Reviewed: Mariage PA, Hovhannisyan A, Panossian AG. Efficacy of Panax ginseng Meyer herbal preparation HRG80 in preventing and mitigating stress-induced failure of cognitive functions in healthy subjects: A pilot, randomized, double-blind, placebo-controlled crossover trial. Pharmaceuticals. March 29, 2020;13(4):57. doi: 10.3390/ph13040057.
The purpose of this three-arm, randomized, double-blind, placebo-controlled crossover study was to assess the safety and efficacy of two standardized Asian ginseng (Panax ginseng, Araliaceae) preparations in reducing symptoms of occupational stress such as fatigue, impaired memory, difficulty with concentration, and attention deficit in healthy adults.
The authors recruited healthy men and women (N = 50, aged 18-65 years) who performed full-time work as teleoperators or in information technology with work-related stress and fatigue. All participants had occupational stress beyond normal limits according to the Perceived Stress Scale (PSS), but none were categorized as having pathological stress. Exclusion criteria included use of over-the-counter medications or dietary supplements that may impact cognitive function, consumption of more than one cup of coffee (Coffea spp., Rubiaceae) daily, allergy to ginseng (Panax spp.) preparations, or “any other condition that precluded participation according to the judgement of the investigator.”
The two ginseng preparations used were red* Asian ginseng (RG) root powder (HRG80™; Botalys SA; Ath, Belgium) capsules and white Asian ginseng (WG) root powder capsules (Arkopharma Laboratories; Carros, France). The 418-mg RG capsules contained 209 mg powdered Asian ginseng root and 209 mg of inactive excipient rice (Oryza sativa, Poaceae) flour and were standardized to contain 31.7 mg ginsenosides (including 25.9 mg “rare ginsenosides”). The 384-mg WG capsules contained 384 mg Asian ginseng root powder with 9.9 mg ginsenosides (including 3.056 mg “rare ginsenosides”).
Participants were randomly assigned to one of three groups: RG (n = 17), WG (n = 16), or placebo (n = 17) capsules, which contained 418 mg of brown sugar (Saccharum officinarum, Poaceae) and rice flour. According to the authors, the capsules’ appearance, taste, smell, and color were similar and indistinguishable. The participants were instructed to take two capsules once per day with water for two weeks. Compliance was self-reported and measured via pill count.
The primary outcome measure was the error-rate score on the d2 Test of Attention, which is used to assess selective attention, sustained attention, and visual-scanning speed. Secondary outcome measures were the PSS score, which is used to assess perceived stress levels, and the verbal memory accuracy score on the Computerized Memory Flow Level 2 test (MT), which is used to assess cognitive functions (learning, memory, and attention). Assessments were made daily before work and at the end of each eight-hour workday for two weeks. There was a 12-day washout period, and then participants were crossed over to an alternate treatment. All participants received all three treatments each for two weeks with a 12-day washout period between each treatment.
In the placebo group, the error rate on the d2 attention test was significantly increased at the end of a stressful workday. At the end of the workday, the d2 error rate in the RG group was significantly decreased compared with placebo and WG groups (P < 0.0001 for both). The d2 error rate in the WG group was not significantly different than the error rate in the placebo group at the end of the workday. The MT accuracy score significantly decreased from the beginning of the day to end of day in the placebo group (P < 0.05), but not the RG and WG groups, and there was no significant difference between ginseng groups.
PSS scores were significantly increased at end of day in the placebo group (P < 0.05), but PSS scores decreased significantly in the RG and WG groups (P < 0.0001 for both). The RG treatment was significantly more beneficial than WG on the PSS. Adverse events were not statistically different between groups.
The authors concluded that the RG preparation was superior to WG and placebo in improving attention, memory, and perceived stress after single and repeated administration for two weeks in healthy stressed people, and RG may be beneficial as a treatment for mental fatigue. These findings may in part be due to the differences in the chemical composition between the two ginseng preparations, and the higher ginsenoside intake overall using RG. The authors acknowledge that the findings need to be confirmed with a larger population and for a longer duration.