Potential Effectiveness of Yokukansan and Lemborexant in Preventing Benzodiazepine Withdrawal Delirium

Strategic Insights -

Researchers from the National Cancer Center Hospital in Tokyo, Japan, have reported a case study and literature review highlighting the potential effectiveness of yokukansan and lemborexant as alternative candidates to benzodiazepines in preventing benzodiazepine withdrawal delirium in the cancer perioperative period. The study involved a patient who had been receiving lorazepam and brotizolam for three years to manage anxiety and insomnia, but had developed problematic drinking behavior and was experiencing ineffective treatment. The researchers gradually reduced the patient's lorazepam dose and introduced yokukansan and lemborexant, which helped stabilize her mental status and prevent postoperative benzodiazepine withdrawal delirium.

Key Takeaways:

  • The case study and literature review suggest that yokukansan and lemborexant may be effective in preventing benzodiazepine withdrawal delirium in cancer patients undergoing surgery.
  • The combination of yokukansan and lemborexant may help regulate the sleep cycle and reduce the risk of benzodiazepine-related delirium.
  • The study highlights the importance of gradual replacement of benzodiazepines with alternative candidates to prevent delirium in cancer patients.
  • Yokukansan and lemborexant may have potential benefits in terms of their effects on 5-hydroxytryptamine-related mechanisms.
  • The study involved a single case and further research is needed to confirm the findings.
  • The patient's background and treatment details are as follows: a woman in her late 80s who had been receiving lorazepam 1.0 mg/day and brotizolam 0.25 mg/day for three years to manage anxiety and insomnia following the death of her husband and son.

Statistics:

  • The patient had been consuming double the prescribed dose of lorazepam, indicating a potential for benzodiazepine-related delirium.
  • The patient's mental status stabilized after the introduction of yokukansan and lemborexant, with no adverse effects reported.
  • The study was conducted at the National Cancer Center Hospital in Tokyo, Japan.
  • The patient's treatment involved a gradual reduction of lorazepam dose and introduction of yokukansan and lemborexant, with a dosage of yokukansan 5.0 g/day and lemborexant 5.0 mg/day.

Sources:

  • Sadahiro, R., Yamaguchi, J., Wada, S., Nishikawa, E., Terada, T., Nakahara, R., & Matsuoka, H. (2025). Potential Effectiveness of Yokukansan and Lemborexant as Alternative Candidates to Benzodiazepines to Prevent Benzodiazepine Withdrawal Delirium in the Cancer Perioperative Period: A Case Report and Literature Review. Neuropsychopharmacology Reports, 45(4).
  • NewsRx. Report Summarizes Delirium Study Findings from National Cancer Center Hospital (Potential Effectiveness of Yokukansan and Lemborexant as Alternative Candidates to Benzodiazepines to Prevent Benzodiazepine Withdrawal Delirium in the Cancer ...). Mental Health Weekly Digest. October 20, 2025; p 1372.