Akito Hisanaga

Four cases of panic disorder successfully treated with Kampo (Japanese herbal) medicines: Kami-shoyo-san and Hange-koboku-to

Kampo medicines have been used to treat patients with psychogenic disorders from ancient times. In the present report the cases are described of four patients with panic disorder successfully treated with Kampo medicines. These four patients fulfilled the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for panic disorder with agoraphobia. The Kampo medicine Kami‐shoyo‐san (TJ‐24) relieved panic attacks, anticipatory anxiety and agoraphobia in two patients, and Hange‐koboku‐to (TJ‐16) relieved these symptoms in the other two patients. The patients in whom Kami‐shoyo‐san was effective were older and complained of more symptoms than those in whom Hange‐koboku‐to was effective. These Kampo medicines may be useful as additional or alternative treatments for panic disorder.

A case of sleep choking syndrome improved by the Kampo extract of Hange-koboku-to

Abstract A case of sleep choking syndrome with typical symptoms is presented. A 44‐year‐old Japanese male suffered from multiple episodes of choking, which suddenly appeared with fear of impending death about 30 min after falling asleep almost every night. Overnight polysomnography showed an apnea index of 0.92 events/h, an apnea–hypopnea index of 2.77 events/h, and normal respiration during sleep with the exception of the episodes of apnea and hypopnea. No choking episode occurred in the sleep laboratory. The administration of 500 mg of acetazolamide was ineffective, but the choking episode improved after the administration of Kampo extract of Hange‐koboku‐to (Ban‐xia‐hou‐pu‐tang). Hange‐koboku‐to may be effective in treating choking sensation during sleep as well as during wakefulness.

Treatment of obstructive sleep apnea syndrome with a Kampo‐formula, San’o‐shashin‐to: A case report

The following describes a 76‐year‐old male with obstructive sleep apnea syndrome successfully treated with a Kampo‐formula, San’o‐shashin‐to (Formula medicamentorum tres ad dispellendi cordis). Polysomnography, performed before and after administration of San’o‐shashin‐to, revealed that the apnea index decreased from 11.1 events/hour to 4.1 events/hour, and that the apnea plus hypopnea index decreased from 18.4 events/hour to 10.7 events/hour. The patient was normo‐weight (body mass index: 20.4 kg/m 2 ), and events of sleep apnea and hypopnea were mostly noted during a non‐rapid eye movement sleep. It is possible that San’o‐shashin‐to has some alleviating effects on the upper airway resistence during sleep.

A case of subwakefulness syndrome.

Abstract We report a patient, a 30‐year‐old male Japanese‐Brazilian migrant construction worker, suffering from excessive daytime sleepiness for at least 6 months. Electroencephalogram recordings during his waking states showed that 10‐Hz and 60‐µV alpha activity was present prominently in the occipital regions. From the multiple sleep latency test, it was found that stages 1–2 NREM sleep episodes appeared repetitively without any REM episodes, and that the mean sleep latency was 10.2 min. These findings support the diagnosis that this patient suffers from subwakefulness syndrome.