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Vinpocetine

Common Name: Vinpocetine
Synonyms: Cavinton

Overview:

Vincamine is an alkaloid found in the common periwinkle or Vinca minor.Vinpocetine is a semi-synthetic derivative of vicamine. This derivative of vicamine was developed over 20 years ago in Hungary. It is now widely used in Europe, Japan, and Mexico, as a drug to treat cognitive disorders such as dementia and the damage done to the brain following an ischemic stroke (when to brain does not receive enough oxygen). Vipocetine is have the ability to enhance brain function and is often called a nootropic or cognitive enhancer.

Vinpocetine is believed to work by increasing blood flow in the brain making it helpful in those suffering from cognitive disorders such as dementia and Alzheimer’s disease. It shows the ability to protects brain cells from damage caused by the substance phosphodiesterase and, as an antioxidant, it protect brain cells from free radical damage.. Vinpocetine is also used as a supplement by healthy adults for memory enhancement and an increase in cognitive abilities

Benefits

Vinpocetine has been used in Europe to treat cognitive brain dysfunctions for many years. The research into vinpocetine’s ability to protect and even restore cognitive function is showing great promise.

  1. In a 16 week multi-centered, double blind, placebo-controlled study, 203 patients who exhibited mild to moderate dementia were treated with vinpocetine or a placebo. The vinpocetine treated group showed significant improvement in cognitive function as measured by “global improvement” and cognitive performance scales.
  2. Similar results were received in another double-blind test comparing vinpocetine to a placebo in elderly patients who suffered from cerebrovascular and nervous system degenerative disorders.
  3. Preliminary studies suggest that vinpocetine may protect eyesight and hearing. A study of patients with mild injuries to the eyes caused by burns showed that vinpocetine enhanced the healing process. It is believed this is a result of vinpocetine’s ability to increase blood flow to all areas of the brain.
  4. Vinpocetine has shown a similar ability to reduce the damage caused by acoustical trauma to the ears.
  5. Vinpocetine also is showing the ability to protect the stomach and the nervous system from the damage that is caused by excessive consumption of alcohol.
  6. In a single-blind placebo controlled group of 30 people who had just suffered a stroke received either vinpocetine or conventional treatment for 30 days. Those receiving vinpocetine supplements showed significantly lower level of residual disability measured three months after the stroke. Other small poorly designed studies also suggested that vinpocetine supplements to be helpful in those who suffered strokes. These preliminary findings need to be confirmed by larger and better designed research studies.

Dietary Sources

Vinpocetine is derived from vincamine and is available only as a supplement in the United States.

Recommended Dosage:

Pediatric

The effects of vinpocetine have not been tested in children. Because of this, vinpocetine should not be given to children.

Adult

Vinpocetine supplements are absorbed better if taken with a meal.

The usual dose of vinpocetine is 10mg 3 times a day. It is recommended that a healthcare practioner be consulted before starting a vinpocetine regime. Some references recommend doses no higher that 20mg a day.

Contra-indications

  1. Vinpocetine inhibits platelets from clotting. Because of this it could cause problems:
    • Before and after surgery
    • During labor and deliver
  2. Women who are pregnant or breastfeeding and those with kidney or liver disease should not take vinpocetine as its safety in these individuals has not been established.

There have been side effects and adverse reactions to vinpocetine supplements. These include:

  1. Nausea
  2. Dizziness
  3. Insomnia
  4. Drowsiness
  5. Dry mouth
  6. Transient hypotension (low blood pressure)
  7. Transient tachycardia ( rapid heart beat, especially over 100 beats per minute)
  8. Pressure headaches
  9. Facial flushing
  10. A slight reduction of systolic and diastolic blood pressure with prolong use
  11. Slight reduction of blood glucose levels with prolonged use.

Drug interactions

Vinpocetine inhibits blood platelets from forming clots.

  1. Taking vinpocetine in combination with medications or other supplements that inhibit clot formation such as: aspirin, Plavix, Ticlid, Trental, garlic, ginko, policosanol or high doses of vitamin E, may significantly increase the time it takes for blood to clot.
  2. In those taking warfarin, their healthcare practioner should monitor their INRs.

