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Coma in a patient with Alzheimer's disease taking low dose trazodone and ginkgo biloba
Open accessAbstract
We describe a patient with Alzheimer's disease who developed coma a few days after starting low dose trazodone associated with ginkgo biloba. Coma was reversed by flumazenil, a specific antagonist of the benzodiazepine (BDZ) receptor. The finding is relevant in that, although the sedative effects of trazodone are well known, the drug is inactive on the BDZ receptor. On the other hand, ginkgo is active on the receptor, but sedation has so far never been reported. Pathway from trazodone to coma. In March 1999, an 80 year old woman was first evaluated in our facility and given a diagnosis of probable Alzheimer's disease (NINCDS-ADRDA criteria) of a moderate severity (mini mental state examination of 10/30). She had no physical comorbidity or vascular risk factors. At the time of observation she was taking 3.5 mg bromazepam for mild restlessness, anxiety, and irritability, with only partial benefit (neuropsychiatric inventory: anxiety 4/12, irritability/lability 3/12). …
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“Surprisingly, Ginkgo did not alter the cognitive function of these AD patients during this period [110]”
From Phytotherapy: A promising approach for the treatment of Alzheimer's disease (2022) · cites this paper as [110]
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Metadata
- Authors
- GALLUZZI, S.
- Affiliations
- University of Rome Tor Vergata (IT)
- Corresponding author
- GALLUZZI, S.
- ORCID
- GALLUZZI, S.
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2000-05-01
- Volume
- 68
- Issue
- 5
- Pages
- 679a-680
- ISSN
- 0022-3050 (ISSN-L)
- PMC
- PMC1736918
- OpenAlex
- W2103060442
- Cited by
- 125
- References
- 5
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 4 · 2021: 6 · 2020: 1 · 2019: 5 · 2018: 3 · 2016: 2 · 2015: 3 · 2014: 6 · 2013: 4 · 2012: 7
- FWCI
- 21.16
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Ginkgo biloba and Cashew Applications
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
- Keywords
- coma, Alzheimer's disease, trazodone, Ginkgo biloba, benzodiazepine receptor, flumazenil, drug interactions, sedation, bromazepam, adverse drug reactions
- MeSH terms
- Aged, Alzheimer Disease, Coma, Drug Interactions, Female, Humans, Plants, Medicinal, Trazodone, Selective Serotonin Reuptake Inhibitors, Receptors, GABA, Ginkgo biloba
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