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    Ginkgo biloba is commonly used to enhance perfusion to vascular areas in cases of dementia or peripheral vascular insufficiency.13 In Germany, Ginkgo biloba is prescribed and dispensed under the standardized extract known as Egb 791 (manufactured by Willmar Schwabe GmbH & Co, Karlruhe, Germany).13 In the United States this herb is also popular, with annual sales of approximately $370 million.13 Ginkgo biloba tree, also known as the maidenhair tree, dates back some 210 million years and is native to China.17 The constituents in Ginkgo biloba are flavonoids, terpenoids, and organic acids.2 The terpenoids are known as ginkgolides A, B, C, J, and M, and the flavonoids are quercetin and kaempferole.2,9 Most reported clinical trials have used the Ginkgo biloba product Egb 831 because of its high quality. Herbal preparations are mostly applicable mostly to mild and occasionally to moderate depression, despite the suggestion of some studies of the possible usefulness of botanicals for severe depression. Clinical studies on depression using drugs or herbs suffer from high placebo effect.

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