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Ginkgo biloba plus psychoeducation reduces anxiety, fatigue in war refugees

Stephen Padilla
31 Jan 2018

Adding ginkgo biloba to psychoeducation effectively lowers anxiety, physical- and mental-fatigue scores in a short period of time among war refugees, according to a recent study.

“The addition of G. biloba to psychoeducation proved superior to psychoeducation alone,” researchers said. “Therefore, combining the two approaches is beneficial in alleviating anxiety and fatigue.”

During follow-up, participants in the control group who received psychoeducation alone showed a nonsignificant improvement in outcome variables, whereas those in the experimental group who received 120-mg G. biloba in addition to psychoeducation exhibited a significant reduction in mental (p=0.001), physical (p=0.001), activity fatigue (p=0.041) and anxiety (p=0.001). [Proceeding of Singapore Healthcare 2018;27:26-32]

“There was a significant decrease in anxiety, physical fatigue, mental fatigue and reduction in activity fatigue scores at follow-up as compared with the baseline in the experimental group receiving G. biloba with psychoeducation,” researchers said.

In one study, the investigators found a limited effect with psychoeducation in refugees, which could be attributed to the short-term intervention. Outcome measures were taken only after 6 weeks, which might have not allowed for subjective improvements among displaced refugees that would require a longer intervention duration. [Br J Psychiatry 2016;208:252-259; J Consul Clin Psychol 2004;72:579]

The present study provided evidence of a positive impact on anxiety with the addition of G. biloba to psychotherapy, according to researchers, adding that anxiety and mood disorders were believed to be associated with impairment in monoamine neurotransmitters (ie, serotonin, dopamine) in the hypothalamus and the mesolimbic system. [Acta Neurobiol Exp 2009;69:217-223; CNS Neurol Disord Drug Targets 2015;14:132-149]

The result of this study could be explained by the increased monoamine neurotransmitter levels associated with long-term use of G. biloba, thus enhancing mood. Oxidative stress may also contribute to anxiety pathophysiology, and G. biloba is known for its antioxidant properties, which may be related to the anxiolytic actions in the study sample. [Pharmacol Res 2009;60:68-73; Front Neurosci 2015;9:3; Int J Tissue React 1994;17:93-100; Neurochem Res 2001;26:1245-1251]

To compare the effect of G. biloba and psychoeducation with psychoeducation alone on refugees’ anxiety, stress and fatigue, researchers used a randomized controlled, pretest‒post-test design and measured data at baseline and 6 weeks later.

The study was limited by the small number of participants and the relatively short duration of intervention and follow-up. In addition, participants were only recruited from three cities in Jordan and among Iraqi refugees only, which might affect the generalizability of the results, according to researchers.

“Refugees and war survivors are at higher risk of developing mental health disorders. Anxiety and stress are caused by many factors, including a stressful environment that could cause fatigue and low quality of life. Despite the existence of many synthetic anxiolytic and antidepressant drugs, symptom management has still not been successful,” researchers said. 

G. biloba extract is a potential herbal remedy used to improve cognitive functions; on the other hand, psychoeducation plays a significant role in easing psychological distress,” they added.

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