American Journal of Alzheimer's Disease and Other Dementias®

 

Advanced Search

Journal Navigation

Journal Home

Subscriptions

Archive

Contact Us

Table of Contents

Click here for more information

Sign In to gain access to subscriptions and/or personal tools.
This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Akhondzadeh, S.
Right arrow Articles by Abbasi, S. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Akhondzadeh, S.
Right arrow Articles by Abbasi, S. H.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
American Journal of Alzheimer's Disease and Other Dementias®, Vol. 21, No. 2, 113-118 (2006)
DOI: 10.1177/153331750602100211

Herbal medicine in the treatment of Alzheimer's disease

Shahin Akhondzadeh, PhD

Psychiatric Research Center Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran

Seyed Hesameddin Abbasi, MD

Research Unit, Tehran Heart Center Tehran University of Medical Sciences, Tehran, Iran; National Iranian Oil Company. Central Hospital. Tehran, Iran

Alzheimer s disease (AD) is characterized by profound memory loss sufficient to interfere with social and occupationalfunctioning. It is the most common form of dementia, affecting more than 20 million people worldwide. AD is characterized by an insidious loss of memory, associated functional decline, and behavioral disturbances. Patients may live for more than a decade after they are diagnosed with AD, making it the leading cause of disability in the elderly. The incidence of AD rangesfrom I to 4 percent of the population per year, rising from its lowest level at ages 65 to 70 years to rates that may approach 6 percent for those over the age of 85 years. The first neurotransmitter defect discovered in AD involved acetylcholine (A Ch). As cholinergic function is requiredfor short-term memory, the cholinergic deficit in AD was also believed to be responsible for much of the short-term memory deficit. Clinical drug trials in patients with AD have focused on drugs that augment levels of A Ch in the brain to compensate for the loss of cholinergic function. These drugs have included ACh precursors, muscarinic agonists, nicotinic agonists, and acetylcholinesterase inhibitors. The most highly developed and successful approaches to date have employed acetylcholinestrase inhibition. Although some Food and Drug Administration-approved drugs are available for the treatment ofAlzheimer's disease, the outcomes are often unsatisfactory, and there is a place for alternative medicine, in particular, herbal medicine. This paper reviews the clinical effects of a number of commonly used types of herbal medicines for the treatment ofAD.

Key Words: Alzheimer's disease • Ginkgo biloba • herbal medicine • Melissa officinalis • Salvia officinalis

