By David Liu and editing by Rachel Stockton
 
A review led by Austrian scientists and published in the Sept 2009 issue of Fortschritte der Neurologie-Psychiatrie suggests that Ginkgo biloba extract is at least as effective as commonly prescribed drugs in treating dementia.
 
Kasper S and Shubert H from Medizinische Universität Wien in Vienna, Austria reported that the ginkgo biloba extract, EGB 761,  affects  pathomechanisms relevant to dementia, such as Abeta agregation, mitochondrial dysfunction, insulin resistance, and hypoperfusion.
 
Kasper and Schubert reviewed 10 randomized, controlled, double-blind clinical trials to evaluate the efficacy of the ginkgo biloba extract in the treatment of dementia, specifically Alzheimer's disease and vascular dementia.
 
They found three of the four large trials showed the ginkgo biloba extract was significantly more effective than a placebo in treating mental dysfunctions.  Six smaller trials are consistent with the larger trials.
 
Only one study was inconclusive; this was in large part due to questionable external validity resulting from uncommonly rigorous patient selection.
 
The reviewed trials along with the most recent clinical trial suggest that the ginkgo biloba extract is most beneficial to patients with neurosychiactric symptoms experienced by the majority of dementia patients.
 
The ginkgo biloba extract was found as effective as cholinesterase inhibitors, which are commonly used to treat dementia including Alzheimer's disease.
 
One trial showed that compared to donepezil, a centrally acting reversible acetylcholinesterase inhibitor marketed under the trade name Aricept by its developer Eisai and partner Pfizer, the herbal medicine was not inferior to the Alzheimer's drug.
 
The reviewers suggest that EGB 761 has its place in the treatment of dementia.