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Gingko biloba extract EGb 761®: clinical data in dementia

Published online by Cambridge University Press:  12 July 2012

Ralf Ihl*
Affiliation:
Clinic of Geriatric Psychiatry and Psychotherapy, Alexian Hospital, Krefeld, Germany, and Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany
*
Correspondence should be addressed to: Ralf Ihl, Department of Geriatric Psychiatry, Alexian Hospital, Oberdiessemer Str. 136, Krefeld, NRW, D-47805, Germany. Phone: +49 2151347904; Fax: +49 2151347901. Email: [email protected].

Abstract

Research into Gingko biloba extract EGb 761® has been ongoing for many years. Early studies showed that the extract was superior to placebo in improving symptoms of dementia, and this has been confirmed by more recent research. The GINDEM-NP, GOTADAY and GOT-IT! studies showed that 240 mg/day EGb 761® improved cognitive function, neuropsychiatric symptoms, activities of daily living, and quality of life in patients with mild to moderate dementia compared with placebo, with results reproducible in independent trials. The strength of the effect in terms of improvements in neurosensory symptoms associated with old age and dementia was strong enough to be detected by caregivers and independent clinicians. A combination of 240 mg/day EGb 761® and 10 mg/day (initially 5 mg/day) donepezil was also more effective than either drug alone. Regarding the improvement of neuropsychiatric symptoms, a cross-comparison of studies with different antidementia agents suggests that EGb 761® is at least as effective as memantine, galantamine, and donepezil. Safety data revealed no important safety concerns with EGb 761®.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Brodaty, H., Corey-Bloom, J., Potocnik, F. C., Truyen, L., Gold, M. and Damaraju, C. R. (2005). Galantamine prolonged-release formulation in the treatment of mild to moderate Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 20, 120132.CrossRefGoogle ScholarPubMed
Cummings, J. L., Schneider, E., Tariot, P. N. and Graham, S. M. (2006). Behavioral effects of memantine in Alzheimer disease patients receiving donepezil treatment. Neurology, 67, 5763.CrossRefGoogle ScholarPubMed
Gauthier, S., Feldman, H., Hecker, J., Vellas, B., Emir, B. and Subbiah, P. (2002). Functional, cognitive and behavioral effects of donepezil in patients with moderate Alzheimer's disease. Current Medical Research and Opinion, 18, 347354.CrossRefGoogle ScholarPubMed
Halama, P., Bartsch, G. and Meng, G. (1988). Hirnleistungsstörungen vaskulärer Genese. Randomisierte Doppelblindstudie zur Wirksamkeit von Ginkgo-biloba-Extrakt. Fortschritte der Medizin, 106: 408412.Google Scholar
Hofferberth, B. (1989). Einfluß von Ginkgo biloba‑Extrakt auf neurophysiologische und psychometrische Meßergebnisse bei Patienten mit hirnorganischem Psychosyndrom. Eine Doppelblindstudie gegen Placebo. Arzneimittelforschung, 39, 918922.Google ScholarPubMed
Ihl, R. et al. (2011a). Efficacy and safety of a once-daily formulation of Ginkgo biloba extract EGb 761® in dementia with neuropsychiatric features: a randomized controlled trial. International Journal of Geriatric Psychiatry, 26, 11861194.CrossRefGoogle ScholarPubMed
Ihl, R., Frölich, L., Winblad, B., Schneider, L., Burns, A., Möller, H. J. and the WFSBP Task Force on Treatment Guidelines for Alzheimer's Disease and other Dementias. (2011b). World Federation of Societies of Biological Psychiatry guidelines for the biological treatment of Alzheimer's disease. World Journal of Biological Psychiatry, 12, 232.CrossRefGoogle ScholarPubMed
Kanowski, S., Herrmann, W. M., Stephan, K., Wierich, W. and Hörr, R. (1996). 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, 29, 4756.CrossRefGoogle ScholarPubMed
