NIS - libdoc.who.int - World Health Organization

WHO monographs on medicinal plants commonly used in the Newly Independent States (NIS)
tract (1:1 in 45% alcohol) using a fixed dose (60 drops/day), in patients
with Alzheimer disease, over a 4-month period. Patients with mild to
moderate Alzheimer disease aged between 65 and 80 years (n = 42,
18 women) with a score of ≥ 12 on the cognitive subscale of the Alzheimer’s
Disease Assessment Scale (ADAS-cog) and ≤ 2 on the Clinical Dementia
Rating (CDR) were randomly allocated to either receive a placebo
or a fixed dose of S. officinalis extract. ADAS-cog is a subscale of
11 items that evaluates selected aspects of attention, language, memory,
orientation, praxis and reasoning. CDR (sum of the boxes) provides a
consensus-based global clinical measure by summing the ratings from
six domains: memory, orientation, judgement, problem-solving, community
affairs, home and hobbies, and personal care. Over a 16-week
period, the primary outcome measure was the change in the ADAS-cog
score. Change in CDR (sum of the boxes) was the secondary outcome of
the trial. In addition, side-effects were systematically recorded throughout
the study using a checklist. The results showed that at 4 months, the
extract led to a better outcome for cognitive functions than placebo
(ADAS-cog: F, 4.77; df, 1; p, 0.03) (CDR-SB: F, 10.84; df, 1; p < 0.003).
There were no significant differences between the two groups in terms of
observed side-effects except for agitation, which appeared to be more
frequent in the group treated with the placebo (p = 0.09). The results of
the study indicate that the extract was efficacious in the management of
mild to moderate Alzheimer disease (52).
Adverse reactions
After prolonged ingestion of ethanol extracts of leaves of Salvia officinalis,
epileptiform convulsions can occur (38).
Contraindications
In view of the toxicity of the plant due to the thujone and camphor content,
extracts should be used with caution and not ingested in large
amounts (95). Because of the known toxic properties of thujone, the described
abortifacient properties (96), and lack of safety data concerning
administration of Folium Salviae and its preparations in children as well
as during pregnancy and lactation, it is contraindicated in these patient
groups (38, 97).
Warnings
Long-term use of essential oil (more than 2 weeks at a time) should be
avoided (98).
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