1
|
Li S, Hou Z, Ye T, Song X, Hu X, Chen J. Saponin components in Polygala tenuifolia as potential candidate drugs for treating dementia. Front Pharmacol 2024; 15:1431894. [PMID: 39050746 PMCID: PMC11266144 DOI: 10.3389/fphar.2024.1431894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024] Open
Abstract
Objective This study aims to elucidate the intervention effects of saponin components from Polygala tenuifolia Willd (Polygalaceae) on dementia, providing experimental evidence and new insights for the research and application of saponins in the field of dementia. Materials and Methods This review is based on a search of the PubMed, NCBI, and Google Scholar databases from their inception to 13 May 2024, using terms such as "P. tenuifolia," "P. tenuifolia and saponins," "toxicity," "dementia," "Alzheimer's disease," "Parkinson's disease dementia," and "vascular dementia." The article summarizes the saponin components of P. tenuifolia, including tenuigenin, tenuifolin, polygalasaponins XXXII, and onjisaponin B, as well as the pathophysiological mechanisms of dementia. Importantly, it highlights the potential mechanisms by which the active components of P. tenuifolia prevent and treat diseases and relevant clinical studies. Results The saponin components of P. tenuifolia can reduce β-amyloid accumulation, exhibit antioxidant effects, regulate neurotransmitters, improve synaptic function, possess anti-inflammatory properties, inhibit neuronal apoptosis, and modulate autophagy. Therefore, P. tenuifolia may play a role in the prevention and treatment of dementia. Conclusion The saponin components of P. tenuifolia have shown certain therapeutic effects on dementia. They can prevent and treat dementia through various mechanisms.
Collapse
Affiliation(s)
- Songzhe Li
- College of Basic Medicine, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Zhitao Hou
- College of Basic Medicine, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ting Ye
- The Second Hospital Affiliated Heilongjiang University of Traditional Chinese Medicine, Harbin, China
| | - Xiaochen Song
- College of Basic Medicine, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xinying Hu
- College of Basic Medicine, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Jing Chen
- College of Basic Medicine, Heilongjiang University of Chinese Medicine, Harbin, China
| |
Collapse
|
2
|
Takayama S, Yamanaka T. Intractable cough and hiccups after resuscitation and acute coronary syndrome treatment successfully treated using the Kampo medicine bukuyoingohangekobokuto: A case report. Explore (NY) 2024; 20:103001. [PMID: 38688807 DOI: 10.1016/j.explore.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 04/16/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Even in patients who survive resuscitation through multidisciplinary treatment, minor persistent symptoms can make hospital discharge difficult. Herein, we report a case of myocardial infarction with intractable symptoms following resuscitation, which were successfully treated using Kampo medicine. CASE PRESENTATION A 71-year-old man experienced intractable cough and hiccups following resuscitation for acute myocardial infarction. Despite successful invasive treatment for his cardiac condition, the patient's persistent symptoms hindered his recovery and discharge from hospital. The patient was diagnosed with qi and blood deficiency, qi stagnation, and fluid retention, before being prescribed the Kampo medicine "bukuryoingohangekobokuto (BRIHK)". Within days of treatment initiation, his symptoms notably improved, allowing him to be discharged. CONCLUSION This case highlights the potential of Kampo medicine for addressing post-resuscitation symptoms that are refractory to conventional treatments, and emphasizes the importance of integrating Kampo medicine with Western medical practices to enhance patient care and quality of life.
Collapse
Affiliation(s)
- Shin Takayama
- Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, 1-2, Seiryo-machi, Aoba ward, Sendai, 980-8575, Japan; Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, 1-1, Seiryo-machi, Aoba ward, Sendai, 980-8574, Japan.
