nach oben

Erschienen in:

01.11.2003 | Review Article

Complementary and Alternative Medicines in the Treatment of Dementia

An Evidence-Based Review

verfasst von: Dr Bruce J. Diamond, Susan K. Johnson, Kathleen Torsney, Jennifer Morodan, Brian J. Prokop, Dana Davidek, Patricia Kramer

Erschienen in: Drugs & Aging | Ausgabe 13/2003

Einloggen, um Zugang zu erhalten

Abstract

Alternative medicines may have potential beneficial results in treating certain forms of dementia and related symptoms, as well as slowing disease progression. Alternative medicines may ameliorate disturbances in cognition, mood, sleep and activities of daily living. Primary mechanisms of action include modifications in neurotransmitter synthesis, inhibition of neurotransmitter reuptake and enzyme-induced neurotransmitter breakdown, antioxidant and anti-platelet activity, enhanced blood flow and glucose metabolism. Adverse events can include cardiovascular, gastrointestinal, mood, autonomic and dermatologic effects. However, adverse events, when reported represent, a small percentage of treated groups and direct links between adverse events and alternative therapies are tenuous.

Many studies of alternative medicines in dementia are inconclusive and characterised by methodological deficiencies such as small sample sizes and inadequate controls. If alternative medicines can be shown to be efficacious using more rigourous experimental designs, both consumers and clinicians could avail themselves of a wider range of pharmacological substances that may offer the advantage of being better tolerated and exhibiting safer therapeutic margins than some allopathic medicines.

While a number of complementary interventions have shown both strengths and weaknesses, huperzine A, levacecarnine and EGB 761, based on the overall quality of the studies, identified mechanisms of activity and safety profiles merit further examination in controlled clinical outcome studies.

The use of tradenames is for product identification purposes only and does not imply endorsement.

Task Force on DSM-IV. Diagnostic and statistical manual for mental disorders. 4th ed (DSM-IV-TR™). Washington (DC): American Psychiatric Association, 2000

McKhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34: 939–44PubMedCrossRef

Ernst E. Herbal medications for common ailments in the elderly. Drugs Aging 1999; 15(6): 423–8PubMedCrossRef

Krapp K, Longe JL. The Gale encyclopedia of alternative medicine. Vol. 1–4. Farmington Mills (MI): Gale Group, 2001

Hoyer S, Oesterriech K, Stoll KD. Effect of pyritinol on blood flow and oxidative metabolism of the brain in patients with dementia. Arzneimittel Forschung 1977; 27(3): 671–4PubMed

Calvani M, Carta A, Caruso G, et al. Action of acetyl-L-carnitine in neurodegeneration and Alzheimer’s disease. Ann N Y Acad Sci 1992; 663: 483–6PubMedCrossRef

Carta A, Calvani M. Acetyl-L-carnitine: a drug able to slow the progress of Alzheimer’s disease? Ann N Y Acad Sci 1991; 640: 228–32PubMed

Herrmann W, Dietrich B, Hiersemenzel R. Pharmacol-electroencephalographic and clinical effects of the cholinergic substance acetyl-L-carnitine in patients with organic brain syndrome. Int J Clin Pharmacol Res 1990; 10(1–2): 81–4PubMed

Parnetti L, Abate G, Bartorelli L, et al. Multicentre study of 1-alpha-glyceryl-phosphorylcholine vs ST200 among patients with probably senile dementia of Alzheimer’s type. Drugs Aging 1993; 3(2): 159–64PubMedCrossRef

10.

Parnetti L, Caita A, Mecocci P, et al. Pharmacokinetics of IV and oral acetyl-1-carnitine in a multiple dose regimen in patients with senile dementia of Alzheimer type. Eur J Clin Pharmacol 1992; 42(1): 89–93PubMedCrossRef

11.

