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Moderate evidenceBrain & cognition

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.

Evidence last reviewed: August 2026

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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

Studied doseTrials used 7.5 g per day of yokukansan extract granules, usually divided into two or three doses before meals.
SafetyThe licorice (Glycyrrhiza) component can cause pseudoaldosteronism with low potassium, high blood pressure and oedema, especially in older adults and with long use — potassium should be monitored. Also reported: nausea and drowsiness. Caution with diuretics and with existing heart or kidney disease.

Scientific references

Where to buy

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