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Ginkgo Biloba EGb 761

Primary medical role: Improve cognitive capacities.

Role in Alzheimer's disease: Improve cognition in mild/moderate AD patients.

Approved by FDA for Alzheimer's use?: No.

Pharmacological role: Possibly, via antioxidant, or antiplatelet actions.

Contraindications: None known.

Side effects: Slightly higher rates of GI irritation, allergic skin reaction, and headache, in comparison to placebo groups.

Evidence pro its efficacy: A recent American, multi-center, placebo-controlled, double-blind, randomized trial demonstrated modest improvements in patients treated with Ginkgo biloba extract relative to patients given placebo only.

Evidence con its efficacy: The improvements ascribed to Ginkgo extract were fairly modest.

Dosage 40 mg, thrice daily with meals.

Cost:

Selected References:

Wettstein A. Cholinesterase inhibitors and Gingko extracts--are they comparable in the treatment of dementia? Comparison of published placebo-controlled efficacy studies of at least six months' duration. Phytomedicine. 2000 Jan;6(6):393-401. Abstract.

Simanyi M. Use of special Ginkgo biloba extract for cognitive disorders in the elderly. Wien Med Wochenschr. 1999;149(8-10):231-4. Review. Article in German. Abstract.

Clostre F. Ginkgo biloba extract (EGb 761). State of knowledge in the dawn of the year 2000. Ann Pharm Fr. 1999 Jul;57 Suppl 1:1S8-88. Article in French. Abstract.

Perry EK, Pickering AT, Wang WW, Houghton PJ, Perry NS. Medicinal plants and Alzheimer's disease: from ethnobotany to phytotherapy. J Pharm Pharmacol. 1999 May;51(5):527-34. Abstract.

Itil TM, Eralp E, Ahmed I, Kunitz A, Itil KZ. The pharmacological effects of ginkgo biloba, a plant extract, on the brain of dementia patients in comparison with tacrine. Psychopharmacol Bull. 1998;34(3):391-7. Abstract.

Maurer K. Ihl R. Dierks T. Frolich L. Clinical efficacy of ginkgo biloba special extract EGb 761 in dementia of the Alzheimer type. Journal of Psychiatric Research. 31(6):645-655, 1997 Nov-Dec. Abstract.

Le Bars PL, Katz MM, Berman N, Itil TM, Freedman AM, Schatzberg AF. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. North American EGb Study Group. JAMA. 1997 Oct 22-29;278(16):1327-32. Abstract.

Kanowski S. Herrmann WM. Stephan K. Wierich W. Horr R. Proof of efficacy of the ginkgo biloba special extract EGb 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia. Pharmacopsychiatry. 1996 Mar;29(2):47-56. Abstract:

Stoll S, Scheuer K, Pohl O, Muller WE. Ginkgo biloba extract (EGb 761) independently improves changes in passive avoidance learning and brain membrane fluidity in the aging mouse. Pharmacopsychiatry 29 (4): 144-149 (Jul 1996). Abstract.

Loas G, Rose D, Nowaczkowski P, Lernout P, Duron B. [Translated from French] . Ann Med Psychol (Paris) 154 (3): 202-203 (Jun 1996). Abstract.

Mizuno M, Droy-Lefaix MT, Packer L. Ginkgo biloba extract EGb 761 is a suppresser of AP-1 transcription factor stimulated by phorbol 12-myristate 13-acetate. Biochem Mol Biol Int 39 (2): 395-401 (May 1996). Abstract.

Letzel H, Schoop W. Ginkgo biloba extract EGb 761 and pentoxifylline in intermittent claudication. Secondary analysis of the clinical effectiveness (see comments) [Translated from German] . Vasa 21 (4): 403-410 (1992). Abstract.

Halama P, Bartsch G, Meng G. Disorders of brain performance of vascular origin. Randomized double-blind study of the effectiveness of Ginkgo biloba extract [Translated from German]. Fortschr Med 106 (19): 408-412 (Jun 1988). No abstract available.

Taylor JE. Neuromediator binding to receptors in the rat brain. The effect of chronic administration of Ginkgo biloba extract [Translated from French]. Presse Med 15 (31): 1491-1493 (Sep 1986). Abstract.