Kenji Takeyoshi,1,2 Masatake Kurita,1–3 Satoshi Nishino,2,3 Mika Teranishi,1 Yukio Numata,2 Tadahiro Sato,2 Yoshiro Okubo1
1Department of Psychiatry and Behavioral Science, Graduate School of Medicine, Nippon Clinical School, Bunkyo-ku, Tokyo, 2Sato Hospital, Koutokukai, Nanyo, Yamagata, 3Department of Cellular Signaling, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan
Abstract: Even though 3 drugs, risperidone, yokukansan, and fluvoxamine, have actually revealed equal efficacy in treating behavioral and psychological symptoms of dementia (BPSD) in our previous study, their mechanisms of action are various from one another. Monoamines have actually attracted focus for their crucial roles in mediating numerous behavioral symptoms or psychological symptoms with synaptic signaling. We aimed to clarify the monoamines changed by therapy along with per drug in patients along with BPSD. The main purpose of this study was to find out whether plasma levels of catecholamine metabolites are correlated along with pharmacological treatments. This was an 8-week, rater-blinded, randomized, flexible-dose, triple-demographic trial. In total, 90 subjects were recruited and subsequently 3 various drugs were allocated to 82 inpatients along with BPSD. We examined BPSD data from patients that completed 8 weeks of treatment. Eventually, we analyzed 42 patients (yokukansan: 17; risperidone: 9; fluvoxamine: 16). Homovanillic acid, a metabolite of dopamine, and 3-methoxy-4-hydroxyphenylglycol, a metabolite of noradrenaline, in their plasma were analyzed by high-performance liquid chromatography along with electrochemical detection. every one of 3 drugs reported equal substantial efficacy in between baseline and study endpoint. By contrast, biomarkers reported mutually various changes. Patients in the yokukansan demographic owned greatly minimized plasma homovanillic acid levels from baseline. Conversely, patients in the risperidone and fluvoxamine teams exhibited no substantial modifications in plasma homovanillic acid levels from baseline. Yokukansan has geissoschizine methyl ether, which is known to have actually a partial agonist effect on the subject of dopamine D2 receptors. An improvement in BPSD problem along with the consumption of yokukansan is advised to occur with a suppressed dopaminergic function, which is just like the effect of aripiprazole.
Keywords: herbal medicine, MHPG, homovanillic acid, HVA, noradrenaline, BPSD
