title: Ginkgo biloba use in nursing home elderly with epilepsy or seizure disorder.
abstract: OBJECTIVE
  Ginkgo biloba, among the most widely used herbs, possesses the capacity both to induce and to inhibit seizures. The purpose of this study was to describe the prevalence of ginkgo and other common herb prescribing in a sample of nursing home (NH) elderly diagnosed with epilepsy/seizure (Epi/Sz) disorder and to determine demographic, clinical, and functional factors associated with ginkgo use.
  
  
  METHODS
  This was a 1-year prevalence study of 68,403 NH residents living in 557 nursing facilities throughout the United States.
  
  
  RESULTS
  Overall, herb use in the NHs was very low (0.41%). Ginkgo was prescribed 162 times, more than any other herb. St. John's wort was prescribed 40 times; garlic, 29 times; and all others, <20 times, for a total of 307 herb orders. Among all residents with an herb order, ginkgo was prescribed for 61.9% of residents with an Epi/Sz diagnosis and 58.0% (p = 0.820) of residents without an Epi/Sz diagnosis. Dementia, educational level, and the interaction of age group with cognitive impairment were all significantly associated with herb use among Epi/Sz residents. Cognitive impairment and the interaction of Epi/Sz disorder with dementia were associated specifically with ginkgo use.
  
  
  CONCLUSIONS
  Ginkgo is the most frequently prescribed herb in this population in which >50% of all herb orders were written for ginkgo. The concern with ginkgo use among elderly with Epi/Sz is the lack of standardization that characterizes ginkgo products. In the absence of standardization, the likelihood is increased that ginkgo products may be adulterated with the Ginkgo biloba plant parts most commonly associated with seizure provocation.
authors.affiliation: Division of Health Services Research and Policy, School of Public Health, 420 Delaware Street SE, MMC 729, Minneapolis, MN 55455, U.S.A. harms010@tc.umn.edu
authors.forename: Susan L
authors.initials: SL
authors.lastname: Harms
authors.forename: Judith
authors.initials: J
authors.lastname: Garrard
authors.forename: Paul
authors.initials: P
authors.lastname: Schwinghammer
authors.forename: Lynn E
authors.initials: LE
authors.lastname: Eberly
authors.forename: Yanping
authors.initials: Y
authors.lastname: Chang
authors.forename: Ilo E
authors.initials: IE
authors.lastname: Leppik
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy / Q000453:epidemiology; D015897:Comorbidity; D003704:Dementia / Q000188:drug therapy / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D020441:Ginkgo biloba; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D017891:Pharmacoepidemiology / Q000706:statistics & numerical data; D008517:Phytotherapy / Q000706:statistics & numerical data; D028321:Plant Preparations / Q000627:therapeutic use*; D010946:Plants, Medicinal; D015995:Prevalence; D014481:United States / Q000453:epidemiology
chemical_list: D028321:Plant Preparations