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Tuesday, December 28, 2010

More On Aricept, Ginkgo Biloba and My bvFTD

Everything here is my account of what happened to me, or my interpretation of stuff. Every case of FTD (Frontotemporal Dementia - Pick's) is different. Keep in mind as you read this that the person who wrote this has dementia - bvFTD. That would be ME.
Medical Disclaimer 

Making big news at the end of 2008 was a six-year research study reported in the November 19, 2008 issue of The Journal of the American Medical Association (JAMA). It found that Ginkgo Biloba was not any more effective for the prevention of Alzheimer’s disease or other dementia than a placebo.

The 3069 subjects, all over age 75, took EGb 761 twice a day (total 240 mg) or a placebo. Let me interject here that EGb761 is one of the supposed active compounds in Ginkgo Biloba, but not the only one. Anyway -  Study volunteers had normal awareness or very mild impairment at the start of the trial. Many news stories have seemed to generalize this research trial, and wrongly discount Ginkgo Biloba for any beneficial use.

Ginkgo Biloba has been all over the news again lately, and all of the stories seem to be based on the same study from 2008 because it was just published in November of 2010 by the The Journal of the American Medical Association (JAMA). The headline usually reads something like,"Ginkgo is not effective in treating Dementia". Well -  as the renowned Dr. Joyce Brothers was always so fond of saying, "One study shows... ". 

It is all the same study. Most of the news stories mis-interpreted the results of the study. When I researched the actual study myself I found that it was performed on an extremely aged sample of people (age 75+!) who were healthy (as in No Dementia!), and it showed that Ginkgo did not significantly prevent dementia over the six year period when they were followed. The dose of Ginkgo administered was the minimum of 120 mg, while the recommended dose for anyone with dementia is 240 mg to as much as 600 mg per day. The study also found no adverse effects when taking Ginkgo Biloba which is consistent with most other studies. Over all it was a very well-done study with a huge sample size, and the conclusions are quite probably correct that Ginkgo Biloba will not prevent dementia. I must mention that there was another study published in a less prestigious journal at the exact same time as this one which came to the exact opposite conclusion. Well... the study was great, but the way it was frequently reported in the media is crap.

My reaction to all that is... So What! I already have dementia, so I don't care if Ginkgo prevents it. Too late for that!

My question is:
Will Ginkgo Biloba help with the symptoms I have now, or slow the progression of my dementia?

Ahhhh... now that seems to be a totally different story. Out of over 125 research studies, many of which are very well done, the overwhelming conclusion is that Ginkgo Biloba has a significant beneficial effect on dementia symptoms. No, I did not review all 125+ studies myself, but I did find several review articles that did that for me which is just as good.

Over a hundred studies all say that Ginkgo Biloba has beneficial effects if you have dementia. Duh! Go do the research for yourself, and then - go Ginkgo!

This is a no-brainer. Since I have dementia, and I do not suffer from seizures, I am going to take Ginkgo Biloba. The fact that it is very inexpensive compared to other medications and supplements is just an added bonus.

So, since I also take Aricept, I was concerned about an interaction. It turns out that there might be one: Ginkgo may act in synergy with Aricept. That means that it could make any side effects of Aricept worse, so is not recommended. It also means that it should enhance any beneficial effects. Since my nasty side effects from Aricept have gone away, I see a clear advantage to taking both if I can tolerate them.

A research study that appeared in the September 2006 issue of the European Journal of Neurology compared EGb 761 to the common drug used to treat mild to moderate Alzheimer’s disease –donepezil (trade name Aricept). The six-month study began with 76 people, ages 50 to 80, who were divided into three groups, those who took EGb 761 (160 mg per day), donepezil (5 mg per day) or a placebo.

The results for the 60 individuals who finished the study showed a significant improvement in attention and memory for the Ginkgo and donepezil groups over the placebo group. In fact, the researchers noted that Ginkgo and donepezil produced the same improved-memory results. Furthermore, the Ginkgo group was side-effect-free compared to the donepezil group that had reported diarrhea or nausea symptoms, and Ginkgo, of course, was considerably less expensive. Note that in this study the 2 were not combined, they were compared.

So, even though the above study may indicate that Ginkgo is just as effective as Aricept, and other studies indicate the two may be synergistic, I would not expect the final outcome to be an effect twice as beneficial as the two taken individually. It just never works that way in real life. I would, however, fully expect that when taking the two together the beneficial effects would be better than either one taken alone.

So, the bottom line is that I am going to try to combine the traditional drug Aricept with the alternative medicine Ginkgo Biloba, and hopefully increase the benefits of both.

So far, after several weeks, that seems to be the case. Though I recently am trying an increased dose of Aricept (23 mg) I have not had any severe side effects. A little nausea, and occasionally a feeling of "jitteryness", but nothing to outweigh the benefits. I am currently taking 120 mg of Ginkgo Biloba Plus twice daily (morning and night) for a total of 240 mg of Ginkgo, and 23 mg of Aricept each morning.

Since I have been taking the combination I feel like I can think again!

No, it has not alleviated all of my symptoms. I still have difficulty with initiation, working memory, and motivation. As far as cognition goes, I have seen a huge improvement. Thinking isn't as difficult as it was a year ago. I no longer need a daily to-do list. I can do some simple mental arithmetic. I am not pausing to search for words as often. I can play video games competitively again! These are huge positive changes compared to a year ago. Again, I am not symptom-free, but I am improved from a year ago.

Of course, this evaluation is subjective. I cannot test or measure any improvement. Others who know me also report seeing a huge improvement. That is the best I have to go on.

The next Alternative Medications to add to my cocktail are... Melatonin and mushrooms. More on that later.


Comments are welcome.

4 comments:

  1. Lee,

    Visit the following website this Doctor has had success in treating FTD. http://www.amenclinics.com/clinics/getting-started/

    Thanks, Kevin

    ReplyDelete
  2. This is excellent Lee!I had wondered what the change was but hadn't had a chance to ask you. It was wonderful to recently watch you totting up your game scores without a pause.

    ReplyDelete
  3. Thanks for the comment Kevin.

    I did check out this web site at your suggestion. It was very commercial, and I wish him all the best, but I do not think that it is for me. I do envy his marketing though. Be skeptical is my motto ; )

    I think the Metformin/Coconot oil is still a better option.

    -Lee

    ReplyDelete
  4. Thanks for the comment Eileen.

    It is important to have others assessments because I have no way to measure the changes objectively. Please always note any changes you may notice.

    I say... rematch!

    -Lee

    ReplyDelete