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According to the Natural Standard, potential interactions with MAOI, SSRI and
antipsychotic drugs have been noted, but have not yet been confirmed in humans.
Thus, caution is appropriate to avoid the potential of serotonin syndrome, and the
prescribing physician should be consulted before using ginkgo in connection with these
drugs. Serotonin syndrome is a condition defined by muscle rigidity, fever, confusion,
increased blood pressure and heart rate, and coma. Fugh-Berman is skeptical about
these concerns. She relies on studies that have shown no interaction with diazepam
(Valium) and others.
In theory, ginkgo may increase the actions of drugs used for erectile dysfunction such as
sildenafil (Viagra).
In theory, drugs such as donepezil (Aricept) and tacrine (Cognex) may have an additive
effect when used at the same time as ginkgo, particularly increasing salivation and
urination.
- SIDE EFFECTS
Brown et al. describe gingko’s side effects as “minimal,” citing only headache, reduced
platelet aggregation and interaction with anticoagulant drugs, and “rare: agitation.”^31
Brown et al. counsel not to use ginkgo prior to surgery or dental procedures. Fugh-
Berman and Cott concluded that “side effects from the use of ginkgo are rare. Side
effects include nausea, headache, stomach problems, diarrhea, allergy, anxiety, and
restlessness.^32 According to Mischoulon and Rosenbaum, ginkgo, "has an excellent
safety record; and except for the assumed possible risk of hemorrhage in patients taking
anticoagulants, having bleeding disorders, or [about to] undergo surgery, EGb 761
appears to be very safe."^33 Berkeley Wellness concurs that ginkgo appears safe overall.
According to the Natural Standard, side effects of ginkgo may include headache, nausea,
gastrointestinal upset, diarrhea, dizziness, palpitations, anxiety, allergy or allergic skin
reactions (rashes), bleeding, blood sugar levels, muscle weakness, loss of muscle tone,
restlessness, racing heart, rash, and irritation around the mouth, reduction of male and
female fertility, and efficacy of electro-convulsive therapy. There may be a risk of seizure
