Ginkgo biloba Extract (EGb761), Cholinesterase Inhibitors, and Memantine for the Treatment of Mild-to-Moderate Alzheimer’s Disease: A Network Meta-Analysis

  • Onnita Thancharoen
  • Chulaporn LimwattananonEmail author
  • Onanong Waleekhachonloet
  • Thananan Rattanachotphanit
  • Phumtham Limwattananon
  • Panita Limpawattana
Original Research Article



Cholinesterase inhibitors (ChEIs) and memantine have been reported to provide modest benefits for cognition and aspects of functioning in Alzheimer’s disease (AD). Ginkgo biloba extract (EGb761), a phytomedicine, is widely used and expected to be well-tolerated. A few trials have compared EGb761 with ChEIs, and the results were inconclusive.


A network meta-analysis was conducted to evaluate the therapeutic benefits and tolerability of EGb761, three ChEIs (donepezil, galantamine, and rivastigmine), and memantine in mild-to-moderate AD patients.


Electronic databases were searched through 30 June 2017. We included randomized double-blinded trials with a minimum treatment duration of 22 weeks for EGb761 240 mg/day and 12 weeks for ChEIs or memantine. The study patients included AD or probable AD patients without other types of dementia or neurological disorders. Cognition, function, and behavior symptoms were compared between treatments using the standardized mean difference (SMD). Clinical global impression, treatment discontinuation, and adverse events were compared between treatments using the relative risk (RR). Statistical pooling of the individual trial results was conducted using a frequentist approach. The probability of being the best for a treatment was estimated using surface under the cumulative ranking.


EGb761 and memantine showed no therapeutic benefits in all study outcomes. For cognition, all ChEIs were significantly better than placebo (SMD from − 0.52 to − 0.26), and galantamine was better than rivastigmine in the oral and patch forms, EGb761, and memantine (SMD [95% confidence interval (CI)]: − 0.22 [− 0.40 to − 0.05]; − 0.26 [− 0.45 to − 0.07]; − 0.34 [− 0.56 to −  0.12]; and − 0.42 [− 0.71 to − 0.13], respectively). Compared to placebo, galantamine, the rivastigmine patch, and oral rivastigmine provided modest functional benefits (SMD, from 0.21 to 0.24), and galantamine provided behavioral benefits (SMD [95% CI]: − 0.15 [− 0.26 to − 0.04]). All ChEIs provided a better improvement in clinical global impression than placebo (RR from 1.20 to 1.69). The global impression ratings were more improved with donepezil than with galantamine (RR [95% CI]: 1.40 [1.09–1.80]) or with EGb761 (RR [95% CI]: 1.40 [1.06–1.85]), with a 96% probability of donepezil being more effective than the other study agents. Rivastigmine in oral and patch forms, galantamine, and donepezil had a higher risk of being discontinued than placebo (RR [95% CI]: 2.14 [1.49–3.06]; 2.04 [1.30–3.20]; 1.79 [1.28–2.49]; 1.49 [1.03–2.17], respectively). Discontinuation of EGb761 was not statistically lower than that of the ChEIs, in which donepezil had the lowest probability (38%) of being discontinued.


EGb761 and memantine showed no treatment benefits compared to placebo and ChEIs. Galantamine provided the highest beneficial effect on cognition and behavioral symptoms. Donepezil provided a better clinical global impression and tolerability than the other ChEIs and EGb761, with a similar benefit for cognition as galantamine.



The authors thank Dr. Cynthia R. Gross for providing editing assistance.

Author Contributions

OT: study concept and design; acquisition; analysis and interpretation of the data; and drafting of the manuscript. CL: study concept and design; acquisition; analysis and interpretation of the data; drafting of the manuscript; and revising it critically for intellectual content. OW, TR, PL, and PL: revising manuscript critically for intellectual content. All authors were involved in the final approval of the version to be published and agree to be accountable for all aspects of the work.

Compliance with Ethical Standards


Funding for this research was provided by Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand. The funding source had no role in the preparation of this article.

Conflict of interest

Onnita Thancharoen, Chulaporn Limwattananon, Onanong Waleekhachonloet, Thananan Rattanachotphanit, Phumtham Limwattananon, and Panita Limpawattana declare that they have no conflict of interest.

