Ginkgo, Ginseng and Bacopa, which have all been used for centuries in the practice of Chinese and Ayurvedic Medicine, are now being recognized within allopathic medicine. Besides being believed to enhance the mental activity of the healthy individual, they are being actively studied as potential therapeutic treatments for combating degenerative diseases such as Altzhiemers and Dementia. Clinical trials are suggesting that these herbs are capable of slowing the progression of these devastating illnesses and significantly improving memory, attention, psychopathology and behavior in afflicted patients.

Ginkgo, Ginseng and Bacopa have been on the forefront of the fight against aging and the lifestyle stress that can accelerate it. Studies so far have suggested that these herbs, alone and in combination, may be helpful in alleviating stress, insomnia, sexual dysfunction, weakened immune systems and vascular disorders.

Study synopsis

It is becoming apparent that the standardized extract of Ginkgo biloba, in proper proportion to Bacopa monnniera and Korean Gingseng, may provide benefit to the cognitive functioning of healthy individuals as well. The following outlines relevant data to each component herb.

Cognitive Improvement: Memory, Energy, IQ

Kennedy, D.O. Scholey, A.B., Wesnes, K.A. The dose-dependent cognitive effects of acute administration of Ginkgo biloba to healthy young volunteers. Psychopharmacology. 151:416-423, 2000.

Study utilized a placebo-controlled, multi-dose, double-blind, balanced, crossover design.

Compared with the placebo, administration of Ginkgo produced a number of significant changes on the performance measures (cognitive testing conducted with the Cognitive Drug Research computerized assessment battery).

The most striking was a dose-dependent improvement of the "speed of attention" factor following both 240 mg and 360 mg of the extract.

McKenna DJ. Jones K. Hughes K. Efficacy, safety, and use of ginkgo biloba in clinical and preclinical applications. Alternative Therapies in Health & Medicine. 7(5):70-86, 88-90, 2001 Sep-Oct.

Ginkgo Biloba, due in part to its potent antioxidant properties, enhances peripheral and cerebral circulation. Ginkgo's primary therapeutic application has been in treating cerebrovascular dysfunctions and peripheral vascular disorders. It has proven efficacious in patients with intermittent claudication.

This potent has been heavily used to combat memory and cognitive impairment in patients with varying degrees of dementia and Alzheimer's disease

Ginkgo has also been investigated as a treatment for sexual dysfunction resulting from antidepressant medications. An extract from the ginkgo leaf was 84% effective in treating antidepressant-induced sexual dysfunction predominantly caused by selective serotonin reuptake inhibitors (SSRIs).

Kennedy, D.O., Scholey, A.B., Wesnes, K.A. Modulation of cognition and mood following administration of single doses of Ginkgo biloba, ginseng, and a ginkgo/ginseng combination to healthy young adults. Physiology & Behavior. 75 (5): 739-751, 2002, April.

Study followed a randomized placebo-controlled, double blind, balanced, crossover design. Cognitive testing was conducted with the Cognitive Drug Research computerized assessment battery and two serial subtraction mental arithmetic tasks. Mood was assessed with Bond-Lader visual analogue scales.

Treatments were associated with improved secondary memory performance on the CDR battery, with the ginseng condition evincing some improvement in the speed of performing memory tasks and in the accuracy of attentional tasks.

Kennedy, D.O., Scholey A.B., Wesnes, K.A. Differential, dose dependent changes in cognitive performance following acute administration of a Ginkgo biloba / Panax ginseng combination to healthy young volunteers. Nutr Neurosci. 4 (5): 399-412, 2001.

Researchers previously showed differential cognitive improvements following single doses of Ginkgo biloba and of Ginseng. There is also evidence that a combination of the standardized extracts may improve aspects of cognitive performance both in pathological populations and the healthy middle aged.

Study followed a placebo-controlled, double blind, balanced, crossover design.

The most striking result was a dose-dependent improvement in performance on the "quality of memory" factor for the highest dose. There was also a dose-dependent decrement in performance of the "speed of attention" factor for both the 320 and 640 mg doses.

