Ginkgo biloba for ADHD: A natural herbal treatment alternative?

A few weeks ago, I discussed the merits of ginseng for treating ADHD. What I did not mention is the fact that this special herb often works even better in tandem with another important "brain herb", Ginkgo biloba. It's benefits also extend beyond the nervous system, and the Ginkgo has been used to treat everything from increasing blood flow to Alzheimer's to glaucoma to hormone replacement to protection against neuronal degradation. While somewhat wary (personally) of using generalized "brain booster" nutrients for ADHD (it is a highly variable disorder of complex etiology and treatment methods), I am interested whenever new research publications arise on the topic. Just this week, a new paper came out on the merits of Ginkgo biloba as an ADHD treatment option.

Here are some of the major points of the publication:

• Irritability is an often overlooked side effect of ADHD. Medications, especially over-prescription with stimulants such as methylphenidate and amphetamines can increase this unwanted side effect. However, Ginkgo exhibited a positive mollifying effect on irritability for the individuals in the study.
  
  
• While one of the knocks against Ginkgo biloba is that it can sometimes result in sedative effects, the study found these to be extremely mild. However, to go along with the irritability-reducing benefits above, Ginkgo was able to improve the individuals' tolerance for frustration (to the degree that this behavior could be measured).
  
  
• We have seen previously that oppositional defiant behaviors are often comorbid to ADHD (which can often manifest themselves alongside seemingly unrelated disorders such as auditory processing disorders or even bedwetting). One of the strongest suits of Ginkgo biloba may actually be in curbing these oppositional behaviors. This suggests that Ginkgo may be effective for the more Hyperactive/Impulsive or Combined Subtypes of ADHD, where comorbid oppositional behaviors are more often seen (as opposed to the predominantly inattentive subtype of the Disorder).
  
  
• Nevertheless, Ginkgo biloba appeared to boost symptoms of attention and working memory as well. This may suggest Ginkgo's versatility, and that it could be used universally across the ADHD "spectrum", including for the 3 classic or traditional subtypes of the disorder.
  
  
• The study highlights the relative success for co-treatment with methylphenidate and clonidine for individuals with ADHD and comorbid anxiety disorders. The authors suggest a functional comparison between Ginkgo and clonidine, and hint at its use as an alternative to clonidine/methylphenidate treatment (of course, it is also possible that Ginkgo may be used alongside lower doses of stimulant medications, which could be very useful in reducing unwanted side effects, which are often mild for low doses of stimulants, but typically begin to appear with greater frequency when stimulant dosing is increased). Thus, Ginkgo could possibly act as a side-effect-saving alternative to higher doses of medication.
  
  
• As a precautionary measure, due, in part to some of its anti-clotting properties, there is some concern about Ginkgo triggering internal cerebral bleeding. Indeed, other studies have also addressed this possible concern, highlighting issues such as haemmorrhage risks, as well as herb-drug interactions with Ginkgo and anti-coagulant medications.
  
  
• Keep in mind the extremely small nature of the study (only 6 individuals) should be met with healthy skepticism. However, the results were still notable. Statistically significant reductions in some of the trademark ADHD symptoms (fidgeting, restlessness, inattention, etc.) upon Ginkgo biloba treatment definitely highlight its potential as a more "natural" alternative treatment method for ADHD.
  

Can ADHD be Treated with Ginseng?

The Theory Behind Ginseng as an ADHD Treatment Option:

Ginseng is well-regarded for its memory boosting, sleep improving, and brain-saving longevity benefits. In a general sense, it appears that it would be a good potential treatment method for ADHD and related disorders. Although successful clinical study publications on the specific use of ginseng for ADHD are relatively scarce, it appears that on at least a theoretical basis, this popular herb could work for treating ADHD and related disorders. I would like to highlight some of the biochemical and physiological reasons supporting its use as an alternative treatment for ADHD:

1. Compound diversity in ginseng: Ginseng is not simply one isolated compound, such as an individual drug, but rather a mixture of substances of potential pharmaceutical benefit. Among these are a family of compounds called ginsenosides. One of the underlying benefits this (and herbal treatments in general), is that many of these related compounds can work together in a synergistic fashion, nature's own alternative to drug cocktails. Given the fact that absorption, metabolism and utilization of biochemical agents for the treatment of disorders is rarely due to one isolated substance of pharmaceutical value, this multi-compound treatment method certainly has potential advantages over a single-drug treatment method for ADHD or related disorders.
   
   
2. Ginseng, dopaminergic activity, and ADHD: It has been demonstrated that herbal extracts of ginseng can exhibit activities that target the dopaminergic (dopamine-related) pathway and can exhibit neuro-protective benefits for these pathways. This is important, because ADHD is often chemically characterized by deficits in this pathway, which typically include reduced dopamine levels in the regions between neuronal cells throughout various key regions of the brain (ones that, among other things, are responsible for attention span, screening out irrelevant stimuli, and impulse control). There are even implications that ginseng compounds can accelerate the neurodevelopment process from stem cells.
   
