Yokukansan and its ingredients as possible treatment options for schizophrenia

Figures & data

Table 1 Components of yokukansan

Constituent herb	Ratio of constituent*
Angelica acutiloba L. (roots)	3
Atractylodes lancea DC. (roots)	4
Bupleurum falcatum L. (roots)	2
Poria cocos Wolf. (fungus)	4
Glycyrrhiza uralensis (roots)	1.5
Cnidium officinale Makino (roots)	3
Uncaria rhynchophylla Schreb. (hooks)	3

Note:

* These are the ratios relative to each other.

Table 2 Clinical trials using yokukansan for patients with schizophrenia and schizophrenia-like psychosis

Study, year	Sample size and study design	Average daily dosage (g/day) mean ± standard deviation	Assessment	Adverse events
Miyaoka,^Citation33 2008	13 males 9 females Mean age: 57.1 years 12-week open-label study Adjunctive therapy	7.5	AIMS (12.1±2.2–>1.6±1.3)** PANSS: Positive (22.2±4.2–>16.6±3.1)**   Negative (26.5±6.3–>14.5±2.3)**   General (42.9±6.7–>25.0±4.9)** CGI-S (4.86±0.9–>1.73±0.6)**	Nausea and constipation (2 cases)
Miyaoka,^Citation34 2009	Treatment group  16 males  18 females  Mean age: 45.5 years Control group  10 males  15 females  Mean age: 45.2 years 4-week open-label control study Adjunctive therapy	6.7±2.5	PANSS: Positive (27.7±6.1–>11.9±3.7)**   Negative (30.4±5.8–>18.2±2.2)**   General (65.1±5.4–>39.6±6.9)** DIEPSS (7.8±4.7–>6.9±4.1)	Nausea (2 cases) Tiredness (1 case)
Miyaoka,^Citation35 2009	A 2-week-treatment case report Monotherapy	7.5	Self-report	No adverse events reported
Miyaoka,^Citation36 2011	7 males 13 females Mean age: 66.3 years 4-week open-label study Monotherapy	5.8±2.6	NPI (20.4±2.4–>5.4±1.5)** HS-PANSS (6.4±2.4–>1.6±1.2)** CGI (4.5±1.8–>1.3±0.3)**	Nausea (3 cases)
Miyaoka,^Citation38 2013	20 males 20 females Mean age: 73.1 years 4-week open-label study Monotherapy	Baseline 5.02±1.06 week 4 5.23±1.22	BPRS (36.7±4.65–>20.1±1.6)* CGI-S (5.03±0.89–>1.73±0.55)* PANSS (66.0±7.3–>34.3±2.2)* Simpson-Angus Scale (0.27±0.45–>0.15±0.36) Barnes Akathisia Rating Scale (0.20±0.41–>0.13±0.34) AIMS (0.23±0.42–>0.18±0.39)	Tremor (3 cases)

Notes:

* P<0.001,

** P<0.0001.

Abbreviations: AIMS, Abnormal Involuntary Movement Scale; BPRS, Brief Psychiatric Rating Scale; CGI, Clinical Global Impression; CGI-S, CGI-Severity; DIEPSS, Drug-Induced Extrapyramidal Symptom Scale; HS-PANSS, hallucination subscale of the PANSS; NPI, Neuropsychiatric Inventory; PANSS, Positive and Negative Symptom Scale.

Figure 1 Chemical structure of geissoschizine methyl ether.

Notes: Molecular formula: C₂₂H₂₆N₂O₃. Molecular weight: 366.4534 g/mol.

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