“Stress‐alleviating” and “vigilance‐enhancing” actions of Ginkgo biloba extract (EGb 761)

Abstract This overview is focused on the stress‐alleviating and vigilance‐enhancing properties of Ginkgo biloba extract (EGb 761) that have been observed in animal models and in humans and that appear useful in explaining the therapeutic effects of the extract on non‐cognitive brain functions that may be reflective of mood changes. With regard to its stress‐alleviating activity, in rodents EGb 761 facilitates behavioral adaptation, decreases circulating levels of corticosterone, catecholamines, ACTH, and CRH, suppresses the expression of the mitochondrial peripheral benzodiazepine receptor of the adrenal cortex, increases the anxiolytic activity of diazepam, increases arousal by an action that may involve GABA A receptor antagonism, induces anxiolytic‐like activity, prevents stress‐induced desensitization of hippocampal 5‐HT 1A receptors, suppresses the down‐regulation of hippocampal glucocorticoid receptors, and facilitates decision‐making. In humans, EGb 761 has vigilance‐enhancing effects that support its clinical use in treating disorders involving stress‐induced brain dysfunction and those non‐cognitive symptoms of dementia currently classified as “behavioral and psychological symptoms of dementia” (BPSD). Collectively, these findings indicate that EGb 761 is useful for treating symptoms that are now classified as components of BPSD. As drug combinations consisting of EGb 761 and a non‐selective cholinesterase inhibitor, an antidepressant drug, or a neuroleptic could possibly be even more useful in treating BPSD, evaluation of such therapy is recommended. Drug Dev. Res. 62:1–25, 2004. © 2004 Wiley‐Liss, Inc.