Supplementary material

40266_2019_648_MOESM1_ESM.pdf (723 kb)
Supplementary material 1 (PDF 723 kb)


  1. 1.
    World Health Organization. Dementia fact sheets; 2017. Accessed 15 Jan 2018.
  2. 2.
    Prince M, Wimo AGM, Ali GC, Wu YT, Prina M. World Alzheimer report 2015: the global impact of dementia: an analysis of prevalence, incidence, cost and trends. London: Alzheimer’s Disease International; 2015.Google Scholar
  3. 3.
    Ngo J, Holroyd-Leduc J. Systematic review of recent dementia practice guidelines. Age Ageing. 2014;44:25–33.CrossRefGoogle Scholar
  4. 4.
    Akram M, Nawaz A. Effects of medicinal plants on Alzheimer’s disease and memory deficits. Neural Regen Res. 2017;12:660–7.CrossRefGoogle Scholar
  5. 5.
    Lang F, Hoerr R, Noeldner M, Koch E. Ginkgo biloba extract EGb 761: from an ancient Asian plant to a modern European herbal medicinal product. In: Wagner H, Ulrich-Merzenich G, editors. Evidence and rational based research on Chinese drugs. Wien: Springer; 2013. p. 431–70.CrossRefGoogle Scholar
  6. 6.
    Jiratchariyakul W, Mahady G. Overview of botanical status in EU, USA, and Thailand. Evid Based Complement Alternat Med. 2013;2013:480128. Scholar
  7. 7.
    Jeschke E, Ostermann T, Vollmar H, Tabali M, Schad F, Matthes H. Prescribing patterns in dementia: a multicentre observational study in a German network of CAM physicians. BMC Neurol. 2011;11:1–11.CrossRefGoogle Scholar
  8. 8.
    Czeche S, Schussel K, Franzmann A, Burkart M, Schulz M. Dosage strength is associated with medication persistence with Ginkgo biloba drug products: a cohort study of ambulatory drug claims data in Germany. BMC Complement Altern Med. 2013;13:1–10.CrossRefGoogle Scholar
  9. 9.
    Stein C, Hopfeld J, Lau H, Klein J. Effects of Ginkgo biloba extract EGb761, donepezil and their combination on central cholinergic function in aged rats. J Pharm Pharm Sci. 2015;18:634–46.CrossRefGoogle Scholar
  10. 10.
    Müller W, Eckert A, Eckert G, et al. Therapeutic efficacy of the ginkgo special extract EGb761® within the framework of the mitochondrial cascade hypothesis of Alzheimer’s disease. World J Biol Psychiatry. 2017. Scholar
  11. 11.
    Gauthier S, Schlaefke S. Efficacy and tolerability of Ginkgo biloba extract EGb 761® in dementia: a systematic review and meta-analysis of randomized placebo-controlled trials. Clin Interv Aging. 2014;9:2065–77.CrossRefGoogle Scholar
  12. 12.
    Tan M, Yu J, Tan C, et al. Efficacy and adverse effects of Ginkgo biloba for cognitive impairment and dementia: a systematic review and meta-analysis. J Alzheimers Dis. 2015;43:589–603.CrossRefGoogle Scholar
  13. 13.
    von Gunten A, Schlaefke S, Uberla K. Efficacy of Ginkgo biloba extract EGb761® in dementia with behavioural and psychological symptoms: a systematic review. World J Biol Psychiatry. 2015;17:622–33.CrossRefGoogle Scholar
  14. 14.
    Yuan Q, Wang CW, Shi J, Lin ZX. Effects of Ginkgo biloba on dementia: an overview of systematic reviews. J Ethnopharmacol. 2017;195:1–9.CrossRefGoogle Scholar
  15. 15.
    Mazza M, Capuano A, Bria P, Mazza S. Ginkgo biloba and donepezil: a comparison in the treatment of Alzheimer’s dementia in a randomized placebo-controlled double-blind study. Eur J Paediatr Neurol. 2006;13:981–5.CrossRefGoogle Scholar
  16. 16.
    Nasab NM, Bahrammi MA, Nikpour MR, Rahim F, Naghibis SN. Efficacy of rivastigmine in comparison to ginkgo for treating Alzheimer’s dementia. J Pak Med Assoc. 2012;62(7):677–80.Google Scholar
  17. 17.