Passed M, Cucinotta D, Bonati P, et al. Acetyl-L-carnitine in the treatment of mildly demented elderly patients. Int J Clin Pharmacol Res 1990; 10(1–2): 75–9

12.

Passed M, Iannuccelli M, Ciotti G, et al. Mental impairment in aging; election of patients, methods of evaluation and therapeutic possibilities of acetyl-L-carnitine. Int J Clin Pharmacol Res 1988; 8(5): 367–76

13.

Rai G, Wright G, Scott L, et al. Double-blind placebo controlled study of acetyl-1-carnitine in patients with Alzheimer’s dementia. Curr Med Res Opin 1990; 11(10): 638–47PubMedCrossRef

14.

Sinforiani E, Iannuccelli M, Mauri M, et al. Neuropsychological changes in demented patients treated with acetyl-L-carnitine. Int J Clin Pharmacol Res 1990; 10(1–2): 69–74PubMed

15.

Spagnoli A, Lucca U, Menasce G, et al. Long-term acetyl-1-carnitine treatment in Alzheimer’s disease. Neurology 1991; 41(11): 1726–32PubMedCrossRef

16.

Thal L, Calvani M, Amato A, et al. A 1-year controlled trial of acetyl-1-carnitine in early-onset AD. Neurology 2000; 55(10): 805–10PubMedCrossRef

17.

Thal L, Carta A, Clarke W, et al. A 1-year multicenter placebo-controlled study of acetyl-1-carnitine in patients with Alzheimer’s disease. Neurology 1996, 11

18.

Holmes C, Hopkins V, Hensford C, et al. Lavender oil as a treatment for agitated behavior in severe dementia. Int J Geriatr Psychiatry 2002; 17: 305–8PubMedCrossRef

19.

Itoh T, Shimada Y, Terasawa K. Efficacy of Choto-san on vascular dementia and the protective effect of the hooks and stems of Uncaria sinensis on glutamate-induced neuronal death. Mech Ageing Dev 1999; 111: 155–73PubMedCrossRef

20.

Diamond BJ, Shiflett SC, Feiwel N, et al. Ginkgo biloba extract: mechanisms and clinical indications. Arch Phys Med Rehabil 2000; 81(5): 668–78PubMed

21.

Mantle D, Pickering AT, Perry EK. Medicinal plant extracts for the treatment of dementia: a review of their pharmacology, efficacy and tolerability. CNS Drugs 2000; 13: 201–13CrossRef

22.

Singh YN, Blumenthal M. Kava: an overview. Herbalgram 1997; 39: 33–56

23.

Higgins JP, Flicker L. Lecithin for dementia and cognitive impairment. Available in the Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 2. Oxford: Update Software, 2000: CD001015

24.

Lamberg L. Melatonin potentially useful but safety, efficacy remain uncertain. JAMA 1996; 276: 1011–4PubMedCrossRef

25.

Hindmarch I, Coleston DM, Kerr JS. Psychopharmacological effects of pyritinol in normal volunteers. Neuropsychobiology 1990–91; 24(3): 159–64PubMedCrossRef

26.

Brown RP, Gerbarg PL, Bottiglieri T. S-adenosylmethionine in the clinical practice of psychiatry, neurology, and internal medicine. Clinical Practice of Alternative Medicine 2000; 1(4): 230–41

27.

Caufield JS, Forbes HJM. Dietary supplements used in the treatment of depression, anxiety and sleep disorders. Lippincotts Prim Care Pract 1999; 3: 290–304

28.

Ang-Lee MK, Moss J, Yuan CS. Herbal medicines and perioperative care. JAMA 2001; 286: 208–16PubMedCrossRef

29.

Smith MA, Perry G, Richey PL, et al. Oxidative damage in Alzheimer’s. Nature 1996; 382: 120–1PubMedCrossRef

30.

Haffsman PM, Sival RC, Lucius SA, et al. Bright light therapy and melatonin in motor restless behavior in dementia: a placebo-controlled study. Int J Geriatr Psychiatry 2001; 16(1): 106–10CrossRef

31.

