Drug Safety

, Volume 25, Issue 5, pp 323–344 | Cite as

Panax ginseng

A Systematic Review of Adverse Effects and Drug Interactions
Review Article

Abstract

Panax ginseng C.A. Meyer is a perennial herb native to Korea and China and has been used as an herbal remedy in eastern Asia for thousands of years. Modern therapeutic claims refer to vitality, immune function, cancer, cardiovascular diseases, improvement of cognitive and physical performance and sexual function. A recent systematic review of randomised controlled trials found that the efficacy of ginseng root extract could not be established beyond doubt for any of these indications. In order to obtain a balanced assessment of the therapeutic value of P. ginseng it is also necessary to consider the safety profile. In view of the extremely widespread use of P. ginseng it seems important to ask whether this herbal medicine involves health risks for the consumer. This review was conducted as a systematic attempt to document and evaluate all the available safety data on P. ginseng root extracts.

Systematic searches were performed in five electronic databases and the reference lists of all papers located were checked for further relevant publications. All articles containing original data on adverse events and drug interactions with P. ginseng were included. Information was also requested from 12 manufacturers of ginseng preparations, the spontaneous reporting schemes of the WHO and national drug safety bodies. No language restrictions were imposed.

Data from clinical trials suggest that the incidence of adverse events with ginseng monopreparations is similar to that with placebo. The most commonly experienced adverse events are headache, sleep and gastrointestinal disorders. The possibility of more serious adverse events is indicated in isolated case reports and data from spontaneous reporting schemes; however, causality is often difficult to determine from the evidence provided. Combination products containing ginseng as one of several constituents have been associated with serious adverse events and even fatalities. Interpretation of these cases is difficult as ingredients other than P. ginseng may have caused the problems. Possible drug interactions have been reported between P. ginseng and warfarin, phenelzine and alcohol. Collectively, these data suggest that P. ginseng monopreparations are rarely associated with adverse events or drug interactions. The ones that are documented are usually mild and transient. Combined preparations are more often associated with such events but causal attribution is usually not possible.

References

  1. 1.
    The description of a Tartarian plant called ginseng with an account of its virtues. Philosophical Transactions of the Society of London 1713; XXVIII: 237–247Google Scholar
  2. 2.
    Blumenthal M. Herb sales down 15 percent in mainstream market. HerbalGram 2001; 51: 69Google Scholar
  3. 3.
    Society of Japanese Pharmacopoeia, Tokyo, Japan. Ginseng. Ginseng radix. The Pharmacopoeia of Japan 1991: 642Google Scholar
  4. 4.
    Tu G, Chen C, Fang Q, et al., editors. Radix ginseng (Renshen). Pharmacopoeia of the People’s Republic of China 1988: 116–7Google Scholar
  5. 5.
    Ginseng root. Ginseng radix. Ginsengwurzel. Deutsches Arzneibuch. 1991: 10Google Scholar
  6. 6.
    Ginseng. Panax ginseng. Commission nationale de Pharmacopée. Paris, 1989Google Scholar
  7. 7.
    Radix ginseng. Ginsengwurzel. In: Oestereichisches Arzneibuch (Pharmacopoea Austriaca). Wien; Verlag der Osterreichischen Staatsdruckemei 1981: 923–5Google Scholar
  8. 8.
    Reynolds JEJ, editor. Ginseng. Martindale the extra pharmacopoeia. London: The Royal Pharmaceutical Society, 1996: 1710Google Scholar
  9. 9.
    O’Hara M, Kiefer D, Farrell K, et al. A review of 12 commonly used medicinal herbs. Arch Fam Med 1998; 7: 523–36PubMedCrossRefGoogle Scholar
  10. 10.
    Vogler BK, Pittler MH, Ernst E. The eficacy of ginseng: a systematic review of randomised clinical trials. Eur J Clin Pharmacol 1999; 55: 567–75PubMedCrossRefGoogle Scholar
  11. 11.
    Rote Liste® Service GmbH, Frankfurt. Rote Liste 1999. Aulendorf, Germany: Editio Cantor Verlag, 1999Google Scholar
  12. 12.
    Wiklund IK, Mattsson L-A, Lindgren R, et al. Effects of a standardised ginseng extract on quality life and physiological parameters in symptomatic postmenopausal women: a double blind, placebo controlled trial. Int J Clin Pharmacol Res 1999; XIX: 89–99Google Scholar
  13. 13.
    Engels H-J, Wirth JC. No erogenic effects of ginseng (Panax ginseng C.A. Meyer) during graded maximal aerobic exercise. J Am Diet Assoc 1997; 97: 1110–5PubMedCrossRefGoogle Scholar
  14. 14.
    Gianoli AC, Riebenfeld D. A double blind study to assess the tolerability and efficacy of the standardised ginseng extract G115 with special regard to its effect on the resistance of the organism to external influences. Cytobiol Rev 1984; 8: 177–86Google Scholar
  15. 15.
    Scaglione F, Catteneo G, Alessandria M, et al. Efficacy and safety of the standardised ginseng extract G115 for potentiating vaccination against common cold and/or influenza syndrome. Drugs Exp Clin Res 1996; 22: 65–72PubMedGoogle Scholar
  16. 16.
    Allen JD, McLung J, Nelson AG, et al. Ginseng supplementation does not enhance healthy young adults’ peak aerobic exercise performance. J Am Coll Nutr 1998; 17: 462–6PubMedGoogle Scholar
  17. 17.
    Mulz D, Scardigli G, Jans G, et al. Long term treatment of the psycho-asthenia in the second half of the life. Pharmazeutische Rundschau 1990; 12: 86Google Scholar
  18. 18.
    Han KH, Choe SC, Kim HS, et al. Effect of red ginseng on blood pressure in patients with essential hypertension and white coat hypertension. Am J Chin Med 1998; XXVI: 199–209CrossRefGoogle Scholar
  19. 19.