    Yancheva S, Ihl R, Nikolova G, Panayotov P, Schlaefke S, Hoerr R. Ginkgo biloba extract EGb761®, donepezil or both combined in the treatment of Alzheimer’s disease with neuropsychiatric features: a randomized, double-blind, exploratory trial. Aging Ment Health. 2009;13:183–90.CrossRefGoogle Scholar
  18. 18.
    Di Santo S, Prinelli F, Adorni F, Caltagirone C, Musicco M. A meta-analysis of the efficacy of donepezil, rivastigmine, galantamine, and memantine in relation to severity of Alzheimer’s disease. J Alzheimers Dis. 2013;35:349–61.CrossRefGoogle Scholar
  19. 19.
    Tan C, Yu J, Wang H, et al. Efficacy and safety of donepezil, galantamine, rivastigmine, and memantine for the treatment of Alzheimer’s disease: a systematic review and meta-analysis. J Alzheimers Dis. 2014;41:615–31.CrossRefGoogle Scholar
  20. 20.
    Kobayashi H, Ohnishi T, Nakagawa R, Yoshizawa K. The comparative efficacy and safety of cholinesterase inhibitors in patients with mild-to-moderate Alzheimer’s disease: a Bayesian network meta-analysis. Int J Geriatr Psychiatry. 2015;31:892–904.CrossRefGoogle Scholar
  21. 21.
    Tricco A, Ashoor H, Soobiah C, et al. Comparative effectiveness and safety of cognitive enhancers for treating Alzheimer’s disease: systematic review and network meta-analysis. J Am Geriatr Soc. 2017;66:170–8.CrossRefGoogle Scholar
  22. 22.
    Deardorff WJ, Feen E, Grossberg GT. The use of cholinesterase inhibitors across all stages of Alzheimer’s disease. Drugs Aging. 2015;32(7):537–47.CrossRefGoogle Scholar
  23. 23.
    Higgins JPT, Green S, editors. Cochrane handbook for systematic reviews of interventions, 418 version 5.1.0; 2011. Accessed 30 Jan 2018.
  24. 24.
    Higgins JPT, Sovović J, Page MJ, Sterne JAC, editors. Revised Cochrane risk of bias tool for randomized trials (RoB 2.0); 2016. Accessed 30 Jan 2018.
  25. 25.
    Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. Am J Psychiatry. 1984;141:1356–64.CrossRefGoogle Scholar
  26. 26.
    Cano S, Posner H, Moline M, et al. The ADAS-cog in Alzheimer’s disease clinical trials: psychometric evaluation of the sum and its parts. J Neurol Neurosurg Psychiatry. 2010;81:1363–8.CrossRefGoogle Scholar
  27. 27.
    Rockwood K, Fay S, Gorman M. The ADAS-cog and clinically meaningful change in the VISTA clinical trial of galantamine for Alzheimer’s disease. Int J Geriatr Psychiatry. 2010;25:191–201.CrossRefGoogle Scholar
  28. 28.
    Kanowski S, Hoerr R. Ginkgo biloba extract EGb761® in dementia: intent-to-treat analyses of a 24-week, multi-center, double-blind, placebo-controlled, randomized trial. Pharmacopsychiatry. 2003;36:297–303.CrossRefGoogle Scholar
  29. 29.
    Herrschaft H, Nacu A, Likhachev S, Sholomov I, Hoerr R, Schlaefke S. Ginkgo biloba extract EGb761® in dementia with neuropsychiatric features: a randomised, placebo-controlled trial to confirm the efficacy and safety of a daily dose of 240 mg. Psychiatry Res. 2012;46:716–23.CrossRefGoogle Scholar
  30. 30.
    Ihl R, Tribanek M, Bachinskaya N. Efficacy and tolerability of a once daily formulation of Ginkgo biloba extract EGb761® in Alzheimer’s disease and vascular dementia: results from a randomised controlled trial. Pharmacopsychiatry. 2012;45:41–6.CrossRefGoogle Scholar
  31. 31.
    Ihl R, Grass-Kapanke B, Janner M, Weyer G. Neuropsychometric tests in cross sectional and longitudinal studies-a regression analysis of ADAS-Cog, SKT and MMSE. Pharmacopsychiatry. 1999;32:248–54.CrossRefGoogle Scholar
  32. 32.
    Galasko D, Bennett D, Sano M, et al. An inventory to assess activities of daily living for clinical trials in Alzheimerʼs disease. Alzheimer Dis Assoc Disord. 1997;11:33–9.CrossRefGoogle Scholar
  33. 33.
