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- Vinpocetine -


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Vinpocetine:

Vinpocetine supplement
by Ray Sahelian, M.D.

Vinpocetine benefit and side effects
Vinpocetine is chemically related to, and derived from vincamine, an alkaloid found in the periwinkle plant. Vinpocetine  was introduced into clinical practice in Europe more than two decades ago for its role in cerebrovascular disorders and related symptoms. Experiments with vinpocetine indicate that it can dilate blood vessels, enhance circulation in the brain, improve oxygen utilization, make red blood cells more pliable, and inhibit aggregation of platelets. Vinpocetine even has antioxidant properties. Levels peak in the bloodstream within an hour and a half after ingestion. Vinpocetine easily crosses the blood-brain barrier.
http://www.raysahelian.com/vinpocetine.html


Is Vinpocetine the Answer to Brain Fog, Cognitive and Memory Problems?
Popular European Supplement, Now Available in U.S., Helps Boost Oxygen in Brain
By Mary Shomon, About.com
About.com
It might be, says Bernd Wollschlaeger, MD, a Florida-based board-certified family physician who specializes in the application of herbal remedies and nutritional supplements. Dr. Wollschlaeger is also the associate editor of the Journal of the American Nutraceutical Association (JANA).

Vinpocetine (pronounced vin-poe-ce-teen), is a nutritional supplement derived from the periwinkle plant. It has just recently become available in the U.S. through food, drug and mass market retailers as a nutritional supplement. The supplement is already very much in use in Europe, where physicians believe it is far more effective than other supplements -- such as ginkgo biloba -- used for memory and brain function. Vinpocetine actually contains many of the same cerebral-enhancing effects as ginkgo biloba, but has been shown to be more effective in much shorter time.

Vinpocetine has been extensively studied in Europe. These clinical studies have found it to provide several advantages for the human brain, including memory enhancement, increased cognitive performance, improved cerebral circulation and higher mental acuity and awareness.
http://thyroid.about.com/cs/alternativehelp/a/vinpocetine.htm

Vinpocetine
From Cathy Wong
About.com
Vinpocetine (pronounced vin-poe-ce-teen) is a synthetic compound derived from vincamine, a substance found naturally in the leaves of the lesser periwinkle plant (Vinca minor). Vinpocetine was developed in the late 1960s.

Vinpocetine is available as a prescription drug in Europe and Japan. In the the United States and Canada, it’s sold in health food stores and online as a dietary supplement.

Why Do People Use Vinpocetine
Stroke and vascular dementia...

Alzheimer's disease...
Vinpocetine is also being explored as a complementary treatment for people with Alzheimer’s disease. It’s thought to enhance the brain's use of oxygen, protect brain cells against damage, and increase blood flow to the brain by inhibiting an enzyme called phosphodiesterase.

Although preliminary studies on the use of vinpocetine for Alzheimer's disease showed promise, a critical review of previously published studies found that the evidence as a whole was too weak to rely on, due to limitations in the design of the studies. More research is needed.

Tinnitus...
To boost brain function...

Vinpocetine is marketed in North America as a supplement that can boost memory and brain function in healthy people, but there is no real evidence yet that it can help.
http://altmedicine.about.com/od/herbsupplementguide/a/vinpocetine.htm

Vinpocetine by Douglas Labs
"VinpocetineVinpocetine is an extract of the periwinkle plant. Its discovery has essentially revolutionized the treatment of vascular dementia. It is a cognitive enhancer that has been demonstrated to increase brain blood flow, increase brain metabolism and act as a potent antioxidant."
http://www.jonnybowden.com/products/product_vinpocetine.html

Vinpocetine for cognitive impairment and dementia
by Szatmari Sz, Whitehouse PJ
The Cochrane Collaboration, Cochrane Reviews
"Insufficient evidence of benefits of vinpocetine for people with dementia.  Preclinical data of uneven quality suggest a potential beneficial effect of vinpocetine in chronic cerebrovascular diseases and on cognitive performance in a variety of animal models. Clinical trials to test these hypotheses were performed before currently used criteria for dementia had become generally accepted. The results show improvement after the treatment with vinpocetine versus placebo, but the number of demented patients treated for at least six months was small. The available data does not demonstrate many side effect problems. Although the basic science is interesting, the evidence for beneficial effect of vinpocetine on patients with dementia is inconclusive and does not support clinical use."
http://www.cochrane.org/reviews/en/ab003119.html

Vinpocetine
From Wikipedia
"Vinpocetine (brand names: Cavinton, Intelectol; chemical name: ethyl apovincaminate) is a semisynthetic derivative alkaloid of vincamine (sometimes described as "a synthetic ethyl ester of apovincamine"), an extract from the periwinkle (plant) Vinca minor.  Vinpocetine is reported to have cerebral blood-flow enhancing and neuroprotective effects, and is used as a drug in Eastern Europe for the treatment of cerebrovascular disorders and age-related memory impairment. Vinpocetine is widely marketed as a supplement for vasodilation and as a nootropic for the improvement of memory. There exists anecdotal report of uncomfortable adverse reactions to vinpocetine in a small subset of users. A low initial dosage is often recommended..."
http://en.wikipedia.org/wiki/Vinpocetine