    Cartwright L. You and ginseng: recent human trials. Aust J Pharm 1982, 62: 47Google Scholar
  20. 20.
    Fulder S, Kataria M, Gethyn-Smith B. A double blind clinical trial of Panax ginseng in aged subjects. Proceedings of the 4th International Ginseng Symposium; 1984 Sep 18-20; Daejeon, Korea, 223Google Scholar
  21. 21.
    Kim NH, Lee HM, Choi CH, et al. Clinical effect of Korean red ginseng on osteoporosis. J Ginseng Res 1998; 22: 114–21Google Scholar
  22. 22.
    Kim YC, Hong YK, Shin JS, et al. Effect of Korean red ginseng on sexual dysfunction and serum lipid level in old aged men. Korean J Ginseng Sci 1996; 20: 125–32Google Scholar
  23. 23.
    Kim S-H, Lee S-R, Do J-H, et al. Effects of Korean red ginseng and western ginseng on body temperature, pulse rate, clinical symptoms and the hematological changes in human. Korean J Ginseng Sci 1995; 19: 1–16Google Scholar
  24. 24.
    Medvedev MA. The effect of ginseng on the working performance of radio operators. Papers on the study of ginseng and other medicinal plants of the Far East. Vladivostok, 1963: 237–9Google Scholar
  25. 25.
    Forgo I. The duration of effect of the standardised Ginseng Extract G115 in healthy competitive athletes. Notabene Medici 1985; 15: 636–40Google Scholar
  26. 26.
    Engels H-J, Said JM, Wirth JC. Failure of chronic ginseng supplementation to affect work performance and energy metabolism in healthy adult females. Nutr Res 1996; 16: 1295–305CrossRefGoogle Scholar
  27. 27.
    Smith K, Engels H-J, Martin J, et al. Efficacy of a standardised ginseng extract to alter psychological function characteristics at rest and during exercise stress [abstract]. Med Sci Sport Exerc 1995; 27: S147CrossRefGoogle Scholar
  28. 28.
    D’Angelo L, Grimaldi R, Caravaggi M, et al. A double blind, placebo controlled clinical study on the effect of a standardised ginseng extract on psychomotor performance in healthy volunteers. J Ethnopharmacol 1986; 16: 15–22PubMedCrossRefGoogle Scholar
  29. 29.
    Scaglione F, Ferrara F, Dugnani S, et al. Immunomodulatory effects of two extracts of Panax ginseng C.A. Meyer. Drugs Exp Clin Res 1990; 16: 537–42PubMedGoogle Scholar
  30. 30.
    Quiroga DHA, Imbriano AE. The effect of Panax ginseng extract on cerebrovascular deficits. Orientacion Medica 1979; 28: 86–7Google Scholar
  31. 31.
    Dorling E. Do ginsenosides influence the performance? Notabene Medici 1980; 10: 241–6Google Scholar
  32. 32.
    Forgo I, Kayasseh L, Staub JJ. Effect of a standardised ginseng extract on general well-being, reaction capacity, pulmonary function and gonadal hormones. Med Welt 1981; 32: 751–6PubMedGoogle Scholar
  33. 33.
    Van Schepdael P. Les effets du ginseng G115 sur la capacite physique de sportifs d’endurance [in French]. Acta Ther 1993; 19: 337–47Google Scholar
  34. 34.
    Forgo I. Effect of drugs on physical performance and hormone system of sportsmen [in German]. Munch Med Wochenschr 1983; 124: 822–4Google Scholar
  35. 35.
    Collomp K, Wright F, Collomp R, et al. Ginseng et exercise supramaximal. Sci Sports 1996; 11: 250–1CrossRefGoogle Scholar
  36. 36.
    Scaglione F, Cogo R, Cocuzza C, et al. Immunomodulatory effects of Panax ginseng C.A. Meyer (G115) on alveolar macrophages from patients suffering with chronic bronchitis. Int J Immunother 1994; 10: 21–4Google Scholar
  37. 37.
    Quiroga HA. Comparative double blind study of the effect of Ginsana and hydergin on cerebrovascular deficits. Orientacion Medica 1982; 31: 201–2Google Scholar
  38. 38.
    Kennedy D, Scholey A, Wesnes KA. Dose-dependent enhancement of cognitive performance in young volunteers by a single dose of ginseng. Int J Neuropsychopharmacol 2000; 3Suppl. 1: S365Google Scholar
  39. 39.
    Sorensen H, Sonne J. A double masked study of the effets of ginseng on cognitive functions. Curr Ther Res 1996; 57: 959–68CrossRefGoogle Scholar
  40. 40.
    Srisurapanon S, Rungroeng K, Apibal S, et al. The effect of standardised ginseng extract on peripheral blood leukocytes and lymphocyte subsets: a preliminary study in young healthy adults. J Med Assoc Thai 1997; 80: S81–5PubMedGoogle Scholar
  41. 41.
    Cherdrungsi P, Rungroeng K. Effects of standardised ginseng extract and exercise training on aerobic and anaerobic exercise capacities in humans. Korean J Ginseng Sci 1995; 19: 93–100Google Scholar
  42. 42.
    Siegl C, Siegl HJ. Die mogliche revision von einbussen an psychiscen fahigkeiten im hoheren alter [in German]. Therapiewoche 1979; 29: 4206–16Google Scholar
  43. 43.
    Gundling K, Brodsky Z, Robbins J, et al. Panax ginseng enhances IGM and IGA antibody titers after influenza vaccination [abstract]. Altern Ther Health Med 2001; 7: 104Google Scholar
  44. 44.
    Chang YS, Park CI. The effect of Panax ginseng on the postoperative radiation complication in cervical cancer patients. Seoul J Med 1980; 21: 187–93Google Scholar
  45. 45.