Stough C, Lloyd J, Clarke J et al. The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects. Psychopharmacology (Berl) 2001; 156 (4):481-484.

The current study examined the chronic effects of an extract of bacopa on cognitive function in healthy human subjects.

Study was double-blind placebo-controlled independent-group design.

Bacopa significantly improved speed of visual information processing, learning rate and memory consolidation and state anxiety compared to placebo, with maximal effects evident after 12 weeks.

These findings suggest that bacopa may improve higher order cognitive processes that are critically dependent on the input of information from our environment such as learning and memory.

Ellis JM. Reddy P. Effects of Panax ginseng on quality of life. Annals of Pharmacotherapy. 36(3):375-9, 2002 Mar.

This study assessed the time-dependent effects of Panax ginseng on health-related quality of life (HRQOL) by use of a general health status questionnaire.

Subjects were randomized in a double-blind manner to P. ginseng. The Short Form-36 Health Survey version 2 (SF-36v2), a validated general health status questionnaire, was used to assess HRQOL at baseline and at 4 and 8 weeks

After 4 weeks of therapy, higher scores in social functioning, mental health, and the mental component summary scales were observed in patients randomized to P. ginseng.

Alzheimer's Disease

*Oken BS, et al. The efficacy of Ginkgo biloba on cognitive function in Alzheimer disease. Arch Neurol 1998; 55 (11):1409-15.

In 1998 a quantitative analysis of the literature showed that three to six months of treatment with 120-mg to 240-mg daily doses of ginkgo extract had a significant effect on cognitive function in patients with Alzheimer's disease.

Shadlen MF, Larson EB. What's new in Alzheimer's disease treatment? Reasons for optimism about future pharmacologic options. Postgrad Med 1999; 105 (1):109-18.

Memory and attention of patients receiving 240 mg per day of ginkgo for three months were shown to improve.

Dementia

*Le Bars PL, et al. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. North American EGb Study Group. JAMA 1997; 278 (16):1327-32.

This 52-week, randomized double-blind, placebo-controlled, parallel-group, multicenter study was designed to assess the efficacy and safety of EGb in Alzheimer disease and multi-infarct dementia. The primary outcome measures were Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog), Geriatric Evaluation by Relative's Rating Instrument (GERRI), and Clinical Global Impression of Change (CGIC).

EGb was safe and appears capable of stabilizing and, in a substantial number of cases, improving the cognitive performance and the social functioning of demented patients for 6 months to 1 year.

Le Bars PL. Kieser M. Itil KZ. A 26-week analysis of a double-blind, placebo-controlled trial of the ginkgo biloba extract EGb 761 in dementia. Dementia & Geriatric Cognitive Disorders. 11(4):230-7, 2000 Jul-Aug.

The data were collected during a 52-week, double-blind, placebo-controlled, fixed dose, parallel-group, multicenter study. The primary outcome measures included the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), Geriatric Evaluation by Relative's Rating Instrument (GERRI) and Clinical Global Impression of Change.

In comparison to the baseline values, the placebo group showed a statistically significant worsening in all domains of assessment, while the group receiving EGb was considered slightly improved on the cognitive assessment and the daily living and social behavior.

Regarding safety, no differences between EGb and placebo were observed.

Itil TM, et al. The pharmacological effects of ginkgo biloba, a plant extract, on the brain of dementia patients in comparison with tacrine. Psychopharmacol Bull 1998; 34 (3):391-7

This study demonstrated that ginkgo's effect on the central nervous system is comparable to that of tacrine and other "cognitive activators" such as pramiracetam and vinpocetine, as well as that of some antidementia medications.

Curtis-Prior P. Vere D. Fray P. Therapeutic value of Ginkgo biloba in reducing symptoms of decline in mental function. Journal of Pharmacy & Pharmacology. 51(5):535-41, 1999 May.

It has been proposed that Ginkgo (EGb761) may improve the memory of healthy volunteers, and in an assessment of forty clinical studies, it was reported that Ginkgo was able to improve the twelve different symptoms comprising 'cerebral insufficiency', all of which are manifest in the elderly.

