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"
- "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:
- Egb 761 (aka Tebonin, Tanakan, rokan)
- LI 1370 (aka Kaveri)
III. Alleged modes of action
- Increase in perfusion through decreased "blood viscosity"
- Inhibition of platelet aggregation
- Prevention of free-radical mediated tissue damage
IV. Clinical trials
- Usual dose 120-160mg/d divided TID
- Review below cites 8 randomized placebo-controlled studies involving total of 849 patients for "cerebral insufficiency"
- Outcomes were mostly pt-reported sx on a 4-point ordinal scale or physician or patient assessment as to improved or not
- Duration of tx 6-12 weeks
- Better results with G. biloba reported in all 8 studies though review doesn't mention whether stat. sig. or not
- Click on link for info on G. biloba for Peripheral Arterial Disease
- 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)
- 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)