    Kuwashima K, Kaneko H, Nakanishi K. Studies of clinical effects of ginseng: 1st report; a double blind study of unsettled complaint improving effect of ginseng. Proceedings of the 3rd International Ginseng Symposium; 1980 Sep 8-10; Seoul, Korea, 191Google Scholar
  46. 46.
    Kuwashima K, Kaneko H, Nakanishi K. Studies on clinical effects of ginseng: 2nd report; Effects of ginseng at acute massive dosage on circulatory function: a study by digital plethysmography. Proceedings of the 3rd International Ginseng Symposium; 1980 Sep 8-10; Seoul, Korea, 196Google Scholar
  47. 47.
    Koo KH, Joo CN. Clinical study on the efficacy of Panax ginseng C.A. Meyer on acute viral (B) hepatitis - (II). Korean J Ginseng Sci 1983; 7: 125–32Google Scholar
  48. 48.
    Wyss V, Ganzit GP, Rienzi A, et al. Effetti della radice di ginseng sul lavoro muscolare sottomassimale e massimale dell’uomo [in Italian]. Medicina dello Sport 1987; 40: 7–16Google Scholar
  49. 49.
    Choi HK, Seong DH, Rha KH. Clinical efficacy of Korean red ginseng for erectile dysfunction. Int J Impot Res 1995; 7: 181–6PubMedGoogle Scholar
  50. 50.
    Choi KM, Lee EJ, Kim YH, et al. Effects of red ginseng on the lipid peroxidation of erthrocyte and antioxidant superoxide dismutase (SOD) activity in NIDDM patients. Korean J Ginseng Sci 1997; 21: 153–9Google Scholar
  51. 51.
    Lee BM, Lee SK, Kim HS. Inhibition of oxidative DNA damage, 8-OHdG, and carbonyl contents in smokers treated with antioxidants (vitamin E, vitamin C, beta-carotene and red ginseng). Cancer Lett 1998; 132: 219–27PubMedCrossRefGoogle Scholar
  52. 52.
    McNaughton L, Egan G, Caelli G. A comparison of Chinese and Russian Ginseng as erogenic aids to improve various facets of physical fitness. Int Clin Nutr Rev 1989; 9: 32–5Google Scholar
  53. 53.
    Hallstrom C, Fulder S, Carruthers M. Effects of ginseng on the performance of nurses on night duty. Comp Med East West 1982; 4: 277–82Google Scholar
  54. 54.
    Teves MA, Wright JE, Welch MJ, et al. Effects of ginseng on repeated bouts of exhaustive exercise [abstract]. Med Sci Sport Exerc 1983; 15: 162CrossRefGoogle Scholar
  55. 55.
    Knapik JJ, Wright JE, Welch MJ, et al. The influence of panax ginseng on indices of substrate utilisation during repeated exhaustive exercise in man [abstract]. Fed Proc 1983; 42: 336Google Scholar
  56. 56.
    Johnson A, Jiang N-S, Staba EJ. Whole ginseng effects on human response to demands for performance. Proceedings of the 3rd International Ginseng Symposium; 1980 Sep 8-10; Seoul, Korea, 244Google Scholar
  57. 57.
    Zhao XZ. Anti-senility effect of ginseng-rhizome saponin. J Modern Developments Traditional Med 1990; 10: 579–589Google Scholar
  58. 58.
    Sotaniemi EA, Haapakoski E, Rautio A. Ginseng therapy in non-insulin dependent diabetic patients. Diabetes Care 1995; 18: 1373–5PubMedCrossRefGoogle Scholar
  59. 59.
    Ziemba AE, Chmura J, Kaciuba-Uscilko H, et al. Ginseng treatment improves psychomotor performance at rest and during graded exercise in young athletes. Int J Sport Nutr 1999; 9: 371–7PubMedGoogle Scholar
  60. 60.
    Scaglione F, Weiser K, Alessandria M. Effects of the standardised ginseng extract G115 in patients with chronic bronchitis. Clin Drug Invest 2001; 21: 41–5CrossRefGoogle Scholar
  61. 61.
    Forgo I, Kirchdorfer AM. The effect of different ginsenoside concentrations on physical work capacity. Notabene Medici 1982; 12: 721–7Google Scholar
  62. 62.
    Lee HY, Kim CS. Clinical investigation of Insam (Korean ginseng) on sexual potency. Korean J Urol 1986; 27: 235–40Google Scholar
  63. 63.
    Mulz D, Degenring F. Doping control after a 14 day treatment [abstract]. Pharmazeutische Rundschau 1989; 11: 22Google Scholar
  64. 64.
    Pujol P, Verdaguer-Codina J, Drobnic F, et al. Effects of a ginseng extract alone and combined with other elements on free radical production and hemoglobin reoxygenation following a maximal stress test. Proceedings of the International Pre-Olympic Science Congress: 1996 Jul 10-14; Dallas (TX)Google Scholar
  65. 65.
    Garcia RR. Estudio comparativo de dos farmacos que actuan sobre el envejecimiento cerebral. Prensa Med Argent 1988; 75: 134–9Google Scholar
  66. 66.
    Wang WK, Chen HL, Hsu TL, et al. Alteration of pulse in human subjects by three chinese herbs. Am J Chin Med 1994; 22: 197–203PubMedCrossRefGoogle Scholar
  67. 67.
    Ding D, Shen T, Cui Y, et al. Effects of red ginseng on the congestive heart failure and its mechanism. Chin J Integrated Traditional West Med 1995; 15: 325–7Google Scholar
  68. 68.
    Shin YO, Cho YK, Ki MK, et al. Effect of Korean red ginseng on immunological markers of persons with human immunodeficiency virus. Proceedings of the 6th International Ginseng Symposium; 1993 Sep 6-9; Seoul, Korea, 56Google Scholar
  69. 69.