These were supported in a second major study, using LI1370. However, in both instances, the evidence was largely based upon the results of self-assessment questionnaires. Latterly, in a large double blind study of men and women with the diagnosis of uncomplicated dementia who were administered Ginkgo for a year, a further positive outcome was claimed.

Sexual Dysfunction

Cohen AJ, Bartlik B. Ginkgo biloba for antidepressant-induced sexual dysfunction. J Sex Marital Ther 1998; 24 (2):139-43.

An extract from the ginkgo leaf was 84% effective in treating antidepressant-induced sexual dysfunction predominantly caused by selective serotonin reuptake inhibitors (SSRIs). Women were more responsive than were men; dosages ranged from 60 mg per day to 120 mg twice daily.

Waynberg J. Brewer S. Effects of Herbal vX on libido and sexual activity in premenopausal and postmenopausal women. Advances in Therapy. 17(5):255-62, 2000 Sep-Oct.

This study investigated the possibility of an alternative to chemical medication in the treatment of sexual dysfunction in healthy women. The efficacy of a unique herbal formulation of Muira puama and Ginkgo biloba (Herbal vX) was assessed in 202 healthy women complaining of low sex drive.

Statistically significant improvements occurred in frequency of sexual desires, sexual intercourse, and sexual fantasies, as well as in satisfaction with sex life, intensity of sexual desires, excitement of fantasies, ability to reach orgasm, and intensity of orgasm.

Intermittent Claudication

*Pittler MH. Ernst E. Ginkgo biloba extract for the treatment of intermittent claudication: a meta-analysis of randomized trials. American Journal of Medicine. 108(4):276-81, 2000 Mar.

Eight randomized, placebo-controlled, double-blind trials were included. Meta-analysis found a significant difference in the increase in pain-free walking distance in favor of Ginkgo biloba. These results suggest that Ginkgo biloba extract is superior to placebo in the symptomatic treatment of intermittent claudication.

Cancer

Shin HR. Kim JY. Yun TK. Morgan G. Vainio H. The cancer-preventive potential of Panax ginseng: a review of human and experimental evidence. Cancer Causes & Control. 11(6):565-76, 2000 Jul.

Published results from a cohort and two case-control studies in Korea suggest that the intake of ginseng may reduce the risk of several types of cancer. When ginseng was tested in animal models, a reduction in cancer incidence and multiplicity at various sites was noted. Panax ginseng and its chemical constituents have been tested for their inhibiting effect on putative carcinogenesis mechanisms; in most experiments inhibitory effects were found.

While Panax ginseng C. A. Meyer has shown cancer-preventive effects both in experimental models and in epidemiological studies, the evidence is currently not conclusive as to its cancer-preventive activity in humans. The available evidence warrants further research into the possible role of ginseng in the prevention of human cancer and carcinogenesis.

Depression, Stress and Fatigue

Wong AH. Smith M. Boon HS. Herbal remedies in psychiatric practice. Archives of General Psychiatry 1998 Nov; 55(11):1033-44.

In eight studies on Ginkgo deemed to be of good quality, all but 1 found clinically significant improvement in symptoms, such as memory loss, concentration difficulties, fatigue, anxiety, and depressed mood.

Ginseng has a long list of indications, including treating stress and fatigue and improving endurance. Although many mechanisms of action have been postulated, it probably affects the hypothalamic-pituitary-adrenal axis, resulting in elevated plasma corticotropin and corticosteroid levels.

Immune System and Anti-Aging

Kitts D. Hu C. Efficacy and safety of ginseng. [Review 101 refs] Public Health Nutrition. 3(4A):473-85, 2000 Dec.

Ginseng (Panax ginseng, C.A. Meyer) has been a popular herbal remedy used in eastern Asian cultures for thousands of years. There are numerous theories and claims describing the efficacy of ginseng, which can combat stress, enhance both the central and immune systems and contribute towards maintaining optimal oxidative status against certain chronic disease states and aging.