Effectiveness of Saikokaryukotsuboreito (Herbal Medicine) for Antipsychotic-Induced Sexual Dysfunction in Male Patients with Schizophrenia: A Description of Two Cases
Antipsychotics sometimes cause sexual dysfunction in people with schizophrenia. The authors report the effectiveness of Saikokaryukotsuboreito (Japanese traditional herbal medicine, Chai-Hu-Jia-Long-Gu-Mu-Li-Tang in Chinese) for antipsychotic-induced sexual dysfunction in two male patients with schizophrenia. The first patient was a 28-year-old man with schizophrenia who suffered erectile dysfunction induced by olanzapine 10？mg/day; the erectile dysfunction significantly improved following the treatment of Saikokaryukotsuboreito 7.5？g/day. The other case was a 43-year-old man with schizophrenia who was receiving fluphenazine decanoate at 50？mg/month and had difficulties in ejaculation; add-on of Saikokaryukotsuboreito 7.5？g/day recovered his ejaculatory function. There has been no report on the effectiveness of Japanese herbal medicine formulations for antipsychotic-induced sexual dysfunction. Although the effectiveness of Saikokaryukotsuboreito needs to be tested in systematic clinical trials, this herbal medicine may be a treatment option to consider for this annoying side effect. 1. Introduction Antipsychotic drugs sometimes cause sexual dysfunction in patients with schizophrenia; the incidence rate has been reported to be as high as 50% in male patients [1]. Among sexual side effects, disturbances of erection and ejaculation are frequent with reported incidence rates being as high as 30–60% [2]. These adverse events can cause substantial subjective burden and are expected to result in an impaired quality of life, potentially leading to poor adherence to antipsychotic treatment [3]. Kampo, or Japanese traditional herbal medicine, has been used in Japan for more than 1300 years as an alternative treatment or sometimes combined adjunctively with the Western modern medicine. Today, 148 Kampo formulations have been approved for use in clinical practice by the Japanese Ministry of Health, Labour and Welfare; some of them have been reported to improve psychotropic side effects as well as psychiatric symptoms [4, 5]. Here we report on two male patients with schizophrenia in whom a Kampo prescription, Saikokaryukotsuboreito (Chai-Hu-Jia-Long-Gu-Mu-Li-Tang in Chinese), which has often been used for sexual dysfunction in general, successfully diminished antipsychotic-induced sexual dysfunction. 2. Case Presentation 2.1. Case 1 A 28-year-old single man who did not have any past history of psychiatric or physical illnesses visited our hospital because of psychotic symptoms characterized with delusions, conceptual disorganization, and hallucinations. He was
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