    Gelinas I, Gauthier L, McIntyre M, Gauthier S. Development of a functional measure for persons with Alzheimer’s disease: the Disability Assessment for Dementia. Am J Occup Ther. 1999;53:471–81.CrossRefGoogle Scholar
  34. 34.
    Cummings J, Mega M, Gray K, Rosenberg-Thompson S, Carusi D, Gornbein J. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology. 1994;44:2308–14.CrossRefGoogle Scholar
  35. 35.
    Cummings J. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology. 1997;48:S10–6.CrossRefGoogle Scholar
  36. 36.
    Olin J, Schneider L, Doody R, et al. Clinical evaluation of global change in Alzheimer’s disease: identifying consensus. J Geriatr Psychiatry Neurol. 1996;9:176–80.CrossRefGoogle Scholar
  37. 37.
    Reisberg B. Global measures: utility in defining and measuring treatment response in dementia. Int Psychogeriatr. 2007;19:421–56.CrossRefGoogle Scholar
  38. 38.
    Schneider L, Olin J, Doody R, et al. Validity and reliability of the Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change. Alzheimer Dis Assoc Disord. 1997;2:22s–32s.CrossRefGoogle Scholar
  39. 39.
    Nakamura Y, Usui M, Nishikawa T, et al. CIBIC Plus-J assessment using a videotaped method in Alzheimer’s disease patients. Dement Geriatr Cogn Disord Extra. 2011;2:271–7.CrossRefGoogle Scholar
  40. 40.
    White IR. Multivariate random-effects meta-analysis. Stata J. 2009;9:40–56.CrossRefGoogle Scholar
  41. 41.
    White IR. Multivariate random-effects meta-regression: updates to mvmeta. Stata J. 2011;11:255–70.CrossRefGoogle Scholar
  42. 42.
    White IR. Network meta-analysis. Stata J. 2015;15:951–85.CrossRefGoogle Scholar
  43. 43.
    White IR, Barrett JK, Jackson D, Higgins J. Consistency and inconsistency in network meta-analysis: model estimation using multivariate meta-regression. Res Synth Methods. 2012;3:111–25.CrossRefGoogle Scholar
  44. 44.
    Dias S, Welton NJ, Caldwell DM, Ades AE. Checking consistency in mixed treatment comparison meta-analysis. Stat Med. 2010;29:932–44.CrossRefGoogle Scholar
  45. 45.
    Salanti G, Ades AE, Ioannidis JP. Graphical methods and numerical summaries for presenting results from multiple-treatment meta-analysis: an overview and tutorial. J Clin Epidemiol. 2011;64:163–71.CrossRefGoogle Scholar
  46. 46.
    Schneider LS, DeKosky ST, Farlow MR, Tariot PN, Hoerr R, Kieser M. A randomized, double-blind, placebo-controlled trial of two doses of Ginkgo biloba extract in dementia of the Alzheimer’s type. Curr Alzheimer Res. 2005;2:541–51.CrossRefGoogle Scholar
  47. 47.
    Rogers SL, Doody RS, Mohs RC, Friendhoff LT. Donepezil improves cognition and global function in Alzheimer disease: a 15-week, double-blind, placebo-controlled study. Arch Intern Med. 1998;158:1021–31.CrossRefGoogle Scholar
  48. 48.
    Rogers SL, Farlow MR, Doody RS, Mohs R, Friendhoff LT. A 24-week, double-blind, placebo controlled trial of donepezil in patients with Alzheimer’s disease. Neurology. 1998;50:136–45.CrossRefGoogle Scholar
  49. 49.
    Burn A, Rossor M, Hecker J, et al. The effects of donepezil in Alzheimer’s disease—results from a multinational trial. Dement Geriatr Cogn Disord. 1999;10:237–44.CrossRefGoogle Scholar
  50. 50.
    Homma A, Takeda M, Imai Y, et al. Clinical efficacy and safety of donepezil on cognitive and global function in patients with Alzheimer’s disease. A 24-week, multicenter, double-blind, placebo-controlled study in Japan. Dement Geriatr Cogn Disord. 2000;11:299–313.CrossRefGoogle Scholar
  51. 51.