    Yamamoto M, Miki S, Deguchi H, et al. Combined effect of red ginseng with xiao-chai-hu-tang in patients with chronic hepatitis. Proceedings of the 6th International Ginseng Symposium; 1993 Sep 6-9; Seoul, Korea, 60Google Scholar
  70. 70.
    Koo KH, Joo CN. Clinical study on the efficacy of Panax ginseng C.A Meyer on acute viral (B) hepatits (I). Korean J Ginseng Sci 1983; 7: 115–24Google Scholar
  71. 71.
    Woo YM, Lee HW, Kim JP. The effect of ginseng on the postoperative nutritional status and immune functions of gastric carcinoma patients. Proceedings of the 6th International Ginseng Symposium; 1993 Sep 6-9; Seoul, Korea, 65Google Scholar
  72. 72.
    Siegel RK. Ginseng use among two groups in the United States. Proceedings of the 3rd International Ginseng Symposium; 1980 Sep 8-10; Seoul, Korea, 236Google Scholar
  73. 73.
    Cho YK, Kim YK, Lee I, et al. The effect of korean red ginseng (KRG), Zidovudine (ZDV) and the combination of KRG and ZDV on HIV-infected individuals. J Korean Soc Microbiol 1996; 31: 353–60Google Scholar
  74. 74.
    Forgo I, Kirchdorfer AM. On the question of influencing the performance of top sportsmen by means of biologically active substances. Aerztliche Praxis 1981; 33: 1784–6Google Scholar
  75. 75.
    von Ardenne M, Klemm W. Measurements of the increase in the difference between the arterial and venous Hb-O2 saturation obtained with daily administration of 200mg standardised ginseng extract for four weeks. Panminerva Med 1987; 29: 143–50Google Scholar
  76. 76.
    Lee HY, Paick JS, Lee SW. Efficacy of ginseng extract on patients with oligospermia. Korean J Urol 1988; 29: 950–60Google Scholar
  77. 77.
    Gross D, Krieger D, Efrat R, et al. Ginseng extrakt G115 for the treatment of chronic respiratory diseases: a pilot study investigating the effects of ginseng extract G115 on pulmonary functions, general functions and oxygenation. Scweiz Z Ganzheits Med 1995; 1: 29–33Google Scholar
  78. 78.
    Reinold E. Der Einsatz von Ginseng in der Gynakologie. Natur Ganzheits Med 1990; 4: 131–4Google Scholar
  79. 79.
    Forgo I. Doping control of top-ranking athletes after a 14-day treatment with Ginsana. Pharmaton SA, Lugano, Switzerland, 1980 (Data on file)Google Scholar
  80. 80.
    Tode T, Kikuchi Y, Hirata J, et al. Effect of Korean red ginseng on psychological functions in patients with severe climacteric syndromes. Int J Gynaecol Obstet 1999; 67: 169–74PubMedCrossRefGoogle Scholar
  81. 81.
    Yamamoto M, Uemura T, Nakama S, et al. Serum HDL-cholesterol-increasing and fatty liver improving actions of Panax Ginseng in high cholesterol diet fed rats with clinical effect on hyperlipidaemia in man. Am J Chin Med 1983; 11: 96–101PubMedCrossRefGoogle Scholar
  82. 82.
    Wyss V, Gribaudo C, Ganzit GP. Effetti del ginseng su alcuni aspetti della performance fisica in atleti. Medicina dello Sport 1982; 35: 383–9Google Scholar
  83. 83.
    Sohn E-S, Huh B-Y, Lee D-H, et al. The effect of korean ginseng on blood pressure in essential hypertension by oral administration. J Korean Med Assoc 1980; 23: 227–33Google Scholar
  84. 84.
    Gezzi A, Longhi MG, Mazzoleni R, et al. Dermocosmetic activity of ginsenosides. Note II: instrumental evaluation of cutaneous hydration and elasticity. Fitoterapia 1986; 57: 15–28Google Scholar
  85. 85.
    Curri SB, Gezzi A, Longhi MG, et al. Dermocosmetic activity of ginsenosides. Note III: long term evaluation of the moisturising and tonifying effect on the face skin. Fitoterapia 1986; 57: 217–22Google Scholar
  86. 86.
    Okuda H, Yoshida R. Studies on the effects of ginseng components on diabetes mellitus. Proceedings of the 3rd International Ginseng Symposium; 1980 Sep 8-10; Seoul, Korea, 57Google Scholar
  87. 87.
    Ogita S. Clinical effectiveness of Korean ginseng on climacteric disturbances and its possible mechanism of action. Korean J Ginseng Sci 1990; 14: 162–6Google Scholar
  88. 88.
    Imamura Y, Kuwashima K. The effects of red ginseng on blood pressure and the quality of life in essential hypertensives. Proceedings of the 4th International Ginseng Symposium; 1984 Sep 18-20; Daejeon, Korea, 91Google Scholar
  89. 89.
    Yamamoto M, Kumagai A. Long term ginseng effects on hyperlipidemia in man with further study on its actions on atherogenesis and fatty liver in rats. Proceedings of the 4th International Ginseng Symposium; 1984 Sep 18-20; Daejeon, Korea, 19Google Scholar
  90. 90.
    Kaneko H, Nakanishi K, Murakami A, et al. Effect of red ginseng on hemodynamic changes by physical exercise. Proceedings of the 4th International Ginseng Symposium; 1984 Sep 18-20; Daejeon, Korea, 256Google Scholar
  91. 91.
    Sung J, Han K-H, Zo J-H, et al. Effects of red ginseng upon vascular endothelial function in patients with essential hypertension. Am J Chin Med 2000; 28: 205–16PubMedCrossRefGoogle Scholar
  92. 92.
