GINKGO BILOBA


aka "Madenhair"; native to China

I. Preparations of the dried leaves traditionally used for respiratory illnesses; used currently in Europe for peripheral vascular disease and "cerebral insufficiency"

  1. "Cerebral insufficiency is an imprecise term that essentially describes a collection of symptoms...difficulties of concentration and of memory; absent mindedness; confusion; lack of energy; tiredness; decreased physical performance; depressive mood; anxiety; dizziness; tinnitus; and headache" (!-Lancet rvw)

II. Two standardized preparations:

  1. Egb 761 (aka Tebonin, Tanakan, rokan)
  2. LI 1370 (aka Kaveri)

III. Alleged modes of action

  1. Increase in perfusion through decreased "blood viscosity"
  2. Inhibition of platelet aggregation
  3. Prevention of free-radical mediated tissue damage

IV. Clinical trials

  1. Usual dose 120-160mg/d divided TID
  2. Review below cites 8 randomized placebo-controlled studies involving total of 849 patients for "cerebral insufficiency"
  1. Outcomes were mostly pt-reported sx on a 4-point ordinal scale or physician or patient assessment as to improved or not
  2. Duration of tx 6-12 weeks
  3. Better results with G. biloba reported in all 8 studies though review doesn't mention whether stat. sig. or not
  1. Click on link for info on G. biloba for Peripheral Arterial Disease
  2. 230 pts > 60yo with Folstein Mini-Mental Status Examination scores > 26/30 randomized to ginkgo 40mg TID vs. placebo; over 6wks there wer no sig. differences in changes in various standardized neuropsychological tests of memory, attention, and concentration (JAMA 288:835, 2002--JW)
  3. In a study in 3,069 community-dwelling adults 72-96yo randomized to ginkgo biloba extract 120mg BID v.s placebo, , over median 6.1y f/u, there was no sig. diff. in rates of decline in various tests of memory and cognitive function ("Ginkgo Evaluation of Memory" ("GEM") trial; JAMA 302:2663, 2009-abst)

V. No differences in side-effect profile vs. placebo in trials so far (Lancet rvw.); no known drug interactions

(Source; Lancet 340:1136, 1992)