    Maher-Edwards G, Dixon R, Hunter J, et al. SB-742457 and donepezil in Alzheimer disease: a randomized, placebo-controlled study. Int J Geriatr Psychiatry. 2010;26:536–44.CrossRefGoogle Scholar
  52. 52.
    Frölich L, Ashwood T, Nilsson J, Eckerwall G, Sirocco Investigator. Effects of AZD3480 on cognition in patients with mild-to-moderate Alzheimer’s disease: a phase IIb dose-finding study. J Alzheimers Dis. 2011;24:363–74.CrossRefGoogle Scholar
  53. 53.
    Zhang Z, Yu L, Gaudig M, Schauble B, Richarz U. Galantamine versus donepezil in Chinese patients with Alzheimer’s disease: results from a randomized, double-blind study. Neuropsychiatr Dis Treat. 2012;8:571–7.Google Scholar
  54. 54.
    Marek GJ, Katz DA, Meier A, et al. Efficacy and safety evaluation of HSD-1 inhibitor ABT-384 in Alzheimer’s disease. Alzheimers Dement. 2014;10:S364–73.CrossRefGoogle Scholar
  55. 55.
    Haig GM, Pritchett Y, Meier A, et al. A randomized study of H3 antagonist ABT-288 in mild-to-moderate Alzheimer’s dementia. J Alzheimers Dis. 2014;42:959–71.CrossRefGoogle Scholar
  56. 56.
    Gault L, Ritchie C, Robieson W, Pritchett Y, Othman A, Lenz R. A phase 2 randomized, controlled trial of the α7 agonist ABT-126 in mild-to-moderate Alzheimer’s dementia. Alzheimers Dement (NY). 2015;1:81–90.Google Scholar
  57. 57.
    Raskind MA, Peskind ER, Wessel T, Yuan W. Galantamine in AD: a 6-month randomized, placebo-controlled trial with a 6-month extension. Neurology. 2000;54:2261–8.CrossRefGoogle Scholar
  58. 58.
    Tariot PN, Solomon PR, Morris JC, Kershaw P, Lilienfeld S, Ding C. A 5-month, randomized, placebo-controlled trial of galantamine in AD. Neurology. 2000;54:2269–76.CrossRefGoogle Scholar
  59. 59.
    Wilcock GK, Lilienfeld S, Gaens E. Efficacy and safety of galantamine in patients with mild to moderate Alzheimer’s disease: multicentre randomised controlled trial. BMJ. 2000;9:1445–9.CrossRefGoogle Scholar
  60. 60.
    Wilkinson D, Murray J. Galantamine: a randomized, double-blind, dose comparison in patients with Alzheimer’s disease. Int J Geriatr Psychiatry. 2001;16:852–7.CrossRefGoogle Scholar
  61. 61.
    Brodaty H, Corey-Bloom J, Potocnik FC, Truyen L, Gold M, Damaraju CR. Galantamine prolonged-release formulation in the treatment of mild to moderate Alzheimer’s disease. Dement Geriatr Cogn Disord. 2005;20:120–32.CrossRefGoogle Scholar
  62. 62.
    Rockwood K, Fay S, Song X, Macknight C, Gorman M, Video-Imaging Synthesis of Treating Alzheimer’s Disease (VISTA) Investigators. Attainment of treatment goals by people with Alzheimer’s disease receiving galantamine: a randomized controlled trial. CMAJ. 2006;174:1099–105.CrossRefGoogle Scholar
  63. 63.
    Corey-Bloom J, Anand R, Veach J. A randomized trial evaluating the efficacy and safety of ENA 713 (rivastigmine tartrate), a new acetylcholinesterase inhibitor, in patients with mild to moderately severe Alzheimer’s disease. Int J Geriatr Psychiatry. 1998;1:55–65.Google Scholar
  64. 64.
    Rosler M, Anand R, Cicin-Sain A, et al. Efficacy and safety of rivastigmine in patients with Alzheimer’s disease: international randomised controlled trial. BMJ. 1999;318:633–8.CrossRefGoogle Scholar
  65. 65.
    Feldman HH, Lane R. Rivastigmine: a placebo-controlled trial of twice daily and three times daily regimens in patients with Alzheimer’s disease. J Neurol Neurosurg Psychiatry. 2007;78:1056–63.CrossRefGoogle Scholar
  66. 66.
    Winblad B, Cummings J, Andreasen N, et al. A six-month double-blind, randomized, placebo-controlled study of a transdermal patch in Alzheimer’s disease-rivastigmine patch versus capsule. Int J Geriatr Psychiatry. 2007;22:456–67.CrossRefGoogle Scholar
  67. 67.
