Ginkgo biloba Compared with Cholinesterase Inhibitors in the Treatment of Dementia: A Review Based on Meta-Analyses by the Cochrane CollaborationKurz A. · van Baelen B.
aDepartment of Psychiatry and Psychotherapy, Technical University Munich, Munich, Germany; bMedisearch International, Mechelen, Belgium
Data were derived from the Cochrane Collaboration meta-analyses of the efficacies of ginkgo, donepezil, rivastigmine and galantamine on changes in cognitive function in patients with dementia and, where necessary, were transformed to standardized mean differences. The proportion of patients discontinuing trials was used as a proxy measure of tolerability. Outcomes were assessed after 6 months of treatment. Trial data for cholinesterase inhibitors were more consistent than those for ginkgo, particularly regarding patient populations and outcome measures. Significant benefits on cognition vs. placebo were seen with donepezil, 5 and 10 mg, rivastigmine, 6–12 mg, and galantamine, 16 and 24 mg. Significant benefit vs. placebo with ginkgo was seen only when all doses were pooled. Similar proportions of patients discontinued treatment with ginkgo and placebo. Cholinesterase inhibitors were also well tolerated, although a significantly greater proportion of patients receiving active treatment discontinued vs. placebo with some doses. An evidence-based medicine approach, taking into account the quality of clinical trials, is essential when assessing the safety and efficacy of medications.
Prof. Alexander Kurz, MD
Department of Psychiatry and Psychotherapy
Technical University Munich
DE–81675 Munich (Germany)
Tel. +49 89 4140 4285, Fax +49 89 4140 4923, E-Mail firstname.lastname@example.org
Accepted after revision: January 8, 2004
Published online: June 28, 2004
Number of Print Pages : 10
Number of Figures : 3, Number of Tables : 3, Number of References : 48
Dementia and Geriatric Cognitive Disorders
Vol. 18, No. 2, Year 2004 (Cover Date: Released August 2004)
Journal Editor: V. Chan-Palay, New York, N.Y.
ISSN: 1420–8008 (print), 1421–9824 (Online)
For additional information: http://www.karger.com/journals/dem