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Caution is advisable if ginkgo is used with psychotropic drugs, especially
antidepressants, in the absence of studies validating lack of adverse drug interactions.
Although it is a suggested use, there is scant evidence in the sources consulted for the
use of ginkgo for depression and no evidence about adjunctive use for depression.
Adjunctive treatment with antipsychotics requires careful coordination with the
prescribing physician, and adjunctive use with antidepressants requires extra
precautions if it is to be attempted at all.
- DRUG INTERACTIONS
According to the Natural Standard, ginkgo has anticoagulant effects, may suppress
platelet aggregation, and in rare cases has been associated with serious bleeding
problems, and thus suggests that people with clotting disorders who are receiving any
anticoagulant therapy, such as warfarin (Coumadin), heparin, aspirin, or ibuprofen,
ticlodipine (Ticlin), antiplatelet drugs such as clopidogrel (Plavix), and nonsteroidal anti-
inflammatory drugs such as ibuprofen (Motrin, Advil) or naproxen (Naprosyn, Aleve), or
have scheduled surgery or dental procedures, should use caution and talk to a health
care provider if using ginkgo.
Fugh-Berman is skeptical about these concerns. She relies on studies that have shown
no interaction with ticlopidine. None of the studies has noted significant bleeding
problems.
The Natural Standard adds that ginkgo may increase blood concentrations of some
drugs used for treating hypertension.
Citing "preliminary research," the Natural Standard also advises that ginkgo may affect
insulin and blood sugar levels. Thus, caution is advised when medications that lower
blood sugar are used.
Ginkgo has also been found to affect blood pressure in healthy volunteers, although the
studies disagree. The Natural Standard suggests that nifedipine should not be used in
conjunction with ginkgo for this reason.
