Ivginkgo Ginkgo Biloba

Ginkgo is used for a range of indications, most importantly perhaps for vascular dementia and Alzheimer's disease. A systematic review (10) included nine double-blind RCTs with a total of 606 patients suffering from dementia. The methodological quality of these studies was on average good (Jadad score 3-5). The dosage regimen varied by more than 100%. All but one of the nine trials yielded positive findings, and our overall judgment was therefore optimistic: ''findings are encouraging and warrant independent, large scale confirmatory and comparative trials'' (10). The question whether ginkgo enhances cognitive function in healthy subjects where it is not impaired, is still controversial. Both positive and negative answers have so far been provided by RCTs.

No systematic review of the safety of ginkgo has yet been published. Adverse effects are rare, usually transient, and mild; they include gastrointestinal disturbances, diarrhea, vomiting, allergic reactions, pruritus, headache, dizziness, and nosebleeds. Ginkgo also has antiplatelet effects and therefore the same cautions apply as for garlic (7).

On balance, this collective evidence suggests that the risk-benefit profile of ginkgo is encouraging. There are few risks with proper use and the potential benefit for dementia patients is substantial.

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