Cardinali DP, Brusco LI, Liberczuk C, et al. The use of melatonin in Alzheimer’s disease. Neuroendocrinol Lett 2002 Apr; 23Suppl. 1: 20–3PubMed

32.

Fainstein I, Bonetto A, Brusco LI, et al. Effects of melatonin in elderly patients with sleep disturbances. Curr Ther Res 1997; 58: 990–1000CrossRef

33.

Brusco LI, Marquez M, Cardinali DP. Melatonin treatment stabilizes chronobiological and cognitive symptoms in Alzheimer’s disease. Neuroendocrinol Lett 1998; 19: 111–5

34.

Brusco LI, Marquez M, Cardinali DP. Monozygotic twins with Alzheimer’s disease treated with melatonin: case report. J Pineal Res 1998; 25: 260–3PubMedCrossRef

35.

Cohen-Mansfield J, Garfinkel D, Lipson S. Melatonin for treatment of sundowning in elderly persons with dementia: a preliminary study. Arch Gerontol Geriatr 2000 Aug 1; 31(1): 65–76PubMedCrossRef

36.

Jean-Louis G, Zizi F, von Gizycki H, et al. Effects of melatonin in two individuals with Alzheimer’s disease. Percept Mot Skills 1998 Aug; 87(1): 331–9PubMedCrossRef

37.

McGaffigan S, Bliwise DL. The treatment of sundowning: a selective review of pharmacological and nonpharmacological studies. Drugs Aging 1997; 10(1): 10–7PubMedCrossRef

38.

Leathwood PD, Chauffard F, Heck E, et al. Aqueous extract of valerian root improves sleep quality in man. Pharmacol Biochem Behav 1982; 17: 65–71PubMedCrossRef

39.

Leathwood PD, Chauffard F. Quantifying the effects of mild sedatives. J Psychiatr Res 1983; 17: 115–22CrossRef

40.

Schulz H, Stolz C, Miller J. The effect of valerian extract on sleep polygraphy in poor sleepers: a pilot study. Pharmacopsychiatry 1994; 27: 147–51PubMedCrossRef

41.

Stevinson C, Ernst E. Valerian for insomnia: a systematic review of randomized clinical trials. Sleep Med 2000 Apr 1; 1(2): 91–9PubMedCrossRef

42.

Ballard CG, O’Brien JT, Reichelt K, et al. Aromatherapy as a safe and effective treatment for the management of agitation in a severe dementia: the results of a double-blind, placebo-controlled trial with Melissa. J Clin Psychiatry 2002; 63: 553–8PubMedCrossRef

43.

Smallwood J, Brown R, Coulter F, et al. Aromatherapy and behavior disturbances in dementia: a randomized controlled trial. Int J Geriatr Psychiatry 2001; 16: 1010–3PubMedCrossRef

44.

Kilstoff K Chenoweth L. New approaches to health and wellbeing for dementia day-care clients, family carers and day care staff. Int J Nurs Pract 1998; 4: 70–83PubMedCrossRef

45.

Booker D, Snape M, Johnson E, et al. Single case evaluation of the effects of aromatherapy and massage on disturbed behaviour in severe dementia. Br J Clin Psychol 1997; 36: 287–96CrossRef

46.

Wolfe N, Herzberg J. Can aromatherapy oils promote sleep in severely demented patients? Int J Geriatr Psychiatry 1996; 11: 926–7CrossRef

47.

Gray S, Clair A. Influences of aromatherapy on medication administration to residential-care residents with dementia and behavioral challenges. Am J Alzheimers Dis Other Demen 2002; 17: 169–74PubMedCrossRef

48.

American Psychiatric Association. Practice guideline for the treatment of patients with Alzheimer’s disease and other dementias of late life. Am J Psychiatry 1997; 154: 1–39

49.

