Yokukansan
A seven-herb Japanese Kampo formula used in dementia care for agitation, delusions and hallucinations. Meta-analyses of randomized trials show a modest benefit on some behavioural symptoms, mainly in Japanese studies of limited quality.
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What the science says
- Improvement in behavioural and psychological symptoms of dementia Moderate evidence
An updated meta-analysis of randomized controlled trials found yokukansan improved Neuropsychiatric Inventory scores compared with control, with the clearest effects on delusions, hallucinations and agitation. Trials were mostly small, Japanese, and often not blinded.
- No clear effect on cognition or daily function Moderate evidence
The same meta-analyses found no significant benefit on cognitive test scores, and effects on activities of daily living were inconsistent. Yokukansan is a symptom-management option, not a treatment for the underlying disease.
- Better tolerated than antipsychotics in these trials Limited evidence
Pooled analyses reported fewer adverse events and less discontinuation than with antipsychotic comparators. The comparisons were rarely blinded and follow-up was short.
Dosage & safety
How to take it
Interactions
With medications
- loop and thiazide diuretics
The liquorice component causes potassium loss that diuretics compound, and pseudoaldosteronism is the main reported harm with this formula. Do not combine without regular potassium monitoring
- corticosteroids
Additive potassium loss, fluid retention and raised blood pressure. Avoid prolonged combined use
- digoxin
Liquorice-induced low potassium raises the risk of digoxin toxicity. Do not combine without potassium and drug-level monitoring
- blood pressure medication
Liquorice raises blood pressure and works against treatment. Monitor blood pressure during use
With other supplements
- other liquorice-containing products
Liquorice effects on potassium and blood pressure add up across products. Do not run two liquorice-containing formulas at once
Well-established interactions only — this is not a complete list. Always tell your doctor and pharmacist what you take.
Frequently asked questions
Does yokukansan work for agitation in dementia?
Yokukansan has moderate evidence for behavioural symptoms of dementia: meta-analyses of randomized trials found improved Neuropsychiatric Inventory scores, clearest on delusions, hallucinations and agitation. The trials were mostly small, Japanese and often not blinded.
Does yokukansan improve memory in dementia?
No: meta-analyses found yokukansan had no significant benefit on cognitive test scores, and effects on daily activities were inconsistent (moderate evidence). Yokukansan is a symptom-management option, not a treatment for the underlying disease.
How much yokukansan should I take?
Trials of yokukansan used 7.5 g per day of extract granules, divided into two or three doses before meals with warm water. If it causes nausea, move it to after food.
What are the side effects of yokukansan?
The main risk of yokukansan is pseudoaldosteronism from its licorice component, causing low potassium, high blood pressure and oedema, especially in older adults and with long use. Have your potassium checked after the first month, and do not combine yokukansan with diuretics, corticosteroids or digoxin without monitoring.
Scientific references
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