.D.; Hiroshi Ujike, M.D., Ph.D.; Manabu Takaki, M.D., Ph.D.; Yutaka Mizuki, M.D.; Yuko Okahisa, M.D., Ph.D.; Masafumi Kodama, M.D., Ph.D.; Yosuke Uchitomi, M.D., Ph.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2013;25:E39-E40. doi:10.1176/appi.neuropsych.12070166
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This study was supported in part by a grant from the Zikei Institute of Psychiatry.

Statement of Interest: None

Dept. of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences Okayama City, Japan

Correspondence: Dr. Sakamoto; e-mail: shinjisakamoto1202@gmail.com

Copyright © 2013 American Psychiatric Association


To the Editor: Yokukansan, a traditional Asian herbal medicine, is reported to be safe and effective for behavioral and psychological symptoms of dementia in randomized, controlled trials, and is widely prescribed for patients with dementia in Japan.1 A recent open-label study indicates that adjunctive yokukansan administration in treatment-resistant schizophrenia improved the positive and negative symptoms of schizophrenia.2 In this report, we present a case of schizophrenia in which adjunctive yokukansan treatment dramatically improved severe cognitive dysfunction.

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FIGURE 1. Changes in BACS–J Scores With Yokukansan Treatment

Black bar shows the Z score before yokukansan treatment; gray bar shows the Z score after yokukansan treatment. [A]: verbal memory; [B]: working memory; [C]: motor speed; [D]: verbal fluency; [E]: attention and processing speed; [F]: executive function.



Mizukami  K;  Asada  T;  Kinoshita  T  et al:  A randomized cross-over study of a traditional Japanese medicine (kampo), yokukansan, in the treatment of the behavioural and psychological symptoms of dementia.  Int J Neuropsychopharmacol 2009; 12:191–199
[CrossRef] | [PubMed]
Miyaoka  T;  Furuya  M;  Yasuda  H  et al:  Yi-gan san as adjunctive therapy for treatment-resistant schizophrenia: an open-label study.  Clin Neuropharmacol 2009; 32:6–9
[CrossRef] | [PubMed]
Terawaki  K;  Ikarashi  Y;  Sekiguchi  K  et al:  Partial agonistic effect of yokukansan on human recombinant serotonin 1A receptors expressed in the membranes of Chinese hamster ovary cells.  J Ethnopharmacol 2010; 127:306–312
[CrossRef] | [PubMed]
Egashira  N;  Iwasaki  K;  Ishibashi  A  et al:  Repeated administration of Yokukansan inhibits DOI-induced head-twitch response and decreases expression of 5-hydroxytryptamine (5-HT)2A receptors in the prefrontal cortex.  Prog Neuropsychopharmacol Biol Psychiatry 2008; 32:1516–1520
[CrossRef] | [PubMed]
Kawakami  Z;  Kanno  H;  Ueki  T  et al:  Neuroprotective effects of yokukansan, a traditional Japanese medicine, on glutamate-mediated excitotoxicity in cultured cells.  Neuroscience 2009; 159:1397–1407
[CrossRef] | [PubMed]
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