Alleviating Neuropsychiatric Symptoms
In Dementia: The Effects of Ginkgo biloba
Extract EGb 761. Findings From a
Randomized Controlled Trial

This section is compiled by Frank M. Painter, D.C.
Send all comments or additions to:    Frankp@chiro.org

FROM:   Neuropsychiatr Dis Treat. 2011;   7:   209-215

Bachinskaya N, Hoerr R, Ihl R.

Institute of Gerontology, Academy of Medical Sciences, Kiev, Ukraine;

Ginkgo is among the oldest living species on earth and has been used extensively as a medicinal agent worldwide for centuries. It is the most frequently prescribed medicinal herb in Europe, with hundreds of studies reporting positive effects from taking ginkgo for both the prevention and treatment of various health complaints. The most dramatic benefits are reported in improving circulation in the elderly. This can lead to enhanced memory, possibly delaying the onset of Alzheimer's disease, reducing senile dementia, tinnitus, and vertigo. Ginkgo's memory-enhancing effects are reported in younger populations as well. Dementias are disorders with symptoms of memory loss and a decrease in cognition and the ability to reason. Dementia, sometimes called "senility," is not a part of the normal aging process, and shows that some other disease may be present. Dementia affects a person's ability to be successful in carrying out their activities of daily living. Accurate diagnosis of the disease that is present is necessary for treating the dementia properly. In this randomized, controlled, double-blind, multicenter clinical trial, researchers investigated the effects of gingko biloba extract in patients with dementia. The study included 410 patients with mild to moderate dementia who were randomized to receive either 240 mg of a gingko biloba extract (EGb 761) or placebo for 24 weeks. The results revealed that treatment with the ginkgo biloba extract appears to improve neuropsychiatry symptoms in patients with dementia. Significant improvements were seen in the symptoms of apathy/indifference, sleep/night-time behavior, irritability/lability, depression/dysphoria and aberrant motor behavior. It was also found that the caregivers’ stress evaluation showed similar improvements. These findings suggest that gingko biloba extract is a safe and effective treatment option to reduce behavioral and psychiatric symptoms in patients with mild to moderate dementia.

PURPOSE:   To examine the effects of Ginkgo biloba extract EGb 761(®) on neuropsychiatric symptoms of dementia.

PATIENTS AND METHODS:   Randomized, controlled, double-blind, multicenter clinical trial involving 410 outpatients with mild to moderate dementia (Alzheimer's disease with or without cerebrovascular disease, vascular dementia), scoring at least 5 on the Neuropsychiatric Inventory (NPI), with at least one item score of 3 or more. Total scores on the SKT cognitive test battery (Erzigkeit's short syndrome test) were between 9 and 23. After random allocation, the patients took 240 mg of EGb 761(®) or placebo once daily for a period of 24 weeks. Changes from baseline to week 24 in the NPI composite and in the SKT total score were the primary outcomes. The NPI distress score was chosen as a secondary outcome measure to evaluate caregivers' distress.

RESULTS:   The NPI composite score improved by -3.2 (95% confidence interval -4.0 to -2.3) in patients taking EGb 761(®) (n = 202), but did not change (-0.9; 0.9) in those receiving placebo (n = 202), which resulted in a statistically significant difference in favor of EGb 761(®) (P < 0.001). Treatment with EGb 761(®) was significantly superior to placebo for the symptoms apathy/indifference, sleep/night-time behavior, irritability/lability, depression/dysphoria, and aberrant motor behavior. Caregivers' distress evaluation revealed similar baseline pattern and improvements.

CONCLUSION:   Treatment with EGb 761(®), at a once-daily dose of 240 mg, was safe, effectively alleviated behavioral and neuropsychiatric symptoms in patients with mild to moderate dementia, and improved the wellbeing of their caregivers.

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