    Punnonen R, Lukola A. The effect of ginseng on serum total cholesterol, HDL-cholesterol and triglyceride levels in postmenopausal women. Asia Oceania J Obstet Gynaecol 1984; 10: 399–401PubMedCrossRefGoogle Scholar
  93. 93.
    Kim HK, Choi WY, Cho WY, et al. Effect of ginseng on renal function in patient with renal injury. Korean J Ginseng Sci 1997; 21: 49–52Google Scholar
  94. 94.
    Zuin M, Battezzati PM, Camisasca M, et al. Effects of a preparation containing a standardised ginseng extract combined with trace elements and multivitamins against hepatotoxin induced chronic liver disease in the elderly. J Int Med Res 1987; 15: 276–81PubMedGoogle Scholar
  95. 95.
    Dorling E, Kirchdorfer AM. Ginseng macht wieder fit. Arztliche Praxis 1989; 41: 1867–9Google Scholar
  96. 96.
    Pieralisi G, Ripari P, Vecchiet L. Effects of a standardised Ginseng extract combined with dimethylaminoethanol bitartrate, vitamins, minerals and trace elements on physical performance during exercise. Clin Ther 1991; 13: 373–82PubMedGoogle Scholar
  97. 97.
    Neri M, Andermarcher E, Pradelli JM, et al. Influence of a double blind pharmacological trial on two domains of well-being in subjects with age associated memory impairment. Arch Gerontol Geriatr 1995; 21: 241–52PubMedCrossRefGoogle Scholar
  98. 98.
    Ussher JM, Dewberry C, Malson H, et al. The relationship between health related quality of life and dietary supplementation in British middle managers: a double blind placebo controlled study. Psychol Health 1995; 10: 97–111CrossRefGoogle Scholar
  99. 99.
    Curutchet Ragusin JE, Perez MR, Dalvarade JU. Clinical trial of a new product for the prevention and treatment of symptoms associated with senility. Lugano: Pharmaton, 1980 (Unpublished report)Google Scholar
  100. 100.
    Thommessen B, Laake K. No identifiable effect of ginseng (Gericomplex) as an adjuvant in the treatment of geriatric patients. Aging 1996; 8: 417–20PubMedGoogle Scholar
  101. 101.
    Sandberg F. Clinical effects of ginseng preparations. Z Praklinische Geriatr 1974; 4: 264–8Google Scholar
  102. 102.
    Colombi R. Clinical report on geriatric Pharmaton. Lugano: Pharmaton, 1970 (Unpublished report)Google Scholar
  103. 103.
    Ussher JM, Swann C. A double blind placebo controlled trial examining the relationship between Health Related Quality of Life and dietary supplements. Br J Health Psychol 2000; 5: 173–87CrossRefGoogle Scholar
  104. 104.
    Sandberg F, Dencker L. Experimental and clinical tests on ginseng. Z Phytother 1994; 15: 38–42Google Scholar
  105. 105.
    Tesch PA, Johansson H, Kaiser P. The effect of ginseng, vitamins and minerals on the physical work capacity in middle agedmen. Lakartidningen 1987; 84: 4326–8Google Scholar
  106. 106.
    Revers WJ, Simon WCM, Popp F, et al. Psychologische Wirkungen eines Geriatrikums auf alte Menschen [in German]. Geriatrie 1976; 6: 418–30Google Scholar
  107. 107.
    Grosse HB, Degenring F, Mulz D. Gincosan bei epileptogenen Hirnleistungsstorungen. Zum einfluss von Gincosan auf kognitive defizite bei langjahrig hospitalisierten epileptikern: Eine plazebokontrollierte Doppelblindstudie [in German]. Psycho 1992; 18: 495–501Google Scholar
  108. 108.
    Warnecke G. Die Behandlung klimakterisher Beshwerden mit einer Wirkstoffcombination ohne Hormone [in German]. Z Ther 1974; 2: 90–5Google Scholar
  109. 109.
    Schmidt UJ. Die Wirkung einer Kombination aus standardisiertem Ginsengextrakt G115, Dimethylaminoathanol, Vitaminen und Mineralstoffen und einzelner ihrer Komponenten auf das biologische Alter, den Blutdruck und die Herzfrequenz von Patienten mit primar chronischer Polyarthritis [in German]. Geriatr Forsch 1992; 2: 111–22Google Scholar
  110. 110.
    Le Faou M. The effect of geriatric pharmaton versus placebo on physical fatigue and recovery. Sport et Medicine 1985; Special Issue: 34–41Google Scholar
  111. 111.
    Liao J, Chen J, Wu Z, et al. Clinical and experimental studies of coronary heart disease treated with Yi-Qi- Huo-Xue injection. J Tradit Chin Med 1989; 9: 193–8PubMedGoogle Scholar
  112. 112.
    Gribaudo CG, Ganzit GP, Baincotti PP, et al. Effects of a natural erogenic product on aerobic capacities in well-trained cyclists. Med Sport (Turin) 1991; 44: 335–43Google Scholar
  113. 113.
    Kiesewetter H, Jung F, Mrowietz C, et al. Hemorrheological and circulatory effects of Gincosan. Int J Clin Pharmacol Ther Toxicol 1992; 30: 97–102PubMedGoogle Scholar
  114. 114.
    Graubaum H-J, Metzner CM, Schneider B. Biologische Wirkstoffkombination zur physischen konditionierung [in German]. Z Phytother 1995; 1: 11Google Scholar
  115. 115.
    Xin Z-C, Choi Y-D, Lee WH, et al. Penile vibratory threshold changes with various doses of SS-cream in patients with primary premature ejaculation. Yonsei Med J 2000; 41: 29–33PubMedGoogle Scholar
  116. 116.
    Le Gal M, Cathebras P, Struby K. Pharmaton capsules in the treatment of functional fatigue: a double blind study versus placebo evaluated by a new methodology. Phytother Res 1996; 10: 49–53CrossRefGoogle Scholar
  117. 117.
