Ginkgo Biloba

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Specifically for Schizophrenia

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Why it works for Schizophrenia:

Ginkgo biloba (usually as a standardized extract such as EGb-761) has been studied as an adjunct (add-on) therapy to antipsychotics in schizophrenia. Some randomized trials report modest improvements (especially in positive symptoms or tardive dyskinesia and some EPS measures), but the evidence is mixed and not strong enough to support Ginkgo as a stand-alone treatment. Safety concerns (bleeding risk, interactions) mean it must be used cautiously and only under medical supervision. Psychiatrist.com

Mechanisms proposed (biological rationale)

Antioxidant / free-radical scavenging: Schizophrenia has been associated with oxidative stress; Ginkgo extracts (EGb-761) contain flavonoids and terpenoids that act as antioxidants and may reduce oxidative neuronal damage. This is one of the main biological rationales used in clinical research. Psychiatrist.com
Neuroprotective / metabolic effects: EGb-761 has been reported to improve cerebral microcirculation, mitochondrial energy metabolism and modulate neurotransmitter systems (serotonin uptake, etc.), which could plausibly affect cognition and some symptom domains. The Clinics
Adjunct to antipsychotics / reduce extrapyramidal effects: Some RCTs found that EGb added to antipsychotics reduced positive symptoms or reduced extrapyramidal side effects — possibly by antioxidant/neuroprotective action or by modulating neurotransmitter handling. Psychiatrist.com

Important caveat: these mechanistic explanations are hypotheses supported by preclinical and limited clinical data — they do not prove effectiveness across all patients. High-quality, large multicentre confirmatory trials are limited and results are heterogeneous. Oxford Academic

How to use for Schizophrenia:

Key points from clinical trials and reviews

Formulation used in most clinical trials: a standardized extract (commonly EGb-761). Trials using non-standardized raw leaf preparations are much harder to interpret; the standardized extract is what research mostly examines. Psychiatrist.com
Typical trial doses:
240 mg/day (80 mg three times daily) was used in a large randomized trial for tardive dyskinesia in people with schizophrenia (EGb-761 80 mg tid → 240 mg/day). Psychiatrist.com
360 mg/day (fixed dose) was used in a 2001 RCT adding EGb to haloperidol in treatment-resistant schizophrenia. Psychiatrist.com
Broader literature reports doses between 80–240 mg/day as common for cognitive/psychiatric indications; some studies have used wider ranges (80–720 mg/day), but higher doses are less common and safety data are more limited. The Clinics
Duration used in trials: most RCTs lasted 8–12 weeks (some up to 6 months follow-up in select trials). Benefits in the trials were measured at weeks 6–12 typically. Psychiatrist.com
How used clinically in trials: always as an adjunct to antipsychotic medication (i.e., added to an otherwise stable antipsychotic regimen), not as a monotherapy. Doses and antipsychotic regimens were kept stable during the trial periods. Psychiatrist.com

Practical (clinical) takeaway

If considered, the common research approach is: standardized EGb-761 extract, 120–240 mg/day (often 240 mg/day split TID or 120 mg BID), as an add-on to a stable antipsychotic regimen, for a trial period of ~8–12 weeks, with monitoring for efficacy and adverse effects. Because some trials used 360 mg/day, clinicians sometimes titrate upward only under supervision. Always use a standardized extract and document brand and batch. Psychiatrist.com

Scientific Evidence for Schizophrenia:

Key randomized controlled trials (examples)

Zhang XY et al., J Clin Psychiatry 2001 — EGb (360 mg/day) + haloperidol vs placebo + haloperidol in treatment-resistant chronic schizophrenia. Found greater improvement in some symptom scales and fewer extrapyramidal symptoms in the EGb group. (PDF). Psychiatrist.com
Zhou D-F et al., J Clin Psychiatry 2011 — EGb-761 240 mg/day for tardive dyskinesia in schizophrenia (randomized, double-blind, placebo-controlled, 12 weeks). Found significant reduction in AIMS (tardive dyskinesia) scores in EGb group. (PDF / trial registry NCT00672373). Psychiatrist.com

Systematic reviews / meta-analyses & reviews

International Journal of Neuropsychopharmacology / systematic review discussing antioxidants and ginkgo as adjuncts in schizophrenia (review/meta-analysis style overview). This review discusses the biological rationale and available trials and calls for more controlled trials. Oxford Academic
A systematic review / meta-analysis focused on EGb as an adjunct in chronic schizophrenia (ScienceDirect summary). These reviews generally report some positive signals in small RCTs but emphasize heterogeneity, small sample sizes, and need for more robust evidence. ScienceDirect

Clinical trial registrations (larger plans)

Trial registry entries for EGb-761 added to risperidone in first-episode schizophrenia and other large trials have been registered (example: double-blind trial of EGb-761 + risperidone in 200 treatment-naïve first-episode patients). These show ongoing or completed investigational interest but highlight the variable trial quality and populations. ICHGCP

Specific Warnings for Schizophrenia:

Major safety issues (documented)