Web References

  1. http://www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/vin_0259.shtml
  2. http://healthlibrary.epnet.com/GetContent.aspx?token=e0498803-7f62-4563-8d47-5fe33da65dd4&chunkiid=21841
  3. http://en.wikipedia.org/wiki/Vinpocetine

Printed Reference Material

  1. 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.
  2. Bereczki D, Fekete I. A systematic review of vinpocetine therapy in acute ischaemic stroke. Eur J Clin Pharmacol. 1999; 55:349-352.
  3. Bereczki D, Fekete I. Vinpocetine for acute ischaemic stroke (Cochrane Review). In The Cochrane Library, Issue 2, 2000. Oxford, England: Update Software. Updated quarterly.
  4. 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.
  5. 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.
  6. Bukanova YV, Solntseva EI. Nootropic agent vinpocetine blocks delayed rectified potassium currents more strongly than high-threshold calcium currents. Neurosci Behav Physiol 1998; 28:116-120.
  7. Cholnoky E, Domok LI. Summary of safety tests of ethyl apovincaminate. Arzneimittelforschung. 1976; 26(10a):1938-1944.
  8. Dragunow M, Faull RL. Neuroprotective effects of adenosine. Trends Pharmacol Sci. 1988;9:193–194.
  9. 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.
  10. 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(1):81-85.
  11. 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.
  12. Gulyas B, Halldin C, Karlsson P, et al. Brain uptake and plasma metabolism of [11C] vinpocetine: a preliminary PET study in a cynomolgus monkey. J Neuroimaging. 1999; 9:217-222.
  13. 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.
  14. Hindmarch I, Fuchs HH, Erzigkeith H. Efficacy and tolerance of vinpocetine in ambulant patients suffering from mild to moderate organic psychosyndromes. Int Clin Psychopharmacol. 1991; 6:31-43.
  15. 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.
  16. Kiss B, Karpati E. [Mechanism of action of vinpocetine.] [Article in Hungarian.] Acta Pharm Hung. 1996; 66:213-224.
  17. Kiss B, Karpati E. Mechanism of action of vinpocetine [in Hungarian; English abstract]. Acta Pharm Hung. 1996;66:213–214.
  18. Lakics V, Sebestyén MG, Erdö SL. vinpocetine is a highly potent neuroprotectant against veratridine-induced cell death in primary cultures of rat cerebral cortex. Neurosci Lett. 1995; 185:127-130.
  19. 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.
  20. 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.
  21. Miskolczi P, Vereczkey L, Szalay L, Gondoc C. Effect of age on the pharmacokinetics of vinpocetine (Cavinton) and apovincaminic acid. Eur J Clin Pharmacol. 1987; 33:185-189.
  22. 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.
  23. Nosalova V, Machova J, Babulova A. Protective action of vinpocetine against experimentally induced gastric damage in rats. Arzneimittelforschung. 1993; 43:981-985.
  24. 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.
  25. Pudleiner P, Vereczkey L. Study of the absorption of vinpocetine and apovincamic acid. Eur J Drug Metab Pharmacokinet. 1993; 18:317-321.
  26. 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.
  27. Subhan Z, Hindmarch I. Psychopharmacological effects of vinpocetine in normal healthy volunteers. Eur J Clin Pharmacol. 1985; 28:567-571.
  28. Szakall S, Boros I, Balkay L, et al. Cerebral effects of a single dose of intravenous vinpocetine in chronic stroke patients: a PET study. J Neuroimaging. 1998; 8:197-204.
  29. Szatmari SZ, Whitehouse PJ. Vinpocetine for cognitive impairment and dementia. Cochrane Database Syst Rev. 2003;(1):CD003119
  30. 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.
  31. Thal LJ, Salmon DP, Lasker B, et al. The safety and lack of efficacy of vinpocetine in Alzheimer's disease. J Am Geriatr Soc. 1989; 37:515-520.
  32. Vereczkey L, Czira G, Tamas J, et al. Pharmacokinetics of vinpocetine in humans. Arzneimittelforschung. 1979; 29:957-960.

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