    Wiklund IK, Karlberg J, Lund B. A double blind comparison of the effect on quality of life of a combination of vital substances including standardised ginseng G115 and placebo. Curr Ther Res 1994; 55: 32–42CrossRefGoogle Scholar
  118. 118.
    Garay Lillo J. Double blind clinical study of Geriatric Pharmaton in the processes of involution. Geriatrika 1984; 1: 29–38Google Scholar
  119. 119.
    Hugonot R, Hugonot L, Israel L. Clinical double-blind study of Geriatric Pharmaton against placebo on 98 patients aged 50 and more, during 60 days. Proceedings of the Symposium Vitality, Creativity and Longetivity; 1981 May 21; ParisGoogle Scholar
  120. 120.
    Kwiencinski H, Lusakowska A, Mieszkowski J. Improvement in concentration following treatment with ginseng/ginkgo biloba combination in patients with chronic cerebrovascular disorders: a double-blind, placebo controlled study. Eur J Clin Res 1997; 9: 59–67Google Scholar
  121. 121.
    Choi H-K, Xin Z-C, Choi Y-D, et al. Safety and efficacy study with various doses of SS cream in patients with premature ejaculation in a double blind, randomised, placebo controlled clinical study. Int J Impot Res 1999; 11: 261–4PubMedCrossRefGoogle Scholar
  122. 122.
    Wesnes KA, Faleni R, Hefting N, et al. The cognitive, subjective and physical effects of a Ginkgo biloba/Panax ginseng combination in healthy volunteers with neurasthenic complaints. Psychopharmacol Bull 1997; 33: 677–83PubMedGoogle Scholar
  123. 123.
    Della Marchina M, Renzi G. Terapia farmacologica protratta in diabetici nid compensati con lievi disturbi cognitivi studio controllato in doppio cieco. Geriatria 1998; 10: 69–83Google Scholar
  124. 124.
    Choi H-K, Jung GW, Moon KH, et al. Clinical study of SS-cream in patients with lifelong premature ejaculation. Urology 2000; 55: 257–61PubMedCrossRefGoogle Scholar
  125. 125.
    Marasco CA, Ruiz VR, Villagomez SA, et al. Double blind study of a multi-vitamin complex supplemented with ginseng extract. Drugs Exp Clin Res 1996; 22: 323–9Google Scholar
  126. 126.
    Mor G. Effect of Pharmaton capsules on convalescents: a comparative study. Adv Diet Nutr 1988; 47: 106Google Scholar
  127. 127.
    El Nasr MSS, El-Desoky M, Sallam MS, et al. Placebo controlled study of Ginseng in the management of diabetes mellitus. Al-Azhar Med J 1982; 11: 361–6Google Scholar
  128. 128.
    Poggi E, Sforzini D, Lazzati-Crespi GL. On the clinical use of an antidepressive neurotonic vitamin association in ageing disorders. Riv Neropsichiatria Scienze Affini 1972; 18: 93–107Google Scholar
  129. 129.
    Shida K, Shimazaki J, Urano E. Clinical study on male infertility (2nd report). Jap J Fertil Steril 1970; 15: 113–8Google Scholar
  130. 130.
    Cascone A. Controlled investigation of geriatric pharmaton. Lugano: Pharmaton, 1973 (Unpublished report)Google Scholar
  131. 131.
    Alessandrini A. Clinical investigation of geriatric pharmaton. Lugano: Pharmaton, 1971 (Unpublished report)Google Scholar
  132. 132.
    Choi DS, Kim SJ, Lee EJ, et al. Effects of red ginseng on platelet function and lipid metabolism or overweighted noninsulin dependent. Proceedings of the 6th International Ginseng Symposium 1993 Sep 6-9; Seoul, Korea, 109Google Scholar
  133. 133.
    Yuan J, Guo W, Yang B, et al. 116 cases of coronary angina pectoris treated with powder composed of radix ginseng, radix notoginseng and succinum. J Tradit Chin Med 1997; 17: 14–7PubMedGoogle Scholar
  134. 134.
    Garay Lillo J. Study over six months on the efficacy and tolerance of Geriatric Pharmaton. Geriatrika 1987; 3: 49–56Google Scholar
  135. 135.
    Mor G. The effect of a combination of biologically active substances (Geriatric Pharmaton) on the well being of cachetic cancer patients. Adv Diet Nutr 1985; 44: 120Google Scholar
  136. 136.
    Murano S, Lo Russo LRR. Experience with Geriatric Pharmaton. Prensa Med Argent 1984; 71: 178–83Google Scholar
  137. 137.
    Kerkhof GA, Middelkoop HAM, van der Hoeve R, et al. Sleep recordings in the elderly before and after usage of a geriatric preparation. J Interdisciplinary Cycle Res 1989; 20: 57–63CrossRefGoogle Scholar
  138. 138.
    Simon WCM, Kirchdorfer AM, Dahse G. Efficiency control of a geriatric preparation containing ginseng by means of Kraepelin’s performance test. Med Monatsschr 1977; 31: 39–41PubMedGoogle Scholar
  139. 139.
    Garay Lillo J, Caballero Garcia JC, Cabeza Mauricio G, et al. Long term multicentre study with Pharmaton Complex in adult patients. Geriatrika 1992; 8: 290–5Google Scholar
  140. 140.
    Ishikawa H, Manabe F, Zhongtao H, et al. The hormonal response to HCG stimulation in patients with male infertility before and after treatment with Hochuekkito. Am J Chin Med 1992; 20: 157–65PubMedCrossRefGoogle Scholar
  141. 141.
    Kuroda M, Kotake T, Sonoda T, et al. Clinical evaluation of hochuekkito for symptoms of malignant neoplasm patients. Hinyokika Kiyo 1985; 31: 173–7PubMedGoogle Scholar
  142. 142.
