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Vinpocetine



Supplement Forms/Alternate Names :

  • Periwinkle
Vinpocetine is a chemical derived from vincamine, a constituent found in the leaves of common periwinkle ( Vinca minor L.), as well as the seeds of various African plants. It is used as a treatment for memory loss and mental impairment.
Developed in Hungary over 20 years ago, vinpocetine is sold in Europe as a drug under the name Cavinton. In the United States it is available as a "dietary supplement," although the substance probably doesn't fit that category by any rational definition. Vinpocetine doesn't exist to any significant extent in nature. Producing it requires significant chemical work performed in the laboratory.

What Is Vinpocetine Used for Today?

Some evidence supports the idea that vinpocetine can enhance memory and mental function, especially in those with Alzheimer's disease and related conditions. It is also widely marketed for enhancing memory in healthy people, but there is no real evidence that it is helpful for this purpose.
It has been hypothesized that vinpocetine helps people with Alzheimer’s disease by enhancing blood flow in the brain, safeguarding brain cells against damage, and inhibiting a substance known as phosphodiesterase. 1-3
Based on these proposed actions, vinpocetine has also been tried as a treatment for reducing brain damage following strokes .

What Is the Scientific Evidence for Vinpocetine?

Alzheimer’s Disease and Related Conditions (Dementia)

A 16-week, double-blind, placebo-controlled trial of 203 individuals with mild to moderate dementia found significant benefit in the treated group. 4 Benefits have been seen in other studies as well. 5-10 However, a major review found that overall the evidence that it works remains too weak to rely upon, due to limitations in study quality. 19

Strokes

In a single-blind , placebo-controlled trial, 30 individuals who had just experienced a stroke received either placebo or vinpocetine along with conventional treatment for 30 days. 11 The results showed that participants in the vinpocetine group experienced a significantly reduced level of residual disability as measured at 3 months.
A few other studies, some of poor design, also provide suggestive evidence that vinpocetine may be helpful for strokes. 12,16,17,20 However, much of the existing evidence is too preliminary to rely on, 18 and a recent review combining two relatively high quality studies involving 63 subjects was unable to determine whether or not vinpocetine provided any benefit for stroke patients. 21
Note : People who have had strokes are sometimes advised to take blood thinning drugs. There are concerns that vinpocetine may interact adversely with some medications of this type. See Safety Issues below.

Dosage

The usual dose of vinpocetine is 10 mg capsules 3 times per day, although dosages ranging from half to twice that amount have been used in studies. Vinpocetine reportedly is better absorbed when taken with a meal. 13

Safety Issues

No serious side effects have been reported in any of the clinical trials. However, there is one case report of vinpocetine apparently causing agranulocytosis (loss of certain white blood cells). 15
Vinpocetine inhibits blood platelets from forming clots, 1 and for this reason it could cause problems if it is taken by individuals with bleeding problems, during the period immediately before or after surgery or labor and delivery, or in combination with medications or natural substances that also affect platelet activity, such as:
The drug warfarin (Coumadin) affects blood clotting, but not through actions on platelets. One study found only a minimal interaction between warfarin and vinpocetine. Interestingly, it was in the direction of decreased clotting. 14 Nonetheless, combination therapy with vinpocetine and warfarin should not be attempted except under the supervision of a physician.
Safety in pregnant or nursing women, young children, or those with severe liver or kidney disease has not been established.

Interactions You Should Know About

If you are taking:
  • Blood-thinning drugs, such as aspirin , clopidogrel (Plavix), ticlopidine (Ticlid), or pentoxifylline (Trental): Simultaneous use of vinpocetine might cause bleeding problems.
  • Natural substances with blood-thinning properties, such as garlic , ginkgo , policosanol , or high-dose vitamin E : Simultaneous use of vinpocetine might in theory cause bleeding problems.
  • Warfarin (Coumadin): Vinpocetine might adversely affect the blood-thinning activity of warfarin (Coumadin).

References

1 Kiss B, Karpati E. Mechanism of action of vinpocetine [in Hungarian; English abstract]. Acta Pharm Hung . 1996;66:213-214.

2 Miyazaki M. The effect of a cerebral vasodilator, vinpocetine, on cerebral vascular resistance evaluated by the Doppler ultrasonic technique in patients with cerebrovascular diseases. Angiology. 1995;46:53-58.

3 Bereczki D, Fekete I. A systematic review of vinpocetine therapy in acute ischaemic stroke. Eur J Clin Pharmacol. 1999;55:349-352.

4 Hindmarch I, Fuchs HH, Erzigkeit H. Efficacy and tolerance of vinpocetine in ambulant patients suffering from mild to moderate organic psychosyndromes. Int Clin Psychopharmacol . 1991;6:31-43.