| | - Tamon Yamanaka
- Department of circulation, Japanese Red Cross Ishinomaki Hospital, 71, hebita-aza-nisimichishita, Ishinomaki city, Miyagi, 986-8522, Japan
| |
Collapse
|
3
|
Takayama S, Ishii T. Kampo medicine bukuryoingohangekobokuto and ninjin'yoeitoyoeito as supportive care for management of anorexia and tightness of the esophagus in advanced esophageal cancer: A case report. Explore (NY) 2023; 19:256-259. [PMID: 35232681 DOI: 10.1016/j.explore.2022.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/05/2022] [Accepted: 02/14/2022] [Indexed: 12/20/2022]
Affiliation(s)
- Shin Takayama
- Department of Education and Support for Regional Medicine (General and Kampo medicine), Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
| | - Tadashi Ishii
- Department of Education and Support for Regional Medicine (General and Kampo medicine), Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
| |
Collapse
|
4
|
Allameh M, Orsat V. Herbal Anxiolytics: Sources and Their Preparation Methods. FOOD REVIEWS INTERNATIONAL 2022. [DOI: 10.1080/87559129.2022.2043895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Mina Allameh
- Department of Bioresource Engineering, McGill University, Ste-Anne-de-Bellevue, Québec, Canada
| | - V. Orsat
- Department of Bioresource Engineering, McGill University, Ste-Anne-de-Bellevue, Québec, Canada
| |
Collapse
|
5
|
Takayama S, Arita R, Kikuchi A, Ishii T. Bukuryoingohangekobokuto may improve recurrent aspiration pneumonia in patients with brain damage and reduce the caregiver burden. J Family Med Prim Care 2021; 10:558-560. [PMID: 34017789 PMCID: PMC8132824 DOI: 10.4103/jfmpc.jfmpc_1627_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/06/2020] [Accepted: 10/28/2020] [Indexed: 11/04/2022] Open
Abstract
A 17-year-old girl with hypoxic encephalopathy was hospitalized over four times in a year because of recurrent aspiration pneumonia (AP). She had dysphagia and reduced cough reflex as sequelae of brain damage. To prevent aspiration, a gastric tube was placed for feeding, but it did not reduce the frequency of AP because the gastroesophageal reflux caused backflow. However, after the Kampo medicine bukuryoingohangekobokuto (BRIHK) was added to the prescriptions, her sputum and gastroesophageal reflux was remarkably reduced. BRIHK is a Kampo medicine that confers multiple benefits such as improving swallowing and cough reflexes, reducing sputum, and improving gastric emptying. Subsequently, the frequency of sputum suction reduced from every 15 min to 30 min, thus reducing the burden on her mother. As a result, she has never been hospitalized for AP in the 7 years after treatment. Overall, BRIHK may be a treatment of choice for similar patients.
Collapse
Affiliation(s)
- Shin Takayama
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, Seiryo-machi 1-1, Aoba-ku, Sendai, Miyagi, Japan.,Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Seiryo-machi 1-1, Aoba-ku, Sendai, Miyagi, Japan
| | - Ryutaro Arita
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, Seiryo-machi 1-1, Aoba-ku, Sendai, Miyagi, Japan.,Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Seiryo-machi 1-1, Aoba-ku, Sendai, Miyagi, Japan
| | - Akiko Kikuchi
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, Seiryo-machi 1-1, Aoba-ku, Sendai, Miyagi, Japan.,Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Seiryo-machi 1-1, Aoba-ku, Sendai, Miyagi, Japan
| | - Tadashi Ishii
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, Seiryo-machi 1-1, Aoba-ku, Sendai, Miyagi, Japan.,Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Seiryo-machi 1-1, Aoba-ku, Sendai, Miyagi, Japan
| |
Collapse
|
6
|
Takayama S, Tomita N, Arita R, Ono R, Kikuchi A, Ishii T. Kampo Medicine for Various Aging-Related Symptoms: A Review of Geriatric Syndrome. Front Nutr 2020; 7:86. [PMID: 32766269 PMCID: PMC7381143 DOI: 10.3389/fnut.2020.00086] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 05/12/2020] [Indexed: 12/12/2022] Open
Abstract
With the continued growth of the aging population in Japan, geriatric syndrome (GS), which is associated with aging-related symptoms, has become a social problem. GS is caused by physiological and pathological aging and may manifest various symptoms. Physicians use multidisciplinary approaches to provide treatment for individual GS symptoms. Kampo medicine, a Japanese traditional medicine that uses multiple pharmacologically active substances, is useful for many syndromes, conditions, disorders, and diseases associated with GS. Evidence of the effectiveness of Kampo medicine for GS has accumulated in recent years. The effects of Kampo treatment for symptoms related to functional decline of the cardiovascular, respiratory, and digestive systems, cognitive impairment and related disorders, pain and other sensory issues, among others, support the use of Kampo medicine for the management of GS. The role of Kampo medicine for GS is summarized in this review.