Gaster B, Holroyd J. St John’s Wort for depression: a systematic review. Arch Intern Med 2000 Jan 24; 160(2): 152–6PubMedCrossRef

50.

Philipp M, Kohnen R, Hiller KO. Hypericum extract versus imipramine or placebo in patients with moderate depression: randomized multicentre study treatment for eight weeks. BMJ 1999; 319: 1534–9PubMedCrossRef

51.

Woelk H. Comparison of St John’s wort and imipramine for treating depression: randomised controlled trial. BMJ 2000; 321: 536–9PubMedCrossRef

52.

Lecrubier Y, Clerc G, Didi R, et al. Efficacy of St John’s Wort extract WS 5570 in major depression: a double-blind, placebo-controlled trial. Am J Psychiatry 2002; 159: 1361–6PubMedCrossRef

53.

Shelton RC, Keller MB, Gelenberg AJ, et al. Effectiveness of St John’s Wort in major depression. JAMA 2001; 285: 1978–86PubMedCrossRef

54.

Hypericum Depression Trial Study Group. Effect of hypericum perforatum (St Johns Wort) in major depressive disorder: a randomized controlled trial. JAMA 2002; 287: 1807–14CrossRef

55.

Linde K, Melchart D, Mulrow CD, et al. St Johns Wort and depression: letter to the editor. JAMA 2002; 288: 447PubMed

56.

Lehmann E, Kinzler E, Freidemann J. Efficacy of a special kava extract (Piper methysticum) in patients with states of anxiety, tension, and excitedness of nonmental origin — a double blind placebo-controlled study of four weeks treatment. Phytomedicine 1996; 2: 113–9CrossRef

57.

Volz HP, Keiser M. Kava-kava extract WS 1490 versus placebo in anxiety disorders: a randomized placebo-controlled 25 week outpatient trial. Pharmacopsychiatry 1997; 30: 1–5PubMedCrossRef

58.

Cropley M, Cave Z, Ellis J, et al. Effect ofkava and valerian on human physiological and psychological responses to mental stress assessed under laboratory conditions. Phytother Res 2002; 16: 23–7PubMedCrossRef

59.

Stevinson C, Huntley A, Ernst E. A systematic review of the safety of kava extract in the treatment of anxiety. Drug Saf 2002; 25: 251–61PubMedCrossRef

60.

Consumer Advisory Center for Food Safety and Applied Nutrition, US Food and Drug Administration, March 25, 2002. “Kava-containing dietary supplements may be associated with severe liver injury.” Available from URL: www.cfsan.fda.gov [Accessed 2002 Oct 17]

61.

Jones GM, Sahakian BY, Levy R, et al. Effects of acute subcutaneous nicotine on attention, information processing and short term memory in Alzheimer’s disease. Psychopharmacology 1992; 108: 485–94PubMedCrossRef

62.

White HK, Levin ED. Four week nicotine skin patch treatment effects on cognitive performance in Alzheimer’s disease. Psychopharmacology 1999; 143: 158–65PubMedCrossRef

63.

Zhang R, Tang X, Han Y, et al. Drug evaluation of huperzine A in the treatment of senile memory disorders [in Chinese]. Zhongguo Yao Li Xue Bao 1991; 12: 250–2PubMed

64.

Xu SS, Gao ZX, Weng Z, et al. Efficacy of tablet huperzine A on memory, cognition and behavior in Alzheimer’s disease. Zhongguo Yao Li Xue Bao 1995; 16: 391–5PubMed

65.

Xu S, Cai Z, Qu Z, et al. Huperzine-A in capsules and tablets for treating patients with Alzheimer disease. Zhongguo Yao Li Xue Bao 1999; 20(6): 486–90PubMed

66.

Zhang Z, Wang X, Chen Q, et al. Clincial efficacy and safety of huperzine Alpha in treatment f mild to moderate Alzheimer disease, a placebo-controlled, double-blind, randomized trial [in Chinese]. Zhonghua Yi Xue Za Zhi 2002; 82(14): 941–4PubMed

67.