    Horii A, Maekawa M. Clinical evaluation of hochue-ekki-to on the patients with renal ptosis. Hinyokika Kiyo 1988; 34: 2243–8PubMedGoogle Scholar
  143. 143.
    Mitsukawa S, Kimura M, Ishikawa H, et al. Treatment of male sterility by Hochuekkito. Jap J Fertil Steril 1984; 29: 458–65Google Scholar
  144. 144.
    Ota H, Fukushima M, Kodama H, et al. Effects of Hotyu-ekkito on the patietns with oligospermia. Jap J Fertil Steril 1987; 32: 624–9Google Scholar
  145. 145.
    Barsom S, Weger N. Steigerung von Abwehrreaktionen, Belastbarkeit und Potenz durch eine Ginseng-Vitamin E-Gelee-Royale Zubereitung [in German]. Erfahrungsheilkunde 1988; 37: 430–7Google Scholar
  146. 146.
    Xin ZC, Choi Y-D, Choi H-K. Efficacy of a topical agent SS cream in the treatment of premature ejaculation: preliminary clinical studies. Yonsei Med J 1997; 38: 91–5PubMedGoogle Scholar
  147. 147.
    Xin Z-C, Choi Y-D, Seong DH, et al. Sensory evoked potential and effect of SS-cream in premature ejaculation. Yonsei Med J 1995; 36: 397–401PubMedGoogle Scholar
  148. 148.
    Feng P, Liu LM, Shen YY. Effect of shen mai injection on sIL-2R NK ad LAK cells in patients with advanced carcinoma. Chin J Modern Dev Tradit Med 1995; 15: 87–9Google Scholar
  149. 149.
    Lin SY, Liu LM, Wu LC. Effect of shenmai injection on immune function in stomach cancer patients after chemotherapy. Chin J Modern Dev Tradit Med 1995; 15: 451–3Google Scholar
  150. 150.
    Wang W, Niu RJ, Sum JP. Effects of sheng mai injection on thoracoabdominal motion. Chin J Modern Dev Tradit Med 1993; 13: 91–3Google Scholar
  151. 151.
    Jiang HW, Qiam ZH, Weng W, et al. Clinical study on treating qi-deficiency blood stasis syndrome of angina pectoris with qi xue granule. Chin J Modern Dev Tradit Med 1992; 12: 663–5Google Scholar
  152. 152.
    Li NQ. Clinical and experimental study on shen qi injection with chemotherapy in the treatment of malignant tumout of digestive tract. Zhongguo Zhong Xi Yi Jie Za Zhi 1992; 12: 582–92Google Scholar
  153. 153.
    Sheng ZL, Lee NY, Ge SP, et al. Clinical study of baoyuang dahuang decoction in the treatment of chronic renal failure. Chin J Modern Dev Tradit Med 1994; 14: 268–70Google Scholar
  154. 154.
    Lu BJ, Rong YZ, Zhao MH. Effect of sheng mai san on lipid peroxidation in acute myocardial infarction patients. Chin J Modern Dev Tradit Med 1994; 14: 712–4Google Scholar
  155. 155.
    Fang J, Jiang J, Luo DC. Effect of shenmai decoction on left ventricular function in patients with coronary heart disease. A randomised, double blind placebo controlled cross over trial. Chin J Int Med 1987; 26: 403–6Google Scholar
  156. 156.
    Zhao MH, Rong YZ, Lu BJ. Effect of shengmaisan on serum lipid peroxidation in acute viral myocarditis. Chin J Modern Dev Tradit Med 1996; 16: 142–5Google Scholar
  157. 157.
    Palmer BV, Montgomery ACV, Monteiro JCMP. Gin Seng and mastalgia [letter]. BMJ 1978; 1(6122): 1284PubMedCrossRefGoogle Scholar
  158. 158.
    Koriech OM. Ginseng and mastalgia. 1978; 1(6126): 1556Google Scholar
  159. 159.
    Greenspan EM. Ginseng and vaginal bleeding [letter]. JAMA 1983; 249: 2018PubMedCrossRefGoogle Scholar
  160. 160.
    Palop-Larrea V, Gonzalvez-Perales JL, Catalan-Oliver C, et al. Metrorrhagia and ginseng. Ann Pharmacother 2000; 34: 1347–8PubMedCrossRefGoogle Scholar
  161. 161.
    Hopkins MP, Androff L, Benninghoff AS. Ginseng face cream and unexplained vaginal bleeding. Am J Obstet Gynecol 1988; 159: 1121–2PubMedGoogle Scholar
  162. 162.
    Becker BN, Greene J, Evanson J, et al. Ginseng-induced diuretic resistance. JAMA 1996; 276: 607CrossRefGoogle Scholar
  163. 163.
    Dega H, Laporte J-L, Frances C, et al. Ginseng as a cause for Stevens-Johnson syndrome? Lancet 1996; 347: 1344PubMedCrossRefGoogle Scholar
  164. 164.
    Gonzalez-Seijo J, Romas Y, Lastra I. Manic episode and ginseng: Report of a possible case. J Clin Psychopharmacol 1995; 15: 447PubMedCrossRefGoogle Scholar
  165. 165.
    Wilkie A, Cordess C. Ginseng - a root just like a carrot? J R Soc Med 1994; 87: 594–5PubMedGoogle Scholar
  166. 166.
    Ryu S-J, Chien Y-Y. Ginseng associated cerebral arteritis. Neurology 1995; 45: 829–30PubMedCrossRefGoogle Scholar
  167. 167.
    Ries CA, Sahud MA. Agranulocytosis caused by Chinese Herbal Medicines. JAMA 1975; 231: 352–5PubMedCrossRefGoogle Scholar
  168. 168.
