Ginkgo biloba, a pharmacological review and its clinical value

Ginkgo biloba originates from China and was used there in traditional medicine but an extract of the leaves is now widely used in Europe. The major indication is the deleterious effects of ageing, particularly those associated with brain function.

Decline in brain function is widely accepted as being due to ischaemia caused by blockage of blood vessels and to the damage caused by oxygen free radicals. Ginkgo contains a mixture of compounds which reduce these deleterious effects. Compounds of interest include flavonoids and the terpenoidal ginkgolides and bilobalides which reduce inflammation, inhibit platelet aggregation and have antioxidant activities. These compounds are thought to be the major causes of the activity noted clinically.

Well-conducted clinical studies have shown that Ginkgo produces significant improvement in mental function in the elderly. Current issues concerned with its effective use include the criteria used to assess quality and its introduction and acceptance as a recognised medicine.