Chatellier G, Lacomblez L, Group Francais d’Etude de la Tetrahydroaminoacridine. Tacrine (tetrahydroaminoacridine; THA) and lecithin in senile dementia of the Alzheimer type: a multicenter trial. British Medical Journal Clinical Research and Education 1990; 300(6723): 495–9CrossRef

68.

Maltby N, Broe GA, Creasey H, et al. Efficacy of tacrine and lecithin in mild to moderate Alzheimer’s disease: double-blind trial. BMJ 1994; 308(6933): 879–83PubMedCrossRef

69.

Foster NL, Petersen RC, Gracon SI, et al. An enriched-population, double-blind, placebo-controlled, crossover study of tacrine and lecithin in Alzheimer’s disease. The tacrine 970-6 study. Dementia 1996; 7(5): 260–6PubMed

70.

Tabet N, Birks J, Grimley-Evans J. Vitamin E for Alzheimer’s disease. Available in the Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 4. Oxford: Update Software, 2000: CD002854

71.

Riviere S, Birlouez-Aragon I, Nourhashemi F, et al. Low plasma vitamin C in Alzheimer patients despite an adequate diet. Int J Geriatr Psychiatry 1998; 13: 749–54PubMedCrossRef

72.

Sano M, Ernesto C, Thomas RG, The Alzhiemer’s Disease Cooperative Study, et al. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer’s disease. N Engl J Med 1997; 336(17): 1216–22PubMedCrossRef

73.

Foley D, White L. Dietary intake of antioxidants and risk of Alzheimer disease. JAMA 2002; 2: 3261–3CrossRef

74.

Bottiglieri T, Godfrey P, Flynn T, et al. Cerebrospinal fluid S-adenosylmethionine in depression and dementia: effects of treatment with potential and oral S-adenosylmethionione. J Neurol Neurosurg Psychiatry 1990; 53(12): 1096–8PubMedCrossRef

75.

Gomes-Trolin C, Regland B, Oreland L. Decreased methionine adenosyltransferase activity in erythrocytes of patients with dementia disorders. Eur Neuropsychopharmocol 1995; 5(2): 107–14CrossRef

76.

Sano M, Bell K, Cote L, et al. Double-blind parallel design pilot study of acetyl levocarnitine in patients with Alzheimer’s disease. Arch Neurol 1992; 49(11): 1137–41PubMedCrossRef

77.

Fischof PK, Saletu B, Rutehr E, et al. Therapuetic efficacy of pyrnitol in patients with senial dementia of the Alzheimer type (SDAT) and multi-infarct dementia (MID). Neuropsychobiology 1992; 26(1–2): 65–70CrossRef

78.

Cooper AJ, Magnus RV. A placebo-controlled study of pyritinol in dementia. Pharmatherapeutica 1980; 2(5): 317–22PubMed

79.

Letzel H, Haan J, Feil WB. Nootropics: efficacy and tolerability of products from three active substance classes. J Drug Dev Clin Pract 1996; 8: 77–94

80.

Geßner B, Voelp A, Klasser M. Study of the long term action of a Ginkgo biloba extract on vigilance and mental performance as determined by means of quantitative pharmaco-EEG and psychometric measurements. Arzneimittel Forschung 1985; 35: 1459–65PubMed

81.

Gerhardt G, Rogalla K, Jaeger J. Medikamentöse Therapie von Hirnleistungsstörungen. Fortschr Med 1990; 108: 384–8PubMed

82.

Hartmann A, Frick M. Effectiveness of a Ginkgo special extact on psychometric parameters in patients with vascular dementia [in German]. Munch Med Wochenschr 1991; 133: S23–5

83.

Hamann KF. Physikalische Therapie des vestibulären Schwindels in Verbindung mit Ginkgo-biloba-Extrakt. Therapiewoche 1985; 35: 4586–90

84.

