Phytopharmaceutical treatment of anxiety, depression, and dementia in the elderly: evidence from randomized, controlled clinical trials

Abstract

Based on subgroup analyses of randomized, controlled clinical trials, we review the efficacy of three phytopharmaceutical drugs, respectively of the corresponding active substances silexan® (WS® 1265, lavender oil) in anxiety disorders, WS® 5570 (Hypericum extract) in major depression, and EGb 761® (Ginkgo biloba extract) in Alzheimer, vascular, or mixed type dementia, in elderly patients aged ≥ 60 years. Four trials were eligible in each indication. Meta-analyses and analyses based on pooled raw data showed that the three drugs were significantly superior to placebo in the elderly subset, and that their treatment effects reflected in the main outcome measures (Hamilton Anxiety scale, Hamilton Depression scale, Neuropsychiatric Inventory) were comparable with those observed in the original trials without age restrictions. The results confirm the efficacy of the three herbal active substances in elderly patients of ≥ 60 years of age. In anxiety, depression, and dementia, they thus represent efficacious and well-tolerated alternatives to synthetic drugs.

Antidepressant and anxiolytic activity of Lavandula officinalis aerial parts hydroalcoholic extract in scopolamine-treated rats

“…Anxiety disorders are a prevalent mental health problem in older age with a considerable impact on quality of life. Longitudinal studies indicate that elderly suffering from anxiety disorders have a high risk of relapse and persistence alongside the progression to depression and mixed anxiety depression states (Kasper 2015 ).…”

“…2011 ). Also, drug treatment of anxiety is predominantly carried out using antidepressant drugs (Kasper 2015 ). However, a number of adverse reactions occur with pharmaceutical antidepressant administration, including anticholinergic effects, gastrointestinal effects including nausea and constipation, orthostatic hypotension, arrhythmias, weight gain and sexual dysfunction (Dwyer et al.…”

An Overview of Systematic Reviews of Ginkgo biloba Extracts for Mild Cognitive Impairment and Dementia

“…However, only two trials were included in the age group above 75 years. When four trials were included in the analysis of old patients, a clear beneficial effect of EGb 761 could be demonstrated by Kasper (2015). (4) Neuropsychiatric and behavioral symptoms (NPS): GBEs improve neuropsychiatric symptoms, including depression (Weinmann et al, 2010; Jiang et al, 2013; Gauthier and Schlaefke, 2014; Tan et al, 2015), there was a significant difference in favor of 240 mg/day EGb761 ( p < 0.00001) when assessing efficacy regarding improvement of neuropsychiatric symptoms (Tan et al, 2015).…”

“…However, only two trials were included in the age group above 75 years. When 4 trials were included in the analysis of old patients, a clear beneficial effect of EGb 761 could be demonstrated by Kasper (2015). Moreover, Jiang et al (2013) inappropriately included the trials by van Dongen et al (2003) and McCarney et al (2008).…”

Tanakan as a multimodal cytoprotective factor in general medicine

“…Получены доказательства того, что дли-тельное введение препарата улучшает внимание, работо-способность и долгосрочную память при усвоении вер-бальной и невербальной информации. Один из последних метаанализов рандомизированных контролируемых ис-следований показал эффективность EGb 761 в лечении разных видов деменции у пациентов старше 60 лет [18].…”