Bleeding risk and antithrombotic interactions: Ginkgo can affect platelet function and has been associated with increased bleeding risk in observational data when combined with warfarin or other anticoagulants/antiplatelets. If the patient is on warfarin, DOACs, clopidogrel, aspirin, or other blood-thinning agents, ginkgo is generally contraindicated or requires specialist oversight and monitoring. Hello Pharmacist
Drug interactions with psychotropic drugs: There are case reports and guidance suggesting possible interactions when ginkgo is used with antidepressants (risk of serotonin syndrome was discussed in guidance documents) and antipsychotics — data are limited but caution is warranted. One review (RACGP) notes limited evidence but warns about combining ginkgo with SSRIs and St John’s wort; psychiatric case reports also exist. RACGP+1
Reports of mood or behavioral changes: There are case reports of mood dysregulation, agitation, or worsening behavioral symptoms in individuals with psychiatric diagnoses after starting ginkgo — monitor mood/behavior closely in people with schizophrenia. BioMed Central
Seizure risk (rare / debated): Historically, there have been concerns about ginkgo seeds and extracts and seizure risk (mainly with ingestion of large amounts of raw seeds or adulterated products). For standardized leaf extracts the risk appears low, but be cautious in people with seizure disorders. (General product safety literature; see review articles). The Clinics
Quality/control of supplements: Herbal supplements vary widely in active component concentrations unless a standardized extract (EGb-761 or equivalent) is used. Use pharmaceutical-grade, standardized extracts where possible. The Clinics

Monitoring and clinical precautions

Always inform the treating psychiatrist and the general practitioner before starting ginkgo. Do not stop or change antipsychotic medication without medical advice.
Baseline review of bleeding risk, concurrent anticoagulant/antiplatelet use, liver disease, seizure history, and close monitoring for worsening psychosis, agitation, or new movement symptoms.
If combined with other medications that affect bleeding or neurotransmitters, consider lab monitoring (INR for warfarin) and closer clinical follow-up. Hello Pharmacist

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General Information (All Ailments)

Note: You are viewing ailment-specific information above. This section shows the general remedy information for all conditions.

What It Is

Ginkgo biloba is an herbal supplement derived from the leaves of the Ginkgo biloba tree, one of the oldest living tree species in the world. Native to China, it has been used in traditional medicine for thousands of years. Today, it is available in various forms such as capsules, tablets, extracts, and teas. The active components of ginkgo include flavonoids and terpenoids, which are known for their potent antioxidant and anti-inflammatory properties.

How It Works

Ginkgo biloba is believed to work primarily through three mechanisms:

Improved Blood Flow: Ginkgo enhances circulation by dilating blood vessels and reducing blood viscosity, which can increase oxygen and nutrient delivery to tissues—especially in the brain, eyes, and extremities.
Antioxidant Action: The flavonoids in ginkgo combat oxidative stress by neutralizing free radicals, which may help protect cells and slow age-related decline.
Neuroprotective Effects: It may improve neuronal function and communication by influencing neurotransmitters such as dopamine and serotonin. Some studies suggest it can support cognitive function and memory, particularly in older adults or those with mild cognitive impairment.

Why It’s Important

Ginkgo biloba is valued for its potential benefits in several health areas:

Cognitive Health: It is widely studied for supporting memory, focus, and mental clarity, with potential benefits for individuals experiencing cognitive decline or dementia.
Circulatory Support: By improving blood flow, it may aid in conditions like peripheral artery disease or tinnitus (ringing in the ears) that are related to poor circulation.
Antioxidant Protection: Its antioxidant capacity can help combat cellular damage associated with aging and environmental stressors.
Mood and Anxiety Relief: Some evidence indicates that ginkgo may have mild anxiolytic (anti-anxiety) effects by modulating stress-related hormones and neurotransmitters.

Considerations

While ginkgo biloba is generally considered safe when taken at recommended doses, there are important precautions:

Interactions: Ginkgo may interact with blood thinners (like warfarin or aspirin), increasing the risk of bleeding. It can also interact with antidepressants and certain diabetes medications.
Side Effects: Possible side effects include headaches, dizziness, upset stomach, or allergic reactions. Rarely, it may cause heart palpitations or gastrointestinal discomfort.
Dosage and Quality: Standardized extracts (often 24% flavone glycosides and 6% terpene lactones) are typically recommended for consistency and safety. The quality of supplements can vary widely, so reputable brands should be chosen.
Special Populations: Pregnant or breastfeeding individuals, and those with seizure disorders or bleeding conditions, should avoid ginkgo unless directed by a healthcare professional.

Helps with these conditions

Ginkgo Biloba is most effective for general wellness support with emerging research . The effectiveness varies by condition based on clinical evidence and user experiences.

PTSD 0% effective

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Erectile Dysfunction 0% effective

Alzheimer's 0% effective

Parkinson's 0% effective

Macular Degeneration 0% effective

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PTSD

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Ginkgo’s plausibility for PTSD comes from several biological actions that map onto processes believed to underlie PTSD (neuroinflammation, oxidative s...

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