Physicians Desk Reference (PDR) for Herbal Medicines. 1st ed. Montvale (NJ): Medical Economics Company, 1998

85.

Barth SA, Inselmann G, Heidemann HT. Influences of Ginkgo biloba on cyclosporin A induced lipid peroxidation in human liver microsomes in comparison to vitamin E, glutathion and N-acetyllcysteine. Biochem Pharmacol 1991; 41: 1521–6PubMedCrossRef

86.

Gryglewski RJ, Korbut R, Robak J, et al. On the mechanism of antithrombotic action of flavonoids. Biochem Pharmacol 1987; 36: 317–22PubMedCrossRef

87.

Coeffler E. PAF-acether analogs, platelet activation an BN 52021. In: Braquet P, editor. Ginkgolides. Barcelona: JR Prous, 1988: 105–113

88.

Janssens D, Michiels C, Delaiv E, et al. Protection of hypoxiainduced ATP decrease in endothelial cells Ginkgo biloba extract and bilobalide. Biochem Pharmacol 1995; 50: 991–9PubMedCrossRef

89.

Ramassamy C, Christen Y, Clostre F, et al. The Ginkgo biloba extract, EGb 761, increases synaptosomal uptake of 5-hydroxytryptamine: in-vitro and ex-vivo studies. J Pharm Pharmacol 1992; 44: 943–5PubMedCrossRef

90.

Amri H, Ogwuegbu SO, Boujrad N, et al. In vivo regulation of the peripheral-type benzodiazepine receptor and glucocorticoid synthesis by ginkgo biloba extract Egb 761 and isolated ginkgolides. Endocrinology 1996; 137: 5707–17PubMedCrossRef

91.

Hofferberth B. The effect of Ginkgo biloba extract on neurophysiological and psychometric measurement results in patients with psychotic organic brain syndrome: a double-blind study against placebo [in German]. Arzneimittel Forschung 1989; 39: 918–22PubMed

92.

Rai GS, Shovlin C, Wesnes KA. A double-blind, placebo controlled study of Ginkgo biloba extract (‘Tanakan’) in elderly outpatients with mild to moderate memory impairment. Curr Med Res Opin 1991; 12: 350–5PubMedCrossRef

93.

Itil T, Martorano D. Natural substances in psychiatry (Ginkgo biloba in dementia). Psychopharmacol Bull 1995; 31: 147–58PubMed

94.

Eckmann F, Schlag H. Kontrollierte Doppelbind-Studie zum Wirksamkeitsnachweis von Tebonin forte® bei Patienten mit zerebrovaskulärer Insuffizienz. Fortschr Med 1982; 100: 1474–8PubMed

95.

Eckmann F. Hirnleistungsstörungen: behandlung mit gingkobiloba extrakt. Fortschr Med 1990; 29: 557–60

96.

Schubert H, Halama P. Depressive episode primarily unresponsive to therapy in elderly patients: efficacy of Ginkgo biloba extract EGb 761 in combination with antidepressants [in German]. Geriatrie Forschung 1993; 1: 45–53

97.

Halama P. Ginkgo biloba: effectiveness of a special extract in patients with cerebral insufficiency [in German]. Munch Med Wochenschr 1991; 133: 190–4

98.

Arrigo A, Cattaneo S. Clinical and psychometric evaluation of Ginkgo biloba extract in chronic cerebro-vascular diseases. In: Agnoli A, Rapin JR, Scapagnini V, Weitbrecht WV, editors. Effects of ginkgo biloba extract on organic cerebral impairment. London: John Libbey & Company Ltd, 1985

99.

van Dongen MC, van Rossum E, Kessels AG, et al. The efficacy of Ginkgo for elderly with dementia and age-associated memory impairment: new results of a randomized clinical trial. J Am Geriatr Soc 2000; 48(10): 1183–94PubMed

100.

