Alzheimer's Disease Treatment: Ginkgo Biloba-Part III

Keeping up with the race by many drug companies to find an effective medication for the cognitive decline (memory loss) seen in Alzheimer's Disease (AD) can be a Herculean job. Searching the literature for help in this area can prove confusing in that it raises hope and also dampens it. The field is still very confused as to the causes of cellular death in AD (plaques or tangles or both or some other process with the plaques and tangles the end result?). This site will try to select information that has specific relevance and implications for clinical treatment of this devastating disorder.

AS WE REPORT ON THE LATEST FINDINGS, WE FEEL IT IMPORTANT THAT WE START WITH THIS CAVEAT (and will repeat it over and over again): To date, no one has found the magic bullet to stop the downward course of this debilitating cognitive disorder. Genetic factors have been implicated as strong indicators of the disorder, meaning they maybe totally penetrant and expressed if the individual lives long enough (research indicates a higher incidence of the disorder in the over 80 population). Many of the findings so far pertain to a small percentage of the cases of AD and are usually associated with early onset Alzheimer's, i. e. before age 65. There are no biological markers for presence of Alzheimer's disease. There are risk factors such as Apo E4 and also indications of amyloid protein precursor mutations which have a role in the process of the disease, as well as presenilin 1 & 2. Last year a team of Alzheimer's disease researchers at Massachusetts General Hospital in Boston announced that they had identified a new gene, called A2M that was involved in causing Alzheimer's in a minority of cases. Recently 3 teams of different researchers reported that they have been unable to confirm the work done by the Massachusetts team. This further underscores the difficulty in confirming gene research findings.

Much of this is still speculation and these factors are hypothesized to be possible initiators of Alzheimer's Disease. The exact process is unknown, making it harder to develop medications to prevent the onset of the disease. Medications that are developed try to retard the progress of the memory decline and are associated with the theory that acetylcholine plays a part in cognitive disorders.

Clinical Study

Mauer and his group in Germany recently completed a clinical study of the efficacy of Ginkgo Biloba, a natural herb. He conducted a double-blind, randomized, placebo-controlled, parallel group design on twenty patients for three months. He used 240 mg/day of Ginkgo Biloba special abstract Egb 761 (Tebonin ® forte, manufactured by Dr. William Schwabe, Karlsruhe) on twenty patients for three months. He concludes that "Efficacy of Ginkgo Biloba special abstract Egb 761 in mild to moderate dementia of Alzheimer's Type has been confirmed."

No adverse events were reported during the study. They did not evaluate effects of medication on activities of daily living. This study needs to be replicated in a larger sample over a longer period of time for it to be accepted as an approved treatment regimen. However, it is a preliminary study to prove the value of natural herbs in dealing with the disease. The study size was very small and as stated above there was no evaluation of daily activity changes.

Remember the dosage of the special abstract Egb 761 may be different from the dosage you buy in the local health food store.

(REF: Maurer, K., Ihl, R., Dierks, T., Frolich, L. (1997). Clinical Efficacy of Ginkgo Biloba Special Extract Egb 761 in Dementia of the Alzheimer. Journal of Psychiatric Research; 31:6:645-655

We wish to thank Edith A.Mark who e-mailed us this important additional information on Ginkgo Biloba:


Gingko is a highly refined extract of the ginkgo tree leaves. The American Association of Nurse Anesthetists reports that ginkgo can prolong coagulation and should not be used prior to surgery. Additionally, because of its blood-thinning ability, it is wise to consult with your doctor or herbalist before combining the herb with aspirin, clopidogrel (Plavix), dipyridamole (Persantine), ticlopodine (Ticlid) or warfarin (Coumadin) – or if you’re preparing for surgery or have a personal history of stroke.

However the herb is safe under most circumstances and millions of people have taken it with only mild digestive upsets reported. Some of the benefits on ginkgo include the following:

DOSAGE: from 60mg. to 240mg. divided into 3 daily doses. Check with your health care professional for the proper dosage for you.

By Edith A. Mark

See: Alzheimer's Disease Part I-Medications for Alzheimer's.
See: Alzheimer’s Disease Part II- Selegiline and AD.
See: Alzheimer's Disease Part III- Use of Gingko Biloba in memory problems of Alzheimer patients
See: Part IV-Alternative Treatments for AD
See: Part V-Possible New Drugs for Alzheimer's Disease
See: Part VI-Early Diagnosis
See: PartVII- Metrifonate
See: Part VIII- Implications of Longer Life Expectancy
See: Part IX-Ethical Care Principles
See: Part X -Estrogen and Alzheimer's Disease
See: Part XI-Pocket Smell Test (PST)
See: Part XII -MAO-B
See: Part XIII -Critical Flicker Fusion Threshold Test
See: Part XIV-Donepezil
See: Part XV-Cerebrolysin
See: Part XVI--MCI
See: Part XVII- Summary
See: Part XVIII--NO Releasing NSAIDs
See: Part XIX--Vitamin E
See: Part XX -Clinical Trials
See: Part XXI- AD and the Brain
See: Part XXII-Lewy Bodies Disease
See: Part XXIV-A Prequel
See: Part XXV- Plus Psychosis
See: Part XXVI- Hypothesis
See: Part XXVII- AD and Diabetes
See: Part XXVIII- Insulin and AD


By Harold Rubin, MS, ABD, CRC, Guest Lecturer
December 5, 2000

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