Ivclinical Indications

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The use of the ginkgo tree in traditional Chinese medicine is very ancient. The seeds have been used since at least the thirteenth century and the leaves since at least the sixteenth century. Modern Chinese pharmacopoeias mention the use of the leaves in the treatment of cardiac and pulmonary diseases but also against dysentery and filariasis (2,7). Modern Western usage of Ginkgo biloba extract is much more recent and results from research inspired not by traditional medicine but linked instead to the development of pharmacology. A first extract was marketed in 1965 in Germany by Dr. Willmar Schwabe Company. EGb 761 was first registered in France in 1974 and sold in 1975 by Institut Ipsen (now Ipsen Pharma) under the trademark Tanakan and in Germany as Rokan by Intersan in 1978 and as Tebonin forte by Dr. Willmar Schwabe Company in 1982. Its first therapeutic indications involved circulatory disturbances. More recently, the therapeutic effects that have been studied most are those affecting the psychobehavioral disorders associated with aging. These include cognitive disturbances, such as age-related memory disorders (grouped together today as mild cognitive impairment, MCI), or dementia, such as Alzheimer's disease. Whether these various indications (Alzheimer's disease, in particular), are included in the approved indications varies from country to country. EGb 761 is also prescribed against several diseases of the sensory organs that are often associated with aging, such as presbyacusis, tinnitus, age-related macular degeneration, glaucoma, etc.

In Europe (principally in France and Germany) these indications are officially approved, and patients are reimbursed for these health expenses. In the United States, on the other hand, Ginkgo biloba extract is mostly considered an herbal drug and is marketed as a health food.

In addition to the indications cited, EGb 761 has been the subject of numerous investigations that have reached definitive conclusions about its action in extremely diverse areas. Some of these indications are justified by serious studies—placebo-controlled and double-blinded—while others rest on much more fragile or uncontrolled foundations. Among the former, we note cognitive impairments associated with multiple sclerosis (8); mood disorders, particularly depression (9); sexual dysfunctions (10); and radiation-related disorders (11).

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