   
3. Boosting of "synaptic plasticity": During the learning process, a certain amount of "agility" is necessary in the regions in between the cells as the brain begins to rewire itself to conform to the newly learned material. The ability of neurons to form new connections is referred to as synaptic plasticity. It appears that ginseng contains several key elements which helps maintain this "pliable" learning-friendly state. Essentially, compounds isolated from ginseng can moderate long-term potentiation, (long term potentiation refers to a learning and memory process in which communication between two neuronal cells is improved or made more efficient by stimulating both cells at the same time. This plays an important role in the development and maintenance of long-term memories). Given the fact that learning disabilities are frequently seen in ADHD (often more on the inattentive side of the ADHD spectrum), it stands to reason that ginseng may be useful in some of these comorbid learning-related deficits as well.
   
   
4. Ginseng boosts aerobic glucose metabolism in the ADHD brain: The ADHD brain typically contains deficits of glucose and oxygen (as determined by multiple imaging and brain scanning studies) in many of the key brain regions which modulate attentional control, impulsivity, and concentration. It is even postulated that ADHD may be an "energy deficient syndrome". Brain metabolic studies indicate that aerobic glucose metabolism is typically improved in the presence of ginseng isolates. Not only does this reduce some of the potentially brain waste products associated with oxygen-deprived brain activity, but this enhanced aerobic form of glucose metabolism in the brain is a more efficient process.
   
   
5. Ginseng may boost dopamine and norepinephrine levels: As mentioned previously, individuals with ADHD are typically deficient of the important neuro-signaling agent dopamine in key regions of the brain. However, a deficiency in another important neuro-signaling agent called norepinephrine is also frequently seen in the ADHD brain. Imbalances of both dopamine and norepinephrine are seen in ADHD patients, and can lead to disruptions in physiological processes such as attention span, complex cognitive processes, auditory processing delays, and motor behavioral dysfunctions. It is believed that the ginsenoside compounds (see point #1) may help alleviate some of these ADHD-related symptoms by boosting levels of dopamine and norepinephrine in these key brain regions, several of which are affiliated with ADHD.
   
   Interestingly, many stimulant meds for ADHD work by boosting levels of these same two compounds, meaning the effects of ginseng may approximate those of a stimulant medication used to treat ADHD. We will see in the next post how another natural brain supplement, Ginkgo biloba, may better approximate the action of non-stimulant ADHD medications. It is also worth noting that isolates of ginseng and ginkgo may work in tandem to boost memory and other related functions.
   
   On a side note, fatty extracts of the ginseng plant have been used to alleviate the dopamine-dependent "high" of cocaine, which supports the use of ginseng as a potential treatment agent for cocaine addictions. Similar results support the use of ginseng for treating nicotine addiction as well. This further validates the dopamine-dependent regulatory benefits of ginseng and its ability to stabilize fluctuations in neuro-signaling agents of relevance to ADHD.
   
   
6. Ginseng may protect against brain damage from excess iron: I have personally advocated the use of iron for treating ADHD in several other posts. It can counteract toxic effects of lead and other metals, improve the synthesis of dopamine from the dietary amino acid tyrosine, and improve sleep quality in ADHD children. However, there are several dangers associated with excessive iron supplementation, one of which is neuronal death and neuro-degenerative diseases such as Parkinson's. However, there is some evidence that ginseng can counteract this iron-related neuronal damage by regulating specific iron-transporting proteins in the brain. If these findings hold true, then ginseng might be of use as some type of "insurance measure" against potential damage from excessive amounts of iron supplementation designed to treat ADHD.
   
   
7. Promote nerve growth in brain regions typically under-developed in ADHD: We have reported earlier on some of the delays in maturation and development of specific brain regions in ADHD. Some research suggests that ginseng compounds may promote neuronal growth and development in the early stages of life. While currently a bit of a stretch, findings such as this may lead to the use of ginseng compounds to offset ADHD-associated neurodevelopmental delays somewhere down the road.
   
   
8. Neuroprotective effects of ginseng for the aging ADHD brain: This may be especially relevant to adults with ADHD as they age. In addition to its ability to help with neuronal cell development in the early stages of life (mentioned in the previous point), evidence suggests that the active ginsenoside "Rd" compound in ginseng can alleviate inflammatory damage and death to neuronal cells. Given the fact that early neurodegenerative effects are often present in ADHD-like mammalian systems, these results at least suggest that ginseng may be a potential life-long treatment option for individuals diagnosed with ADHD.