Date of Award

2017

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C

Abstract

Objective: The objective of this selective evidence based medicine review is to determine whether or not ginkgo biloba is effective in managing the symptoms of ADHD and if it exhibits lower adverse side effects as compared to the current standard of treatment.

Study Design: Systematic review of three English language studies, two of which were randomized, double blind, controlled trials (one positive controlled, one placebo controlled), and one open prospective cohort study, published between 2009-2015.

Data Source: Two randomized, double blind, controlled trials (one positive controlled, one placebo controlled), and one open prospective cohort study. In one study the group received only ginkgo biloba as tolerated with no comparison group. In another study, one group received methylphenidate and ginkgo biloba while the comparison group received methylphenidate and a placebo. In the final study one group received ginkgo biloba while the comparison group received methylphenidate. All studies were published in peer reviewed journals and were found via Medline and Pubmed.

Outcomes Measured: The efficacy and tolerability of ginkgo biloba in the treatment of ADHD symptoms as well as its side effects. This was measured by an ADHD Rating Scale IV and FBB-HKS (a German DSM-IV-oriented rating scale for ADHD problems) performed by the subjects’ parents and teachers, CGAS by the subjects’ parents, and side effects by parents, subjects, and psychiatrists using a rating scale.

Results: The positive controlled study showed methylphenidate to be significantly more efficacious than ginkgo biloba, however ginkgo biloba showed fewer adverse side effects. The placebo controlled study showed ginkgo biloba was effective as an add on therapy to methylphenidate as compared to methylphenidate and a placebo. The open prospective study showed that with ginkgo biloba, there was improvement in ADHD symptoms as compared to baseline, with minimal adverse side effects.

Conclusions: From the studies conducted, ginkgo biloba showed to be inferior to methylphenidate. However, it was an effective alternative or adjunctive treatment for ADHD symptoms as compared to no treatment or a placebo. Furthermore, it exhibited minimal adverse side effects.

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