Collapse
Affiliation(s)
- Shin Takayama
- Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Naoki Tomita
- Department of Geriatrics and Gerontology, Institue of Development, Aging and Cancer, Tohoku University, Sendai, Japan
| | - Ryutaro Arita
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Rie Ono
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Akiko Kikuchi
- Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Tadashi Ishii
- Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| |
Collapse
|
7
|
Network Pharmacology-based Research of Active Components of Albiziae Flos and Mechanisms of Its Antidepressant Effect. Curr Med Sci 2020; 40:123-129. [PMID: 32166674 DOI: 10.1007/s11596-020-2155-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 11/05/2019] [Indexed: 12/12/2022]
Abstract
Albiziae Flos (AF) has been experimentally proven to have an antidepressant effect. However, due to the complexity of botanical ingredients, the exact pharmacological mechanism of action of AF in depression has not been completely deciphered. This study used the network pharmacology method to construct a component-target-pathway network to explore the active components and potential mechanisms of action of AF. The methods included collection and screening of chemical components, prediction of depression-associated targets of the active components, gene enrichment, and network construction and analysis. Quercetin and 4 other active components were found to exert antidepressant effects mainly via monoaminergic neurotransmitters and cAMP signaling and neuroactive ligand-receptor interaction pathways. DRD2, HTR1A, and SLC6A4 were identified as important targets of the studied bioactive components of AF. This network pharmacology analysis provides guidance for further study of the antidepressant mechanism of AF.
Collapse
|
8
|
Bhattacharjee M, Perumal E. Potential plant-derived catecholaminergic activity enhancers for neuropharmacological approaches: A review. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2019; 55:148-164. [PMID: 30668425 DOI: 10.1016/j.phymed.2018.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/07/2018] [Accepted: 07/16/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Catecholamines (CAs) have been reported to be involved in numerous functions including central nervous system. CA release from the intra neuronal storage vesicles aid in the therapy of various neurological and neuropsychiatric disorders where the catecholaminergic neurotransmission is compromised. Bioavailability of CA at the synapse can be increased through stimulated neurotransmitter release, monoamine oxidase and CA reuptake inhibition. Plant based galenicals are reported to have similar CA enhancement activities and have been used for the management of neurological disorders. AIM To review evidence-based literature with plant extracts, bioactive compounds, and composite extracts that modulate central catecholaminergic system, thereby enhancing CA activity for beneficial neurological effect. METHODS Electronic databases such as PubMed, Scopus, and ScienceDirect were used to search scientific contributions until January 2018, using relevant keywords. Literature focusing plant-derived CA enhancing compounds, extracts and/or composite extracts were identified and summarized. In all cases, dose, route of administration, the model system and type of extract were accounted. RESULTS A total of 49 plant extracts, 31 compounds and 16 herbal formulations have shown CA activity enhancement. Stimulated CA release from the storage vesicles, monoamine oxidase and CA reuptake inhibition were the major mechanisms involved in the increase of CA bioavailability by these phytoconstituents. CONCLUSION This review provides an overview on the phytoconstituents with CA enhancement property that have been used for neuropsychiatric disorders. Such herbal remedies will provide an avenue for cost effective and easily available medication which have holistic approach towards disease management. There is also scope for alternate medicines or prototype drug development utilizing these phytomedicines for treating neurodegenerative diseases. However, hurdles are to be met for analyzing the mode and mechanism of action associated with these phytomedicines and their proper scientific documentation.
Collapse
Affiliation(s)
- Monojit Bhattacharjee
- Defence Research and Development Organisation - Bharathiar University Center for Life Sciences (DRDO-BU CLS), Bharathiar University Campus, Coimbatore, Tamil Nadu 641046, India
| | - Ekambaram Perumal
- Defence Research and Development Organisation - Bharathiar University Center for Life Sciences (DRDO-BU CLS), Bharathiar University Campus, Coimbatore, Tamil Nadu 641046, India; Molecular Toxicology Laboratory, Department of Biotechnology, Bharathiar University, Coimbatore, Tamil Nadu 641046, India.