    Nakamura Y, Imai Y, Shigeta M, et al. A 24-week, randomized, double-blind, placebo-controlled study to evaluate the efficacy, safety and tolerability of the rivastigmine patch in Japanese patients with Alzheimer’s disease. Dement Geriatr Cogn Dis Extra. 2011;1:163–79.CrossRefGoogle Scholar
  68. 68.
    Zhang ZX, Hong Z, Wang YP, et al. Rivastigmine patch in Chinese patients with probable Alzheimer’s disease: a 24-week, randomized, double-blind parallel-group study comparing rivastigmine patch (9.5 mg/24 h) with capsule (6 mg twice daily). CNS Neurosci Ther. 2016;22:488–96.CrossRefGoogle Scholar
  69. 69.
    Bakchine S, Loft H. Memantine treatment in patients with mild to moderate Alzheimer’s disease: results of a randomised, double-blind, placebo-controlled 6-month study. J Alzheimers Dis. 2007;11:471–9.CrossRefGoogle Scholar
  70. 70.
    Hashiguchi M, Ohta Y, Shimizu M, Maruyama J, Mochizuki M. Meta-analysis of the efficacy and safety of Ginkgo biloba extract for the treatment of dementia. J Pharm Health Care Sci. 2015;1:1–12.CrossRefGoogle Scholar
  71. 71.
    Strohle A, Schmidt DK, Schultz F, et al. Drug and exercise treatment of Alzheimer disease and mild cognitive impairment: a systematic review and meta-analysis of effects on cognition in randomized controlled trials. Am J Geriatr Psychiatry. 2015;23:1234–49.CrossRefGoogle Scholar
  72. 72.
    Yang M, Xu D, Zhang Y, Liu X, Hoeven R, Cho W. A systematic review on natural medicines for the prevention and treatment of Alzheimer’s disease with meta-analyses of intervention effect of ginkgo. Am J Chin Med. 2014;42:505–21.CrossRefGoogle Scholar
  73. 73.
    Yang G, Wang Y, Sun J, Zhang K, Liu J. Ginkgo biloba for mild cognitive impairment and Alzheimer’s disease: a systematic review and meta-analysis of randomized controlled trials. Curr Top Med Chem. 2016;16:520–8.CrossRefGoogle Scholar
  74. 74.
    Bartus RT, Dean RL, Beer B, Lippa AS. The cholinergic hypothesis of geriatric memory dysfunction. Science. 1982;217:408–14.CrossRefGoogle Scholar
  75. 75.
    Contestabile A. The history of the cholinergic hypothesis. Behav Brain Res. 2011;221:334–40.CrossRefGoogle Scholar
  76. 76.
    Razay G, Wilcock G. Galantamine in Alzheimer’s disease. Expert Rev Neurother. 2008;8:9–17.CrossRefGoogle Scholar
  77. 77.
    Parsons CG, Danysz W, Quack G. Memantine is a clinically well tolerated N-methyl-d-aspartate (NMDA) receptor antagonist a review of preclinical data. Neuropharmacology. 1999;38:735–67.CrossRefGoogle Scholar
  78. 78.
    Olivares D, Deshpande VK, Shi Y, et al. N-Methyl d-aspartate (NMDA) receptor antagonists and memantine treatment for Alzheimer’s disease, vascular dementia and Parkinson’s disease. Curr Alzheimer Res. 2012;9:746–58.CrossRefGoogle Scholar
  79. 79.
    Canevelli M, Adali N, Kelaiditi E, Cantet C, Ousset PJ, Cesari M. Effects of Ginko biloba supplementation in Alzheimer’s disease patients receiving cholinesterase inhibitors: data from the ICTUS study. Phytomedicine. 2014;21:888–92.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Pharmacy and Health System Graduate Program, Faculty of Pharmaceutical SciencesKhon Kaen UniversityKhon KaenThailand
  2. 2.Division of Clinical Pharmacy, Faculty of Pharmaceutical SciencesKhon Kaen UniversityKhon KaenThailand
  3. 3.Department of Clinical Pharmacy, Faculty of PharmacyMahasarakham UniversityMaha SarakhamThailand
  4. 4.Department of Surgery, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand
  5. 5.Department of Internal Medicine, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand

Personalised recommendations