Kanowski, S. and Hoerr, R. (2003). Ginkgo biloba extract EGb 761® in dementia: Intent-to-treat analyses of a 24-week, multi-center, double-blind, placebo-controlled, randomized trial. Pharmacopsychiatry, 36, 297303.Google ScholarPubMed
Le Bars, P. L., Katz, M. M., Berman, N., Itil, T. M., Freedman, A. M. and Schatzberg, A. F. (1997). A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. Journal of the American Medical Association, 278, 13271333.CrossRefGoogle ScholarPubMed
Le Bars, P. L., Kieser, M. and Itil, K. Z. (2000). A 26-week analysis of a double-blind, placebo-controlled trial of the Ginkgo biloba extract EGb 761® in dementia. Dementia and Geriatric Cognitive Disorders, 11, 230237.CrossRefGoogle ScholarPubMed
Napryeyenko, O. and Borzenko, I.for the GINDEM-NP Study Group. (2007). Ginkgo biloba special extract in dementia with neuropsychiatric features: a randomized, placebo-controlled, double-blind clinical trial. Arzneimittelforschung, 57, 411.Google Scholar
Schneider, L. S., DeKosky, S. T., Farlow, M. R., Tariot, P. N., Hoerr, R. and Kieser, M. (2005). A randomized, double-blind, placebo-controlled trial of two doses of Ginkgo biloba extract in dementia of the Alzheimer's type. Current Alzheimer Research, 2, 541551.CrossRefGoogle ScholarPubMed
Scripnikov, A., Khomenko, A., Napryeyenko, O. and the GINDEM-NP Study Group. (2007). Effects of Ginkgo biloba extract EGb 761 on neuropsychiatric symptoms of dementia: findings from a randomised controlled trial. Wien Med Wochenschr, 157, 295300.CrossRefGoogle ScholarPubMed
Stern, R. G., Mohs, R. C., Davidson, M., Schmeidler, J., Silverman, J., Kramer-Ginsberg, E., Searcey, T., Bierer, L. and Davis, K. L. (1994). A longitudinal study of Alzheimer's disease: measurement, rate, and predictors of cognitive deterioration. American Journal of Psychiatry, 151, 390396.Google ScholarPubMed
Taillandier, J., Ammar, A., Rabourdin, J. P., Ribeyre, J. P., Pichon, J., Niddam, S. and Pierart, H. (1986). Traitement des troubles du vieillissement cérébral par l'extrait de Ginkgo biloba. Etude longitudinale multicentrique à double insu face au placebo. La Presse Médicale, 15, 15831587.Google ScholarPubMed
Tariot, P. N., Solomon, P. R., Morris, J. C., Kershaw, P., Lilienfeld, S. and Ding, C.. (2000). A 5-month, randomized, placebo-controlled trial of galantamine in AD. Neurology, 54, 22692276.CrossRefGoogle ScholarPubMed
Tune, L., Tiseo, P. J., Ieni, J., Perdomo, C., Pratt, R. D., Votaw, J. R., Jewart, R. D. and Hoffman, J. M. (2003). Donepezil HCl (E2020) maintains functional brain activity in patients with Alzheimer disease: results of a 24-week, double-blind, placebo-controlled study. American Journal of Geriatric Psychiatry, 11, 169177.CrossRefGoogle ScholarPubMed
van Dyck, C. H., Tariot, P. N., Meyers, B. and Malca Resnick, E. (2007). A 24-week randomized, controlled trial of memantine in patients with moderate-to-severe Alzheimer disease. Alzheimer Disease and Associated Disorders, 21, 136143.CrossRefGoogle ScholarPubMed
Weitbrecht, W. U. and Jansen, W. (1986). [Primary degenerative dementia: therapy with Ginkgo biloba extract. Placebo-controlled double-blind and comparative study]. Fortschritte der Medizin, 104, 199202 (in German).Google ScholarPubMed
Wesnes, K., Simmons, D., Rook, M. and Simpson, P. (1987). A double-blind placebo-controlled trial of tanakan in the treatment of idiopathic cognitive impairment in the elderly. Human Psychopharmacology, 2, 159169.CrossRefGoogle Scholar
Yancheva, S., Ihl, R., Nikolova, G., Panayotov, P., Schlaefke, S. and Hoerr, R. for the GINDON Study Group (2009). Ginkgo biloba extract EGb 761®, donepezil or both combined in the treatment of Alzheimer's disease with neuropsychiatric features: a randomised, double-blind, exploratory trial. Aging & Mental Health, 13, 183190.CrossRefGoogle ScholarPubMed