Can Ginkgo biloba help counteract the age, drug, or disease-induced cognitive impairment, such as anticholinergics, antihistamines or Alzeheimer?
Thank you Dr Guda for sharing!
Ginko biloba has been available on market under different brands for quite long time now. Early enthusiasm regarding pro-cognitive actions esp in dementia of Alzheimer's disease soon waned with mixed results from different studies. In my opinion, 2 factors have contributed towards this aversive attitude. First, many clinicians tend to use suboptimal doses. Doses that helped dementia in studies were in range of 120 mg at laest (that is 3 tab of Tebonina 40 mg). Second, many unforseen drug-herbal interactions were unknown. We have previously reported on resultant serious IC hemorrhage with Ginko. With this and similar reports, clinicians refrain from prescribing Ginko. Interestingly, a renewed interest in Ginko has recently surged with a meta-analysis by Andrade et al. speaking to pro-cognitive, anti-oxidant, anti-inflammatory, non-amyloidogenic actions etc. A repurposing of Ginko for SSRIs-induced sexual dysfunction resurrected its use in clinical practice.
Regarding reversing AChs actions, I do not believe so, since Ach is not a target for action. Moreover, we know these drugs can plummet ACEi actions(eg donepezi= Aricept for AD). So, in my experience, I would prefer to discontinue AChs first. If any, Ginko, at 120 mg/d at least, can mitigate rather than reverse this horrendous anti-cognitive actions.
Trust this may help.
Regards.
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