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highly recognized herbal supplements with well-proven efficacy. It is recommended
for managing symptoms associated with a range of neurologic and vascular disorders
including dementia .... It is approved for treatment of Alzheimer’s disease in Belgium,
the Czech Republic and Germany, and suggested for memory complaints in France and
Spain. It is classified by the World Health Organization (“WHO”) as among the
available anti-dementia drugs.”^3
In addition, Germany’s Commission E specifies use for primary degenerative dementia
(mental degeneration due to aging), vascular dementia, and a combination of both.^4
Mischoulon and Rosenbaum conclude that: "there is a large body of data to support
the efficacy of EGb761 as a neuroprotector and an enhancer of neural functioning.
Evidence from biomedical research supports its effects on memory impairment, lack
of concentration, cerebral-vascular insufficiency, as well as age-related and dementia-
related cognitive weaknesses.”^5
Inconsistent results are explained as derived from the characteristics of the population
studied, the type of outcome measurements selected, and the EGb 761 regimen tested
in the trial. Mischoulon and Rosenbaum further conclude that: “assessments measuring
accuracy and speed, which are most closely related to working memory, better
demonstrate the effect of EGP 761 rather than assessments that measure long-term
storage and retrieval abilities, regardless of the study population.”^6 They conclude that
EGb 761: “seems to enhance complex attention, speed of information processing, and
the rate of working memory.”^7
With regard to the studies measuring EGb 761’s effect on Alzheimer’s disease,
Mischoulon and Rosenbaum conclude that "There are several large scale studies and
literature analyses that support the prophylactic and treatment use of EGb 761 for
Alzheimer dementia.”^8 In particular, they cite with approval the Oken et al.’s meta-
analysis of EGb 761’s effect on Alzheimer's disease and associated dementia, which
reviewed over 50 clinical studies and was relied on by Fugh-Berman and Cott. “After
applying several exclusion criteria, the authors concluded that their quantitative analysis
of the literature showed a small significant effect on objective measures of cognitive