Vinpocetine
PDRhealth
"What is it?  Vinpocetine is an herbal supplement used to treat thinking and memory problems, such as Alzheimer's disease.  Other names for Vinpocetine include: Ethyl apovincaminate, Ethyl apovincaminoate, and vinca minor.  Ask your doctor, nurse, or pharmacist if you need more information about this medicine or if any information in this leaflet concerns you..."
http://www.pdrhealth.com/drugs/altmed/altmed-mono.aspx?contentFileName=ame0376.xml&contentName=Vinpocetine&contentId=532

Vinpocetine
ThirdAge
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 Condtions (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 couldcause problems if it is taken by individuals with bleeding problems, during the period immediately before or after surgery or labor and delivery, or in combinationwith medications or natural substances that also affect platelet activity, such as aspirin , clopidogrel (Plavix), ticlopidine (Ticlid), pentoxifylline (Trental), garlic , ginkgo , policosanol , or high-dosage vitamin E .

The drug warfarin (Coumadin) affects blood clotting, but not through actions on platelets. One study found only a minimal interaction between warfarin and vinpocetine, and 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

    * Simultaneous use of vinpocetine with blood-thinning drugs, such as aspirin , clopidogrel (Plavix), ticlopidine (Ticlid), or pentoxifylline (Trental), might cause bleeding problems.
    * It is also possible that simultaneous use of vinpocetine in combination with natural substances with blood-thinning properties, such as garlic , ginkgo , policosanol , or high-dose vitamin E , might cause bleeding problems.
    * Vinpocetine might impair the action of the blood thinning drug 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(1):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 (Cochrane Review). In The Cochrane Library , Issue 2, 2000. Oxford, England: Update Software. Updated quarterly.

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 Jan 23;(1):CD000480.
http://www.thirdage.com/healthguide/vinpocetine

Lack of Efficacy of Vinpocetine in Vascular Dementia
by B. Robertsson, A. Wallin, A.L. Nyth, C.G. Gottfries, K. Blennow
Department of Psychiatry and Neurochemistry, University of Göteborg, Sweden
Dementia 1990;1:316-322 (DOI: 10.1159/000107159)

Abstract:
Twenty-two patients suffering from mild to moderate dementia of vascular origin were treated with vinpocetine, 30 mg/day during 16 weeks, in an open pilot study. Response to treatment was assessed with the Gottfries-Brĺne-Steen geriatric rating scale and psychometric tests. Effects on concentrations of neurotransmitters in the cerebrospinal fluid (CSF) and on the blood-brain barrier function were also studied. According to the ratings and tests, the only noticeable improvement was reduced fear/panic. This improvement may very well be attributable to increased care of the patients during the study. The drug did not influence the monoamine metabolites in the CSF or the blood-brain barrier function. On the basis of these results we conclude that vinpocetine has no effect on patients suffering from mild to moderate dementia of vascular origin.
http://content.karger.com/ProdukteDB/produkte.asp?Doi=107159

Oh... and this rather interesting article from "Neurology India" was in that folder.  Not really realted to vinpocetine, but it is interesting.  Note the very low incidence of AD in India.  Is it genetic or diet?  Curcumin has been shown to have anti-amyloid and anti-inflammatory properties and is an iron and copper chelator.  It is abundant in the cury spice tumeric.  Coconut products are also used in India cusine, I think (MCT oils?)...

Some observations on the spectrum of dementia
Abstract:
A study was designed to generate epidemiological and clinical data on dementia, in a teaching hospital in India. It was conducted on 124 (94 male and 30 female) elderly patients (aged more than 60 years) presenting with clinical syndrome of dementia (DSM-3). Their age range was 64-78 (mean 65.7 4.1) years. Detailed clinical, biochemical, radiological and electrophysiological evaluation was done to establish etiology. Patients with psychiatric ailments, cranial trauma and tumors were excluded. The study period was 4.2 years. Multi-infarct dementia (MID) was observed to be commonest cause of dementia and was present in 59 (47.6%) cases. There were 10 (8%) patients each of tuberculosis (TB) and neurocysticercosis (NCC). Alcohol-related dementia was present in 13 (10.5%), while malnutrition (Vitamin B12 deficiency) was present in 9 (7.2%). Alzheimer's Disease (AD) was present (NINCDS-ADRDA criteria) in 6 patients (4.8%). There were 3 (2.4%) cases 1 each of Huntington's disease, Parkinson's and Normal Pressure Hydrocephalus and 2 each of diabetes, hypothyroidism, hyperthyroidism and Creutzfeldt' Jakob Disease. We conclude that AD, which is irreversible and common in the west, is relatively uncommon in India as compared to MID, infections and malnutrition, which are potentially treatable.
http://www.neurologyindia.com/article.asp?issn=0028-3886;year=2004;volume=52;issue=2;spage=213;epage=214;aulast=Jha



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