Alarge and increasing number of patients use medicinal herbs or seek the advice of their physician regarding their use. More than one third of Americans use herbs for health purposes, yet patients (and physicians) often lack accurate information about the safety and efficacy of herbal remedies. Burgeoning interest in medicinal herbs has increased scientific scrutiny of their therapeutic potential and safety, thereby providing physicians with data to help patients make wise decisions about their use. This article provides a review of the data on 12 of the most commonly used herbs in the United States. In addition, we provide practical information and guidelines for the judicious use of medicinal herbs.

A review of 12 commonly used medicinal herbs.

The amnesic action of benzodiazepines in man

https://www.archives-pmr.org/article/S0003-9993(00)90052-2/pdf

Ginkgo biloba extract: mechanisms and clinical indications.

Midazolam is a short-acting water-soluble benzodiazepine (at pH less than 4), a member of a new class of imidazobenzodiazepine derivatives. At physiological pH the drug becomes much more lipid soluble. Water solubility minimises pain on injection and venous thrombosis compared with diazepam administered in organic solvent. Midazolam is a hypnotic-sedative drug with anxiolytic and marked amnestic properties. To date it has been used mostly by the intravenous route, for sedation in dentistry and endoscopic procedures and as an adjunct to local anaesthetic techniques. It has proved less reliable than thiopentone, but preferable to diazepam, as an intravenous induction agent and is unlikely to replace the other well established drugs. However, due to the cardiorespiratory stability following its administration, midazolam is useful for anaesthetic induction in poor-risk, elderly and cardiac patients. The short elimination half-life (1.5-3.5h) and the absence of clinically important long acting metabolites make midazolam suitable for long term infusion as a sedative and amnestic for intensive care, but clinical trials have yet to be completed. Thus, a combination of properties make midazolam a useful addition to the benzodiazepine group.

Midazolam. A review of its pharmacological properties and therapeutic use

1. By means of a critical review we tried to establish whether there is evidence from controlled trials in humans on the efficacy of Ginkgo biloba extracts in cerebral insufficiency. 2. The methodological quality of 40 trials on Ginkgo and cerebral insufficiency was assessed using a list of predefined criteria of good methodology, and the outcome of the trials was interpreted in relation to their quality. A comparison of the quality was made with trials of co-dergocrine, which is registered for the same indication. 3. There were eight well performed trials out of a total of 40. Shortcomings were limited numbers of patients included, and incomplete description of randomization procedures, patient characteristics, effect measurement and data presentation. In no trial was double-blindness checked. Virtually all trials reported positive results, in most trials the dosage was 120 mg Ginkgo extract a day, given for at least 4-6 weeks. For the best trials, there were no marked differences in the quality of the evidence of the efficacy of Ginkgo in cerebral insufficiency compared with co-dergocrine. The results of the review may be complicated by a combination of publication bias and other biases, because there were no negative results reported in many trials of low methodological quality. 4. Positive results have been reported for Ginkgo biloba extracts in the treatment of cerebral insufficiency. The clinical evidence is similar to that of a registered product which is prescribed for the same indication. However, further studies should be conducted for a more detailed assessment of the efficacy.

/pdf/ginkgo-biloba-for-cerebral-insufficiency-58gpcjdoyz.pdf

Ginkgo biloba for cerebral insufficiency.

The development of an objective measure of car driving performance, brake reaction time (BRT), is described, and the effects of amitriptyline and zimeldine on this measure are compared in a placebo-controlled, acute, single dose, volunteer study. The effects of treatment on laboratory tests of critical flicker fusion (CFF) threshold, choice reaction time (CRT) and tracking accuracy and on self-assessments of sedation are also examined. At 2 hours post-treatment, amitriptyline produced a significant increase in brake reaction time when compared to both placebo and zimeldine. At 4 hours post-treatment, a significant reduction in "tracking accuracy" and a significant increase in CRT was observed after treatment with amitriptyline, while no such effects were seen with zimeldine. Measures of CFF threshold and self-ratings of sedation also revealed that amitriptyline produced a significant degree of sedation at 4 hours when compared to zimeldine and placebo. In contrast, zimeldine produced elevated CFF threshold, but did not affect self-ratings of sedation. Language: en

The effects of zimeldine and amitriptyline on car driving and psychomotor performance

Eight healthy female volunteers received Ginkgo biloba extract (G.B.E.) 120, 240, 600 mg and placebo according to a randomized, double-blind crossover design. One hour following treatment, subjects completed a battery of psychological tests including critical flicker fusion (CFF), choice reaction time (CRT), subjective ratings of drug effects (LARS) and a Sternberg memory scanning test. No statistically significant changes from placebo were observed on CFF, CRT or subjective ratings of drug effects. However, memory as assessed using the Sternberg technique was found to be significantly improved following treatment with G.B.E. 600 mg when compared to placebo and results suggested a localized effect of the drug on the serial comparison stage of the reaction process.

The psychopharmacological effects of Ginkgo biloba extract in normal healthy volunteers

Twelve healthy female volunteers received pre-treatments with vinpocetine 10, 20, 40 mg and placebo (t.d.s.) for two days according to a randomised, double-blind crossover design. On the third day of treatment and 1 h following morning dosage, subjects completed a battery of psychological tests including Ciritcal Flicker Fusion (CFF), Choice Reaction Time (CRT), Subjective Ratings of Drug Effects (LARS) and a Sternberg Memory Scanning Test. No statistically significant changes from placebo were observed on CFF, CRT or subjective ratings of drug effects. However, memory as assessed using the Sternberg technique was found to be significantly improved following treatment with vinpocetine 40 mg when compared to placebo and results suggested a localised effect of the drug on the serial comparison stage of the reaction process.

Psychopharmacological effects of vinpocetine in normal healthy volunteers

A double-blind, randomized, cross-over study was carried out in 10 normal healthy volunteers to investigate the residual effects of 7.5 mg zopiclone, 1 mg lormetazepam, 0.25 mg triazolam, 1 mg flunitrazepam and placebo. Tests of psychomotor performance and analogues of car driving ability were administered the morning following night-time medication. Changes with respect to placebo in an information-processing task one hour after taking the medications confirmed the hypnotic efficacy of zopiclone, triazolam and flunitrazepam. Flunitrazepam also produced a significant depression of the Critical Flicker Fusion Threshold (CFF) and increased subjective ratings of sedation one hour after nocturnal dosing. Flunitrazepam impaired the reaction time on the information-processing test the morning following doses of 1 mg.

Residual effects of zopiclone and benzodiazepine hypnotics on psychomotor performance related to car driving.

The effects of zopiclone 7.5 mg in comparison to flunitrazepam 1 mg, triazolam 0.25 mg and lormetazepam 1 mg on stages of information processing in a memory-scanning task were investigated in 10 normal volunteers using a double-blind placebo-controlled cross-over design. Overall reaction times for the test were significantly increased 1 h following treatment with zopiclone, flunitrazepam and triazolam and in the morning following nighttime medication with flunitrazepam. The effects of zopiclone, flunitrazepam and triazolam were found to be located in the serial comparison and response-selection organization stages of the reaction process although both flunitrazepam and triazolam caused additional impairment of stimulus encoding.

Zahed Subhan

Papers

The effects of zimeldine and amitriptyline on car driving and psychomotor performance

The psychopharmacological effects of Ginkgo biloba extract in normal healthy volunteers

Psychopharmacological effects of vinpocetine in normal healthy volunteers

Residual effects of zopiclone and benzodiazepine hypnotics on psychomotor performance related to car driving.

Effects of Zopiclone and Benzodiazepine Hypnotics on Search in Short-Term Memory