    Lou BY, Li CF, Li PY, et al. Eye symptoms due to ginseng poisoning. Yen Ko Hsueh Pao (CHINA) 1989; 5: 96–7Google Scholar
  169. 169.
    Hammond TG, Whitworth JA. Adverse reactions to ginseng [abstract]. Med J Aust 1981 May; 1(9): 492PubMedGoogle Scholar
  170. 170.
    Palop V, Catalan C, Rubio E, et al. Ginecomastia en un varon y ginseng. Med Clin(Barc) 1999; 112: 46Google Scholar
  171. 171.
    Nielsen AS. Hypertension af ginsengtabletter? Ugeskr Laeger 1988; 150: 377PubMedGoogle Scholar
  172. 172.
    Nakagawa A, Yamaguchi T, Takao T, et al. Five cases of drug induced pneumonitis due to Sho-saiko-to interferon-alpha or both. Nihon Kyobu Shikkan Gakkai Zasshi 1995; 33: 1361–6PubMedGoogle Scholar
  173. 173.
    Sato A, Toyoshima M, Kondo A, et al. Pnemonitis induced by the herbal medicine Sho-saiko-to in Japan. Nihon Kyobu Shikkan Gakkai Zasshi 1997; 35: 391–5PubMedGoogle Scholar
  174. 174.
    Hatakeyama S, Tachibana A, Morita M, et al. Five cases of pneumonitis induced by sho-saiko-to. Nihon Kyobu Shikkan Gakkai Zasshi 1997; 35: 505–10PubMedGoogle Scholar
  175. 175.
    Tojima H, Yamazaki T, Tokudome T. Two cases of pneumonia caused by sho-saiko-to. Nihon Kyobu Shikkan Gakkai Zasshi 1996; 34: 904–10PubMedGoogle Scholar
  176. 176.
    Ishizaki T, Sasaki F, Ameshima S, et al. Pneumonitis during interferon and/or herbal drug therapy in patients with chronic active hepatitis. Eur Respir J 1996; 9: 2691–6PubMedCrossRefGoogle Scholar
  177. 177.
    Shader RI, Greenblatt DJ. Bees, ginseng and MAOIs revisited. J Clin Psychopharmacol 1988; 8: 235PubMedGoogle Scholar
  178. 178.
    Shader RI, Greenblatt DJ. Phenelzine and the dream machine: ramblings and reflections [abstract]. J Clin Psychopharmacol 1985; 5: 65PubMedCrossRefGoogle Scholar
  179. 179.
    Jones BD, Runikis AM. Interaction of ginseng with phenelzine. J Clin Psychopharmacol 1987; 7: 201–2PubMedCrossRefGoogle Scholar
  180. 180.
    Janetsky K, Morreale AP. Probable interaction between warfarin and ginseng. Am J Health Syst Pharm 1997; 54: 692–3Google Scholar
  181. 181.
    Lee FC, Ko JH, Park JK, et al. Effects of Panax ginseng on blood alcohol clearance in man. Clin Exp Pharmacol Physiol 1987; 14: 543–6PubMedCrossRefGoogle Scholar
  182. 182.
    Naranjo CA, Busto U, Sellers M, et al. Method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981; 30: 239–45PubMedCrossRefGoogle Scholar
  183. 183.
    Zhu M, Chan KW, Ng LS, et al. Possible influences of ginseng on the pharmacokinetics and pharmacodynamics of warfarin in rats. J Pharm Pharmacol 1999; 51: 175PubMedCrossRefGoogle Scholar
  184. 184.
    Yun T-K, Choi S-Y. A case control study of ginseng intake and cancer. Int J Epidemiol 1990; 19: 871–6PubMedCrossRefGoogle Scholar
  185. 185.
    Yun T-K, Choi S-Y. Preventative effect of ginseng intake against various human cancers: a case control study on 1987 pairs. Cancer Epidemiol Biomarkers Prev 1995; 4: 401–8PubMedGoogle Scholar
  186. 186.
    Salvati G, Genovesi G, Marcellini L, et al. Effects of Panax Ginseng C.A. Meyer saponins on male fertility. Panminerva Med 1996; 38: 249–54PubMedGoogle Scholar
  187. 187.
    Garay Lillo J. Profile of a combination preparation with standardised G115 ginseng extract: a retrospective cohort study. Scweiz Z Ganzheits Med 1998; 10: 97–101Google Scholar
  188. 188.
    Siegel RK. Ginseng abuse syndrome. Problems with the panacea. JAMA 1979; 241: 1614–5PubMedCrossRefGoogle Scholar
  189. 189.
    Yun T-K, Choi S-Y. Non-organ specific cancer prevention of ginseng: a prospective study in Korea. Int J Epidemiol 1998; 27: 359–64PubMedCrossRefGoogle Scholar
  190. 190.
    Pharmaton SA, Lugano, Switzerland, Jul 2000 (Data on file)Google Scholar
  191. 191.
    Barnes J, Mills SY, Abbot NC, et al. Different standards for reporting ADRs to herbal remedies and conventional OTC medicines: face to face interviews with 515 users of herbal medicines. Br J Clin Pharmacol 1998; 45: 496–500PubMedCrossRefGoogle Scholar
  192. 192.
    Smith CC, Bennett PM, Pearce HM, et al. Adverse drug reactions to a hospital general medical unit meriting notification to the Committee on Safety of Medicines. Br J Clin Pharmacol 1996; 42: 423–9PubMedCrossRefGoogle Scholar
  193. 193.
    Koren G, Randor S, Martin S, et al. Maternal ginseng use associated with neonatal androgenisation. JAMA 1990; 264: 2866PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 2002

Authors and Affiliations

  1. 1.Department of Complementary MedicineSchool of Postgraduate Medicine and Health Sciences, University of ExeterExeterUnited Kingdom

Personalised recommendations