By Richard Harkness
Enquirer contributor

Question: Can ginkgo reverse the sexual problems caused by antidepressant drugs?

Answer: There's preliminary evidence that ginkgo biloba can improve sexual function in some individuals with antidepressant-related sexual dysfunction.

Ginkgo is a popular herbal supplement used for a variety of conditions, including Alzheimer's disease and other dementias, age-related memory loss, intermittent claudication, macular degeneration and premenstrual syndrome.

This potential benefit of ginkgo for antidepressant-

induced sexual dysfunction first came to light several years ago.

A psychiatrist reported the case of an elderly male patient experiencing antidepressant-related impotence and decreased libido, which had not responded to conventional treatment.

The patient decided to try ginkgo to see if it would improve his mental processes. A month later, he reported that his sexual problems had disappeared.

The man had been taking Zoloft (sertraline), an SSRI antidepressant. Other members of the SSRI family include Celexa (citalopram), Prozac (fluoxetine), Luvox (fluvoxamine) and Paxil (paroxetine).

The psychiatrist was impressed enough to conduct a four-week open trial using ginkgo biloba extract in 30 men and 33 women with sexual dysfunction related to SSRI antidepressants and other types of antidepressants.

Based on the study criteria, ginkgo treatment was found to be 84 percent effective, with women more responsive than men.

However, not all findings have shown a benefit for ginkgo in this regard.

Double-blind studies are needed to confirm the positive results, and none has as yet been performed.

Antidepressant-related sexual dysfunction, estimated to occur in up to 60 to 70 percent of patients, is an important quality-of-life issue and a major reason for noncompliance with treatment.

For years, the published rate for these problems has been much underestimated.

One reason is that sexual side effects often go unreported. Doctors may be reluctant to ask, and patients reluctant to tell.

The SSRI antidepressants appear to be associated with the highest incidence of sexual side effects.

Reported problems include impotence (erectile dysfunction), decreased libido (sexual desire), delay of orgasm or ejaculation, and anorgasmia (failure to reach orgasm).

Several conventional strategies are available for dealing with antidepressant-induced sexual dysfunction. Check with your physician about this.

For ginkgo, the dose used for sexual dysfunction due to SSRI antidepressants has been 60 to 120 mg twice daily of ginkgo leaf extract.

Look for a product standardized to contain 22 to 27 percent flavone glycosides, 2.8 to 3.4 percent ginkgolides A, B and C, 2.6 to 3.2 percent bilobalide, and no more than 5 ppm ginkgolic acids.

Because ginkgo might thin the blood similarly to aspirin, use caution when combining ginkgo with blood thinners such as aspirin or warfarin (Coumadin).

It is at least theoretically possible that a similar interaction might occur with supplements such as garlic, phosphatidylserine, policosanol or high-dose vitamin E. The most common side effect associated with ginkgo biloba extract is gastrointestinal discomfort.

Rarer, more serious side effects have been reported, so consult with your physician before taking ginkgo.

E-mail rharkn@aol.com.