$392

P.6 Other topics

completed the study. On each study day (weeks 0, 4, 8, 12 and 14) the volunteers performed the Cognitive Drug Research computerised cognitive assessment system prior to morning dosing and again at 1, 3 and 6 hours later. The tests in the system assessed various aspects of attention and memory. On each study day the volunteers also completed questionnaires about mood states, quality of life and sleep quality. Results and Conclusions: The Ginkgo/Ginseng combination was found to significantly improve an Index of Memory Quality, supporting the previous finding with the compound. No evidence of a bi-phasic effect was seen, the effects being as marked in the afternoon as they were in the morning. Thus the negative effects seen previously were either chance effects or effects specific to patients with neurasthenia. The beneficial effects represented an average improvement of 7.5% and reflected improvements to a number of different aspects of memory, including working and long-term memory. This enhancement to memory was seen throughout the 12 week dosing period and also after a two week wash-out. The combination was well tolerated by the volunteers. This is one of the first demonstrations that phytopharmaceuticals can beneficially affect the memory of healthy middle aged volunteers.

from neurastehnia (Wesnes et al, 1997) and normal middle aged volunteers (Wesnes et al, this meeting). The possibility of acute cognitive benefits following single doses of ginseng has received sparse attention and was the focus of the present study. Design: The study utilised a placebo-controlled, double-blind, balanced, crossover design. Methods: Twenty participants received 200, 400 and 600 mg of a standardised extract of Ginseng (Pharmaton SA) or a placebo, on separate days. The order in which they received each dose was pseudo-random, following a Latin Squares design. For each participant doses were administered on different days, each separated by a 7-day wash-out period. Cognitive performance was assessed using the Cognitive Drug Research (CDR) computerised test battery immediately prior to treatment and at 1 hr, 2.5 hr, 4 hr and 6 hr thereafter. Results: The primary outcome measures were four aspects of cognitive performance which have previously been derived by factor analysis of CDR subtests and a further factor which was derived from memory accuracy measures. There were a number of significant changes in these measures following Ginseng. In particular both the 'Quality of Memory' factor and the 'Secondary Memory' factor was significantly improved by the 400 mg dose of ginseng at all test times. Conclusions: These data provide comprehensive evidence that single doses of Ginseng are capable of a continued and coherent improvement in important aspects of memory.

References
[1] Wesnes, K., Faleni, R.A., Hefting, N.R., Houben, J.J.G., Jenkins, E., Jonkman, J.H.J., Leonard, J., Petrini O., van Lier J.J., 1997. The cognitive,subjectiveand physical effects of a Ginkgo biloba/Panaxginseng combination in healthy volunteers with neurasthenic complaints. Psychopharmacology Bulletin 33, 677-683.

References
[1] Wesnes, K., Simmons, D., Rook, M., Simpson, P.M., 1987 A double blind placebo controlled trial of Tanakan in the treatment of idiopathic cognitive impairment in the elderly. Human Psyehopharmacology 2: 159-171. [2] Wesnes, K., Faleni, R.A., Hefting, N.R., Houben, J.J.G., Jenkins, E., Jonkman, J.HJ., Leonard, J., Petrini O., van Lier J.J., 1997. The cognitive,subjectiveand physical effects of a Ginkgo biloba/Panax ginseng combination in healthy volunteers with neurasthenic complaints. Psychopharmacology Bulletin 33, 677-683.

IP.6.0231 Differentiation

between autism and Multiple Complex Developmental Disorder in the response to psychosocial stress

L.M.C. Jansen, C.C. Gispen-de Wied, H. Van Engeland.

A Ginkgo bilobalPanax ginseng combination

enhances memory in healthy middle aged volunteers
K.A. Wesnesl, T. Ward1, O. Petrini2. 1Cognitive Drug Research Ltd, 24 Portman Rd, Reading, RG30 lEA, UK; 2pharmaton SA, Lugano, Switzerland Background: Ginkgo biloba is becoming increasingly recognised to improve cognitive function in various populations. We reported the first data on the cognitive effects of Ginkgo biloba when combined with Panax ginseng (Wesnes et al, 1997). The findings of that study were that over a 90 day dosing period the combination had beneficial effects on the memory of a middle aged population (n = 64) diagnosed with neurasthenic complaints. However, when testing was repeated 1 hour after early afternoon dosing, some impairments were seen. The purpose of the present study was to replicate the positive effects seen in the first study with a more substantial population and also to confirm whether or not a biphasic effect of the combination exists. Methods: The present trial was a double blind, placebo controlled, 14 week, parallel group, repeated assessment, multi-centre trial of a combination of Ginkgo biloba and Panax ginseng on cognitive fimction in healthy middle aged volunteers. Two dosing regimens were compared, 160 mg b.i.d, and 320 mg o.d. Twohundred and fifty six healthy middle aged volunteers successfully

Department of Psychiatry, University Hospital Utrecht and the Rudolf Magnus Institute of Neuroscience, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
Multiple Complex Developmental Disorder (MCDD) forms a distinct group within the autistic spectrum, characterized by impaired regulation of anxiety and affective state, impaired social behavior and sensitivity and thought disorders. Unlike autistic children, part of MCDD children develops schizophrenia in adult life (Van Engeland & Van der Gaag, 1994). As is expressed in the socalled vulnerability-stress model for schizophrenia, stress is one of the factors that play a role in the development of schizophrenia. Extreme reactions to stress are described clinically for both autism and autistic-like disorders. A previous study on the biological stress response in MCDD children, revealed decreased cortisol responses to psychosocial stress (Jansen et al. submitted). In the present study, MCDD children were compared to autistic children in their cortisol response to both psychosocial and physical stress. 10 autistic children were compared to 10 MCDD children and 12 healthy control children in their response to a psychosocial stressor, consisting of a public speaking task. For the physical stress test, consisting of 10 minutes of bicycle exercise, the same 10 autistic children were compared to 11 MCDD children and 15 healthy controls. Both tests were inbedded in a two-hour test session and compared to a control test session. Responses to the stress tests were measured on salivary cortisol and on heart rate. Repeated measures analyses revealed significant group by test by time effects for the cortisol response to psychosocial stress (F