5 Balestreri R, Fontana L, Astengo F. A double-blind placebo controlled evaluation of the safety and efficacy of vinpocetine in the treatment of patients with chronic vascular senile cerebral dysfunction. J Am Geriatr Soc . 1987;35:425-430.

6 Dragunow M, Faull RL. Neuroprotective effects of adenosine. Trends Pharmacol Sci . 1988;9:193-194.

7 Fenzl E, Apecechea M, Schaltenbrand R, et al. Efficacy and tolerance of vinpocetine administered intravenously, in addition of standard therapy, to patients suffering from an apoplectic insult. In: Krieglstein J, ed. Pharmacology of Cerebral Ischemia: Proceedings of the International Symposium on Pharmacology of Cerebral Ischemia. New York, NY: Elsevier Science Publishers; 1986:430-434.

8 Manconi E, Binaghi F, Pitzus F. A double-blind clinical trial of vinpocetine in the treatment of cerebral insufficiency of vascular and degenrative origin. Curr Ther Res Clin Exp . 1986;30:702-709. Cited by: Hindmarch I, Fuchs HH, Erzigkeit H. Efficacy and tolerance of vinpocetine in ambulant patients suffering from mild to moderate organic psychosyndromes. Int Clin Psychopharmacol . 1991;6:31-43.

9 Peruzza M, DeJacobis M. A double-blind placebo controlled evaluation of the efficacy and safety of vinpocetine in the treatment of patients with chronic vascular or degenerative senile cerebral dysfunction. Adv Ther .1986;3:201-209. Cited by: Hindmarch I, Fuchs HH, Erzigkeit H. Efficacy and tolerance of vinpocetine in ambulant patients suffering from mild to moderate organic psychosyndromes. Int Clin Psychopharmacol . 1991;6:31-43.

10 Blaha L, Erzigkeit H, Adamczyk A, et al. Clinical evidence of the effectiveness of vinpocetine in the treatment of organic psychosyndrome. Hum Psychopharmacol. 1989;4:103-111. Cited by: Hindmarch I, Fuchs HH, Erzigkeit H. Efficacy and tolerance of vinpocetine in ambulant patients suffering from mild to moderate organic psychosyndromes. Int Clin Psychopharmacol . 1991;6:31-43.

11 Feigin VL, Doronin BM, Popova TF, et al. Vinpocetine treatment in acute ischaemic stroke: a pilot single-blind randomized clinical trial. Eur J Neurol. 2001;8:81-85.

12 Bereczki D, Fekete I. A systematic review of vinpocetine therapy in acute ischaemic stroke. Eur J Clin Pharmacol. 1999;55:349-352.

13 Lohmann A, Dingler E, Sommer W, et al. Bioavailability of vinpocetine and interference of the time of application with food intake. Arzneimittelforschung . 1992;42:914-917.

14 Hitzenberger G, Sommer W, Grandt R. Influence of vinpocetine on warfarin-induced inhibition of coagulation. Int J Clin Pharmacol Ther Toxicol . 1990;28:323-328.

15 Shimizu Y, Saitoh K, Nakayama M, et al. Agranulocytosis induced by vinpocetine. Medicine Online [serial online]. Available at: http://www.priory.com/med/vinpocetine.htm . Accessed July 20, 2002.

16 Feigin VL, Doronin BM, Popova TF, Gribatcheva EV, Tchervov DV. Vinpocetine treatment in acute ischaemic stroke: a pilot single-blind randomized clinical trial. Eur J Neurol. 2001;8:81-85.

17 Bonoczk P, Panczel G, Nagy Z. Vinpocetine increases cerebral blood flow and oxygenation in stroke patients: a near infrared spectroscopy and transcranial Doppler study. Eur J Ultrasound. 2002;15(1-2):85-91.

18 Bereczki D, Fekete I. Vinpocetine for acute ischaemic stroke. In The Cochrane Library . Oxford, England: Update Software; 2000.

19 Szatmari SZ, Whitehouse PJ. Vinpocetine for cognitive impairment and dementia. Cochrane Database Syst Rev . 2003;(1):CD003119

20 Szilagyi G, Nagy Z, Balkay L, et al. Effects of vinpocetine on the redistribution of cerebral blood flow and glucose metabolism in chronic ischemic stroke patients: a PET study. J Neurol Sci . 2005;229-230:275-84.

21 Bereczki D, Fekete I. Vinpocetine for acute ischaemic stroke. Cochrane Database Syst Rev. 2008;(1):CD000480.

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