Yokukansan and its ingredients as possible treatment options for schizophrenia

Chuan-Hsun Yu,¹ Ryouhei Ishii,² Shun-Chieh Yu,¹ Masatoshi Takeda<sup>2

1</sup>Yuli Hospital, Department of Health, Hualien, Taiwan; ²Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan

Abstract: Schizophrenia is a debilitating psychotic mental disorder that affects almost the entire range of human mental function. The devastating effect of the illness is usually long-lasting and requires lifelong treatment. Despite an evolved psychopharmacological understanding, the overall therapeutic effect of antipsychotics is still not satisfactory. The choice of proper medication presents a clinical dilemma between efficacy and safety. As a result, searching for comparable treatment options with safer profiles is very important. Yokukansan (TJ-54), also called yi-gan san in Chinese, is a traditional herbal medicine with evident therapeutic effect for neuropsychiatric disorders. There are several open-label clinical studies upholding the possibility of using yokukansan to treat schizophrenia or schizophrenia-like psychosis. Evidence from animal studies and neurobiology also sheds light on the antipsychotic implications of yokukansan and its ingredients. Nevertheless, correlations between the experimental environment and clinical settings may be complicated by a number of confounders. Clinical trials with more sophisticated designs are required to fill the gap between the experimental environment and clinical settings.

Keywords: herbal medicine, geissoschizine methyl ether, glycyrrhizin, antipsychotics, D2 receptor