| |
Collapse
|
9
|
Takayama S, Arita R, Kikuchi A, Ohsawa M, Kaneko S, Ishii T. Clinical Practice Guidelines and Evidence for the Efficacy of Traditional Japanese Herbal Medicine (Kampo) in Treating Geriatric Patients. Front Nutr 2018; 5:66. [PMID: 30083536 PMCID: PMC6064728 DOI: 10.3389/fnut.2018.00066] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 07/02/2018] [Indexed: 11/13/2022] Open
Abstract
Frailty is defined as a state of increased vulnerability to poor resolution of homeostasis following stress, which increases the risk of adverse outcomes such as falls, delirium, and disability in the elderly. Recently in Japan, clinical practice guidelines (CPG) have recommended kampo treatment. We conducted a search for reports on Japanese CPG and kampo medicine in the treatment of symptoms in the elderly. The search was performed using the databases PubMed, Ichushi Web, J-Stage, Japan Medical Publishers Association, Medical Information Network Distribution Service, and CPG containing kampo products in Japan; reports from January 1st, 2012 to October 31st, 2017 were reviewed. Over the past 5 years, nine CPGs have recommended kampo treatment based on the evidence for improvement in skin symptoms, cough, gastro-intestinal dysfunction, urinary dysfunction, and dementia. Treatments with kampo medicine are performed depending on the coexistence of manifestations based on the original kampo concept, i.e., cognitive dysfunction and dementia with sarcopenia showing urinary disorder. Each kampo formula includes multiple crude drugs that have several pharmacological functions; these drugs include alkaloids, glycosides, and polysaccharides. Thus, kampo formula has an effect on multiple organs and coordinates the relationship between the brain, endocrine system, immune system, and skeletal muscles. Kampo treatment can be considered as supporting holistic medicine in elderly individuals with frailty.
Collapse
Affiliation(s)
- Shin Takayama
- Department of Education and Support for Regional Medicine, Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | | | | | | | | | | |
Collapse
|
10
|
Harada Y, Yamaguchi T, Hu A, Otani S, Han C, Kurihara Y, Kobayashi H, Arai H. Effect of hangekobokuto for amelioration of aggressiveness and social behavior in socially isolated mice. ACTA ACUST UNITED AC 2018. [DOI: 10.1002/tkm2.1095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Yoshinao Harada
- Department of Neurosurgery; Juntendo University Faculty of Medicine; Tokyo Japan
- Center for Advanced Kampo Medicine and Clinical Research; Juntendo University Graduate School of Medicine; Tokyo Japan
| | - Takuji Yamaguchi
- Center for Advanced Kampo Medicine and Clinical Research; Juntendo University Graduate School of Medicine; Tokyo Japan
| | - Ailing Hu
- Center for Advanced Kampo Medicine and Clinical Research; Juntendo University Graduate School of Medicine; Tokyo Japan
| | - Satoru Otani
- Center for Advanced Kampo Medicine and Clinical Research; Juntendo University Graduate School of Medicine; Tokyo Japan
| | - Cheolsun Han
- Center for Advanced Kampo Medicine and Clinical Research; Juntendo University Graduate School of Medicine; Tokyo Japan
| | - Yumiko Kurihara
- Center for Advanced Kampo Medicine and Clinical Research; Juntendo University Graduate School of Medicine; Tokyo Japan
| | - Hiroyuki Kobayashi
- Center for Advanced Kampo Medicine and Clinical Research; Juntendo University Graduate School of Medicine; Tokyo Japan
| | - Hajime Arai
- Department of Neurosurgery; Juntendo University Faculty of Medicine; Tokyo Japan
| |
Collapse
|
11
|
Satoh H, Kagohashi K, Ohara G. Bronchial asthma in a very elderly improved by hange-koboku-to. Eur Geriatr Med 2014. [DOI: 10.1016/j.eurger.2014.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
12
|
A review on bioactivities of perilla: progress in research on the functions of perilla as medicine and food. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:925342. [PMID: 24319488 PMCID: PMC3844277 DOI: 10.1155/2013/925342] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Accepted: 09/24/2013] [Indexed: 11/17/2022]
Abstract
Perilla is a useful pharmaceutical and food product and is empirically consumed by humans. However, its properties have not been evaluated extensively. In this review, we summarize the progress made in research, focusing on the bioactivities of perilla. There are many in vitro and animal studies on the cytostatic activity and antiallergic effects, respectively, of perilla and its constituents. However, its influence on humans remains unclear. Hence, investigating and clarifying the physiological effects of perilla and its constituents on humans are imperative in the future to adhere to the ideals of evidence-based medicine.
Collapse
|
13
|
Lavretsky H. Complementary and alternative medicine use for treatment and prevention of late-life mood and cognitive disorders. ACTA ACUST UNITED AC 2009; 5:61-78. [PMID: 19956796 DOI: 10.2217/1745509x.5.1.61] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Late-life mood disorders and cognitive aging are the most common reasons for using complementary and alternative therapies. The amount of rigorous scientific data to support the efficacy of complementary therapies in the treatment of depression or cognitive impairment is extremely limited. The areas with the most evidence for beneficial effects are exercise, herbal therapy (Hypericum perforatum), the use of fish oil, and, to a lesser extent, acupuncture and relaxation therapies. There is a need for further research involving randomized, controlled trials to investigate the efficacy of complementary and alternative therapies in the treatment of depression and cognitive impairment in late-life. This research may lead to the development of effective treatment and preventive approaches for these serious conditions.