References

  • 1. Katzman R: The prevalence and malignancy of Alzheimer's disease. A major killer. Arch Neurol. 1976; 33: 217-218.[Medline] [Order article via Infotrieve]
  • 2. Evans DA, Funkenstein HH, Albert MS: Prevalence of Alzheimer's disease in a community population of older persons: Higher than previously reported. JAMA. 1989; 262: 2551-2556.[Abstract]
  • 3. Geldmacher DS, Whitehouse PJ: Differential diagnosis of Alzheimer's disease. Neurology. 1997; 48(Suppl 6): S2-S9.[Medline] [Order article via Infotrieve]
  • 4. World Health Organization: The ICD-JIO Classification of Mental and Behavioral Disorders. Geneva: World Health Organization, 1992.
  • 5. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Association, 1994.
  • 6. McKhann G. Drachman D, Folstein M, et al.: Clinical diagnosis of AD: Report of NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on AD. Neuiology. 1984; 34: 939-944.
  • 7. Schneiders LS: An overview of rating scales used in dementia. Alzheimer Insights. 1996; 2: 1-7.
  • 8. Selkoe DJ: Amyloid beta-protein and genetics of Alzheimer's disease. JBiol Chem. 1996; 27: 18295-18298.
  • 9. Lue LF, Kuo YM, Roher AE: Soluble amyloid beta peptide concentration as a predictor of synaptic changes in Alzheimer's disease. Am J Pathol. 1999; 155: 853-862.[Abstract/Free Full Text]
  • 10. Francis PT, Palmer AM, Snape M, et al.: The cholinergic hypothesis of Alzheimer's disease: A review of progress. J Neurol,Veurozsurg Psjchiatrjl 1999; 54: 137-147.
  • 11. Wright CI, Geula C, Mesulam MM: Neurological cholinesterase in the normal brain and in Alzheimer's disease: Relation to plaques, tangles, and patterns of selective vulnerability. Ann Neurol. 1993; 34: 373-384.[CrossRef][Medline] [Order article via Infotrieve]
  • 12. Davies P, Maloney AJ: Selective loss of central cholinergic neurons in Alzheimer's disease. Lancet. 1976; 2: 1457-1459.
  • 13. Livingston G. Katona C: How useful are cholinesterase inhibitors in the treatment of Alzheimer's disease? A number needed to treat analysis. Int J Geriatric Psychiatry 2000; 15: 203-207.[CrossRef][Medline] [Order article via Infotrieve]
  • 14. Giacobini E: Cholinesterase inhibitor therapy stabilizes symptoms of Alzheimer's disease. Alzheimer Dis Assoc Disord. 2000; 14: S3-S11.
  • 15. Nordberg A, Svensson AL: Cholinesterase inhibitors in the treatment of Alzheimer's disease: A comparison of tolerability and pharmacology. Drug Safey. 1998; 19: 465-480.
  • 16. Weinstock M: Selectivity of cholinesterase inhibition: Clinical implication for the treatment of Alzheimer's Disease. CNS Drugs. 1999; 12: 307-303.[CrossRef]
  • 17. Bullock R: Drug treatment in dementia. Curr Opin Psychiatry 2001; 14: 349-353.[CrossRef]
  • 18. Bullock R: New drugs for Alzheimer's disease and other dementias. Br JPsychiatry. 2002; 180: 135-139.
  • 19. Keltner NL, Beth Williams SN: Memantine: A new approach to Alzheimer's disease. Perspect Psychiatric Care. 2004; 40: 123-124.
  • 20. Akhondzadeh S, Noroozian M: Alzheimer's disease: Pathophysiology and pharmacotherapy. IDrugs. 2002; 4: 1167-1172.
  • 21. Bullock R: New drugs for Alzheimer's disease and other dementias. Br J Psychiatry. 2002; 180: 135-139.[Abstract/Free Full Text]
  • 22. Shadlen MF, Larson EB: What's new in Alzheimer's disease treatment? Reasons for optimism about future pharmacologic options. Postgrad Med. 1999; 105: 109-118.[Medline] [Order article via Infotrieve]
  • 23. Mayeux R, Sano M: Treatment of Alzheimer's disease. NEngl J Med. 1999; 34: 1670-1679.
  • 24. Bush Al: Therapeutic targets in the biology of Alzheimer's disease. Curr Opin Psychiatry. 2001; 14: 341-348.[CrossRef]
  • 25. Raskind MA, Peskind ER, Wessel T: Galantamine in AD: A six month randomized placebo-controlled trial with a six month extension. Neurology. 2000; 54: 2261-2268.[Abstract/Free Full Text]
  • 26. Kanowski S, Hoerr R: Proof of the efficacy of the Ginkgo biloba special extract egb76 1 in outpatients suffering from mild to moderate primary degenerative dementia of the Alzheimer type of multi-infarct dementia. Phytomedicine. 1997; 4: 215-222.
  • 27. Le Bars PL, Katz MM, Berman N, et al.: A placebo-controlled, double-blind, randomized trial of an extract of Ginkgo biloba for dementia. North American EGb Study Group. JAMA. 1997; 278: 1327-1332.[Abstract]
  • 28. De Feudis FV: Ginkgo biloba Extract EGb761. Pharmacological Activities and Clinical Applications. Paris: Elsevier, 1991.
  • 29. Kleijnen J: Ginkgo biloba. Lancet 1992; 340: 1136-1139.[CrossRef][Medline] [Order article via Infotrieve]
  • 30. Wettstein A: Cholinesterase inhibitors and ginkgo extracts-are they comparable in the treatment of dementia? Comparison of published placebo-controlled efficacy studies of at least six months' duration. Phytomedicine. 2000; 6: 393-401.[Medline] [Order article via Infotrieve]
  • 31. Dore S, Bastianetto S, Kar S, et al.:.Protective and rescuing abilities of IGF-I and some putative free radical scavengers against betaamyloid-inducing toxicity in neurons. Ann N YAcad Sci. 1999; 890: 356-364.[Abstract/Free Full Text]
