Interesting trial and...a nice try at the same time. Using too low a dose will generate no clear answers on gingko efficacy. In my opinion, the arm of 120 mg of gingko versus 240 mg of gingko versus placebo would be rational advice. So far, both doses have been shown to be either beneficial (e.g., ref 1,2) or of no effect (e.g., ref 3,4). Additionally, the trial should be powered to detect a possible relationship between severity of cognitive decline, dose of gingko, and its efficacy. This should be done, since most of the negative trials are in healthy subjects or in subjects who do not fulfill criteria for dementia.

Reference:
1. 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

2. Kanowski S, Hoerr R. Ginkgo biloba extract EGb 761 in dementia: intent-to-treat analyses of a 24-week, multi-center,...  Read more

Interesting trial and...a nice try at the same time. Using too low a dose will generate no clear answers on gingko efficacy. In my opinion, the arm of 120 mg of gingko versus 240 mg of gingko versus placebo would be rational advice. So far, both doses have been shown to be either beneficial (e.g., ref 1,2) or of no effect (e.g., ref 3,4). Additionally, the trial should be powered to detect a possible relationship between severity of cognitive decline, dose of gingko, and its efficacy. This should be done, since most of the negative trials are in healthy subjects or in subjects who do not fulfill criteria for dementia.

Reference:
1. 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

2. Kanowski S, Hoerr R. Ginkgo biloba extract EGb 761 in dementia: intent-to-treat analyses of a 24-week, multi-center, double-blind, placebo-controlled, randomized trial. Pharmacopsychiatry. 2003 Nov;36(6):297-303. Abstract

3. van Dongen M, van Rossum E, Kessels A, Sielhorst H, Knipschild P. Ginkgo for elderly people with dementia and age-associated memory impairment: a randomized clinical trial. J Clin Epidemiol. 2003 Apr;56(4):367-76. Abstract

4. Solomon PR, Adams F, Silver A, Zimmer J, DeVeaux R. Ginkgo for memory enhancement: a randomized controlled trial. JAMA. 2002 Aug 21;288(7):835-40. Abstract

View all comments by Tomasz Sobow

Two years ago, my wife, now age 76, was diagnosed as early phase AD. Personal observations caused my concern at least four years ago, and we thus reported this to her internist. There followed multiple consultations with neurologists, psychotherapists, MRIs, etc. The use of ginko was not encouraged, and as a matter of fact, one internist halted its use.

She takes 3/30 mg of ginko biloba each morning and night. Prescriptions include Aricept, 10 mg/p.m. since May 2002, and Namenda, 10 mg twice each day since September 2003.

Her current stage is now diagnosed as early middle AD. Any comments?

View all comments by GREG GUTGSELL