Collapse
Affiliation(s)
- Helen Lavretsky
- Associate Professor of Psychiatry, Department of Psychiatry & Biobehavioral Sciences, and, Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA, Tel.: +1 310 794 4619, ,
| |
Collapse
|
14
|
Andreescu C, Mulsant BH, Emanuel JE. Complementary and alternative medicine in the treatment of bipolar disorder--a review of the evidence. J Affect Disord 2008; 110:16-26. [PMID: 18456339 DOI: 10.1016/j.jad.2008.03.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2007] [Revised: 03/20/2008] [Accepted: 03/26/2008] [Indexed: 11/26/2022]
Abstract
A growing number of patients with mood disorders are using complementary and alternative medicine (CAM) interventions. In this paper, we review the published scientific evidence on the benefits and risks of CAM for the treatment of patients with bipolar disorder. Since very few studies of CAM have involved patients with bipolar disorder, most available evidence is derived from trials conducted in patients with major depressive disorder. The use of omega-3 fatty acids has been studied in two controlled studies in bipolar disorder while St. John's wort (Hypericum perforatum), S-adenosyl-l-methionine (SAMe), and acupuncture have been studied in a series of randomized controlled trials in patients with major depression. Overall, the best evidence supports the use of St. John's wort for the treatment of mild to moderate depression. SAMe may also be effective for depression. However, both of these products have the potential to induce mania; the extent of this risk needs to be quantified. St. John's wort can also interact with a variety of medications. Evidence regarding the benefits of omega-3 fatty acids or acupuncture is inconsistent. Data regarding other CAM interventions (e.g., aromatherapy massage, massage therapy, yoga) are almost entirely lacking. In conclusion, better studies are needed before CAM interventions can be recommended to patients with bipolar disorder. In the meantime, patients need to be informed about the possible risks associated with the use of these interventions.
Collapse
Affiliation(s)
- Carmen Andreescu
- The Advanced Center for Interventions and Services Research for Late-life Mood Disorders, Department of Psychiatry, University of Pittsburgh School of Medicine, USA
| | | | | |
Collapse
|
15
|
Iwasaki K, Kato S, Monma Y, Niu K, Ohrui T, Okitsu R, Higuchi S, Ozaki S, Kaneko N, Seki T, Nakayama K, Furukawa K, Fujii M, Arai H. A pilot study of banxia houpu tang, a traditional Chinese medicine, for reducing pneumonia risk in older adults with dementia. J Am Geriatr Soc 2007; 55:2035-40. [PMID: 17944889 DOI: 10.1111/j.1532-5415.2007.01448.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate whether the traditional Chinese herbal medicine banxia houpu tang (BHT, formula magnolia et pinelliae) prevents aspiration pneumonia and pneumonia-related mortality in elderly people. DESIGN A prospective, observer-blinded, randomized, controlled trial. SETTING Two long-term care hospitals for handicapped elderly patients in Japan from March 2005 to February 2006. PARTICIPANTS One hundred four elderly patients (31 men and 73 women; mean age+/-standard deviation 83.5+/-7.8) with dementia and cerebrovascular disease, Alzheimer's disease, or Parkinson's disease. INTERVENTION Ninety-five participants (mean age 84.0, M:F=28:67) were randomly assigned to the BHT treatment group (n=47) or the control group (n=48) and took BHT or placebo for 12 months. MEASUREMENTS The occurrence of pneumonia, mortality due to pneumonia, and the daily amount of self-feeding. RESULTS Complete data were available for analysis on 92 of the 95 subjects randomized. Four patients in the BHT group developed pneumonia, and one of them died as a result. Fourteen patients in the control group developed pneumonia, and six of them died as a result. There was a significant difference between the two groups in pneumonia onset (P=.008), and a tendency toward significance in pneumonia-related mortality (P=.05). The relative risk of pneumonia in the BHT group compared with the control group was 0.51 (95% confidence interval (CI)=0.27-0.84, P=.008) and that of death from pneumonia was 0.41 (95% CI=0.10-1.03, P=.06) according to the Cox proportional hazards model. No adverse events were observed from treatment with BHT. The BHT group was able to maintain self-feeding better than the control group (P=.006). CONCLUSION Treatment with BHT reduced the risk of pneumonia and pneumonia-related mortality in elderly patients with dementia.
Collapse
Affiliation(s)
- Koh Iwasaki
- Center for Asian Traditional Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|