  • 32. Kanowski S, Hoerr R: Ginkgo biloba extract EGb 761 in dementia: Intent-to-treat analyses of a 24-week, multi-center, double-blind, placebo-controlled, randomized trial. Pharmacopsychiatry. 2003; 36: 297-303.[CrossRef][Medline] [Order article via Infotrieve]
  • 33. Schulz V: Ginkgo extract or cholinesterase inhibitors in patients with dementia: What clinical trials and guidelines fail to consider. Phytomedicine. 2003; 10(Suppl) 14-14: 74-79.
  • 34. Kurz A, Van Baelen B: Ginkgo biloba compared with cholinesterase inhibitors in the treatment of dementia: A review based on meta-analyses by the Cochrane collaboration. Dementia Geriatr Cogn Disord. 2004; 18: 217-226.
  • 35. Xu SS, Gao ZX, Weng Z: Efficacy of tablet huperzine-A on memory, cognition, and behavior in Alzheimer's disease. Zhongguo Yao Li XueBao. 1995; 16: 391-395.
  • 36. Zhang RW, Tang XC, Han YY: Drug evaluation of huperzine A in the treatment of senile memory disorders [in Chinese; English abstract]. Zhongguo Yao LiXue Bao. 1991; 12: 250-252.
  • 37. Zhang Z, Wang X, Chen Q: Clinical efficacy and safety of huperzine alpha in treatment of mild to moderate Alzheimer disease: A placebo-controlled, double-blind, randomized trial. Zhonghua Yi XueZaZhi. 2002; 82: 941-944.
  • 38. Xu SS, Cai ZY, Qu ZW: Huperzine-A in capsules and tablets for treating patients with Alzheimer disease. Zhongguo Yao Li Xue Bao. 1999; 20: 486-490.[Medline] [Order article via Infotrieve]
  • 39. Szatmari SZ, Whitehouse PJ: Vinpocetine for cognitive impairment and dementia;. Cochrane Database Syst Rev. 2003; CD003 119-119.
  • 40. Hindmarch I, Fuchs HH, Erzigkeit H: Efficacy and tolerance of vinpocetine in ambulant patients suffering from mild to moderate organic psychosyndromes. Int Clin Psychopharmacol. 1991; 6: 31-43.[Medline] [Order article via Infotrieve]
  • 41. Balestreri R, Fontana L, Astengo F: A double-blind placebo controlled evaluation of the safety and efficacy of vinpocetine in the treatment of patients with chronic vascular senile cerebral dysfunction. JAm Geriatr Soc. 1987; 35: 425-430.[Medline] [Order article via Infotrieve]
  • 42. Fenzl E, Apecechea M, Schaltenbrand R: Efficacy and tolerance of vinpocetine administered intravenously, in addition of standard therapy, to patients suffering from an apoplectic insult. In Krieglstein J (ed): Pharmacology of Cerebral Ischemia. Proceedings of the International Symposium on Pharmacology of Cerebral Ischemia. New York: Elsevier Science Publishers; 1986: 430-434.
  • 43. Manconi E, Binaghi F, Pitzus F: A double-blind clinical trial of vinpocetine in the treatment of cerebral insufficiency of vascular and degenerative origin. Curr Ther Res Clin Exp. 1986; 30: 702-709.
  • 44. Peruzza M, DeJacobis M: A double-blind placebo controlled evaluation of the efficacy and safety of vinpocetine in the treatment of patients with chronic vascular or degenerative senile cerebral dysfunction. Adv Ther. 1986; 3: 201-209.
  • 45. Blaha L, Erzigkeit H, Adamczyk A: Clinical evidence of the effectiveness of vinpocetine in the treatment of organic psychosyndrome. Hum Psychopharmacol. 1989; 4: 103-111.
  • 46. Perry EK, Pikering AT, Wang WW, et al.: Medicinal plants and Alzheimer's disease: Integrating ethnobotanical and contemporary scientific evidence. JAltern Complement Med 1998; 4: 419-428.
  • 47. Perry EK, Pikering AT, Wang WW, et al.: Medicinal plants and Alzheimer's disease: From etnobotany to phytotherapy. J Pharm Pharmacol. 1999; 51: 527-534.[CrossRef][Medline] [Order article via Infotrieve]
  • 48. Kennedy DO, Scholey AB, Tildesley NTJ, et al.: Modulation of mood and cognitive performance following acute administration of Melissa officinalis lemon balm. Pharmacol Biochem Behav. 2002; 72: 953-964.[CrossRef][Medline] [Order article via Infotrieve]
  • 49. Akhondzadeh S, Noroozian M, Mohammadi M, et al.: Melissa officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: A double blind, randomised, placebo controlled trial. JNeurol Neurosurg Psychiatry. 2003; 74: 863-866.[Abstract/Free Full Text]
  • 50. Akhondzadeh S, Noroozian M, Mohammadi M, et al.: Salvia officinalis extract in the treatment of patients with mild to moderate Alzheimer's disease: A double blind, randomized and placebo-controlled trial. J Clin Pharm Ther 2003; 28: 53-59.[CrossRef][Medline] [Order article via Infotrieve]
  • 51. Wake G, Court J, Pikering A, et al.: CNS acetylcholine receptor activity in European medicinal plants traditionally used to improve failing memory. JEthnopharmacol. 2000; 69: 105-114.
  • 52. Schulz V, Hansel R, Tyler VE: Rational Phytotherapy. A Physicians' Guide to Herbal Medicine, 3rd ed. Berlin: Springerverlag, 1998.

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?



This Article
Right arrow Abstract Freely available
Right arrow Free Full Text (Free PDF) Free
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Saved Citations
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Request Reprints
Right arrow Add to My Marked Citations
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Akhondzadeh, S.
Right arrow Articles by Abbasi, S. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Akhondzadeh, S.
Right arrow Articles by Abbasi, S. H.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?