Le Bars PL, Katz MM, Berman N, et al. A placebo-controlled, double-blind, randomized trial of an extract of Gingko biloba for dementia. JAMA 1997; 278: 1327–32PubMedCrossRef

101.

Le Bars PL, Katz MM, Berman N, North American EGb Study Group, et al. A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. Dement Geriatr Cogn Disord 2000; 11(4): 230–7PubMedCrossRef

102.

Birks J, Grimley Evans J, Van Dongen M. Ginkgo biloba for cognitive impairment and dementia. Available in The Cochrane Library [database on disk and CD ROM]. Updated quarterly. The Cochrane Collaboration; issue 1. Oxford: Update Software, 2003

103.

Oken BS, Storzbach DM, Kaye JA. The efficacy of Ginkgo biloba on cognitive function in Alzheimer disease. Arch Neurol 1998; 55(11): 1409–15PubMedCrossRef

104.

Kleijnen J, Knipschild P. Ginkgo biloba for cerebral insufficiency. Br J Clin Pharmacol 1992; 34: 352–8PubMedCrossRef

105.

Kanowski S, Herrmann WM, Stephan K, et al. Proof of efficacy of the Ginkgo biloba special extract EGB 761 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type or multi-infarct dementia. Pharmacopsychiatry 1996; 29: 47–56PubMedCrossRef

106.

Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract [letter]. N Engl J Med 1997 Apr 10; 336(15): 1108PubMedCrossRef

107.

Rowin J, Lewis SL. Spontaneous bilateral subdural hematomas associated with chronic Ginkgo biloba ingestion. Neurology 1996; 46: 1775–6PubMedCrossRef

108.

Gilbert GJ. Ginkgo biloba. Neurology 1997; 48: 1137PubMedCrossRef

109.

Vale S. Subarachnoid hemorrhage associated with Ginkgo biloba [letter]. Lancet 1998; 352: 36PubMedCrossRef

110.

Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990–1997. JAMA 1998; 280: 1569–75PubMedCrossRef

111.

Gold JL, Laxer DA, Dergal JM, et al. Herbal-drug therapy interactions: a focus on dementia. Curr Opin Clin Nutr Metab Care 2001; 4: 29–34PubMedCrossRef

112.

Hofferberth B. Ginkgo biloba special extract in patients with psychotic organic brain syndrome [in German]. Munch Med Wochenschr 1991; 133: S30–3

113.

Brüchert E, Heinrich SE, Ruf-Kohler P. Efficacy of LI 1370 in elderly patients with cerebral insufficiency: multicentric double-blind trial [in German]. Munch Med Wochenschr 1991; 133: S9–S14

114.

Brailowsky S, Montiel T, Hernandez-Echeagarray E, et al. Effects of ginkgo biloba extract on cortical hemiplegia in the rat. In: Christen Y, Costentin J, Lacour M, editors. Effects of ginkgo biloba extract (EGb 761) on the central nervous system. Paris: Elsevier, 1992: 95–103

115.

Kleijnen J, Knipschild P. Ginkgo biloba. Lancet 1992; 340: 1136–9PubMedCrossRef

116.

Ernst E. Second thoughts about the safety of St Johns Wort. Lancet 1999; 354: 2014–5PubMedCrossRef

Titel: Complementary and Alternative Medicines in the Treatment of Dementia
An Evidence-Based Review
verfasst von: Dr Bruce J. Diamond
Susan K. Johnson
Kathleen Torsney
Jennifer Morodan
Brian J. Prokop
Dana Davidek
Patricia Kramer
Publikationsdatum: 01.11.2003
Verlag: Springer International Publishing
Erschienen in: Drugs & Aging / Ausgabe 13/2003
Print ISSN: 1170-229X
Elektronische ISSN: 1179-1969
DOI: https://doi.org/10.2165/00002512-200320130-00003

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen