VINPOCETINE

BACKGROUND

Ingredient Type: Extract, Botanical

Also Known As: Vincamine, Periwinkle extract, Cavinton, Vinca minor, Ethyl apovincaminate, Ethyl ester, Eburnamenine-14-carboxylic acid

Vinpocetine is a modified alkaloid that closely resembles an extract from the lesser periwinkle plant.  Vinpocetine has been used for over 30 years to help with certain brain disorders (1).  The active periwinkle compound was first discovered in the late 1960s, but it wasn’t until 1975 that a Hungarian chemist named Csaba Szántay was able to isolate it.  Soon after the isolation of vinpocetine, a Hungarian pharmaceutical company called Gedeon Richter started producing the compound in large quantities (2).

TRADITIONAL USES

In the medieval times, herbalists used the periwinkle plant to help with headaches, vertigo, and poor memory.  The periwinkle plant was also used in some parts of Europe to make a traditional tonic to help relieve weariness associated with aging, diarrhea, bleeding gums, and mouth sores (3).

WHAT DOES SCIENCE TELL US?

Vinpocetine May Help Improve Cognition and Memory:

There has not been a large amount of research conducted on the use of vinpocetine for health benefits.  There is, however, some research on the effects of vinpocetine on cognition and memory.  The studies that have been conducted suggest that vinpocetine may be useful for improving cognition and memory.

In a randomized trial among 610 stroke patients, patients either received standard medical treatment or the standard treatment plus 30 mg of intravenous vinpocetine once a day for one week.  Assessment tests were completed before the supplementation and 7 days, 14 days, and 90 days after supplementation.  After 90 days, a significant increase in blood flow to the brain was observed in the group that received vinpocetine compared to the control group.  Furthermore, a significant improvement in cognitive ability, neurological functioning, and quality of life were also reported in the vinpocetine group (4).

Similarly, 4,865 patients were included in a research study investigating the effects of vinpocetine on poor brain blood flow.  Participants received 25 mg of intravenous vinpocetine for four days, followed by 50 mg intravenously for three days, and then 30 mg orally once a day for 90 days.  It was reported that neurological symptom severity decreased (p<0.05) and cognitive impairment test scores improved (P<0.001) in those treated with vinpocetine.  It should be noted, however, that this was not a placebo-controlled trial (5).

A double-blind, placebo-controlled study gave 42 elderly patients with chronic brain dysfunction 10 mg of vinpocetine three times daily for one month, followed by 5 mg of vinpocetine three times daily for two months.  In comparison to the placebo group, the patients who took vinpocetine performed significantly better on all of the tests that measured cognitive functioning and dementia severity at the end of the study (6).

Similar findings were reported in research conducted among 203 elderly patients with moderate to mild psychiatric conditions, including dementia.  The randomized, double-blind, placebo-controlled study administered either 10 mg or 20 mg of vinpocetine three times a day, or a placebo for 16 weeks.  In comparison to the placebo group, both vinpocetine groups experienced significant improvements in quality of life, depressive symptoms, cognitive functioning, and the severity of illness.  A significant difference between the 10 mg and 20 mg vinpocetine groups was not found (7).

In contrast to these findings, an open-label pilot study including 15 Alzheimer’s patients found little benefit to using vinpocetine.  Participants in this study were given increasing amounts of vinpocetine (30 mg, 45 mg, and 60 mg) per day for one year.  At the end of the trial period, it was determined that vinpocetine had no significant effects on slowing the progression of the disease (8).

Vinpocetine May Help Improve Blood Flow to the Brain:

The few studies that have looked at the effect of vinpocetine on strokes have shown consistently positive benefits to supplementation.  While the body of research is not large enough to make a definitive conclusion, existing published studies are promising.

Research done within a group of 138 patients diagnosed with dyscirculatory encephalopathy looked at the effects of vinpocetine on strokes.  The patients either received standard medical treatment or standard treatment and 30 mg of vinpocetine daily for 90 days. The control group was clinically matched to the treatment group, and neurological tests were performed after 3 months, 6 months, and 12 months.  The results from the tests showed that the vinpocetine treatment resulted in a significant reduction in the risk of dyscirculatory encephalopathy progression as well as a decreased risk for having a stroke or transient ischemic attack when compared to the control group (9).

A randomized, double-blind, placebo-controlled study divided 43 patients with ischemic stroke into two groups.  One group received a single dose of 20 mg vinpocetine intravenously and the other group received a placebo.  The effects of supplementation on cerebral blood flow were observed using different tests.  The results showed that vinpocetine significantly increased cerebral blood flow (p<0.005) with no changes to blood flow velocity (p=0.28) (10).  This increase in blood flow to the brain indicates that vinpocetine may be a useful treatment for those with ischemic stroke.  In addition, a different double-blind research study administered vinpocetine intravenously for two weeks to patients with chronic ischemic stroke.  PET scans and measurements of cerebral blood flow were taken and results showed an increase in cerebral blood flow among these patients (11).

Another single-blind, randomized study enrolled 30 eligible patients who were diagnosed with an acute ischemic stroke to receive either standard treatment or standard treatment with vinpocetine within 72 hours of the stroke.  After three months, results showed that those who received vinpocetine had significantly better scores on the NIH Stroke Scale, in comparison to those who just received standard treatment (12).

Vinpocetine May Help Promote Eye Health:

Although vinpocetine’s effect on eye health has not been extensively researched, available data suggests it may be beneficial.  More research is needed to fully determine if vinpocetine helps with eye health.

40 adult patients with various forms of age-related macular degeneration were enrolled in a study to determine the efficacy of vinpocetine supplementation on their condition.  Half the group received 10 mg of vinpocetine daily, while the other half received a placebo once a day for two months; both groups also received standard treatment the entire time.  After the trial period, those in the vinpocetine group were found to have an improved visual acuity and retinal functioning, as well as increased ocular blood flow (13).

A separate retrospective analysis also examined the effects of vinpocetine on different conditions of the eye.  Data from 280 patients revealed that vinpocetine infusions seemed to help with ocular diseases such as hypertonia, sclerosis, macular degeneration, glaucoma, and myopia (14).

Vinpocetine May Help With Motion Sickness:

The use of vinpocetine on motion sickness has not been well-studied.  A study of 8 participants prone to motion sickness administered vinpocetine to the subjects while they were kept in a rotating chamber for 5 hours.  In comparison to a single dose of scopolamine, a common motion sickness drug, or a placebo, it was concluded that taking vinpocetine regularly during exposure was effective (15).  This study is very outdated, however, and the study group was extremely small.  There needs to be more research on the effectiveness of vinpocetine as an anti-motion sickness supplement before this effect can be validated.

Vinpocetine May Help Stabilize Brain Function:

Research on vinpocetine’s effect on seizures has not been thoroughly investigated.  One clinical study gave 41 children who had intracranial birth trauma and seizures vinpocetine in addition to standard treatment.  In comparison to a control group of 20 children who only received standard treatment, it was concluded that the vinpocetine group had reduced seizures after one year (16).  This study does, however, have many limitations and more clinical research is needed to determine the effects of vinpocetine on seizures

SAFETY

Vinpocetine seems to be safe for use by most people, even when taken long-term (17).  It has been deemed safe to use for up to 18 months and is typically well-tolerated when taken orally (4).  Studied dosages deemed safe range from 10mg to 60mg.

As with any dietary supplement, do not take vinpocetine without first consulting your healthcare practitioner, especially if you are pregnant, nursing, or are under medical supervision for any reason.

Interactions:

Moderate

• Some evidence of vinpocetine slowing blood clotting has been reported (18).  Vinpocetine supplementation with anticoagulants such as aspirin, ibuprofen, naproxen, dalteparin, heparin, and warfarin can be dangerous.

Side-Effects:

Reports of adverse side effects from vinpocetine are rare, but may include:

• Headache, nausea, dizziness, stomach pain, nervousness, sleep problems, and abnormal heart rhythms (19).

REFERENCES

1. Zhang Y, Li J, Yan C. An update on vinpocetine: New discoveries and clinical implications. Eur J Pharmacol. 2018;819:30-34. doi:10.1016/j.ejphar.2017.11.041
2. Szatmári S, Whitehouse P. Vinpocetine for cognitive impairment and dementia. Cochrane Database Syst Rev. 2003;(1):CD003119. doi:10.1002/14651858.CD003119
3. Periwinkle. Michigan Medicine University of Michigan. https://www.uofmhealth.org/health-library/hn-3659003. Accessed June 22, 2018.
4. Zhang W, Huang Y, Li Y, et al. Efficacy and Safety of Vinpocetine as Part of Treatment for Acute Cerebral Infarction: A Randomized, Open-Label, Controlled, Multicenter CAVIN (Chinese Assessment for Vinpocetine in Neurology) Trial. Clin Drug Investig. 2016;36(9):697-704. doi:10.1007/s40261-016-0415-x
5. Chukanova EI. [Efficacy of cavinton in the treatment of patients with chronic blood flow insufficiency. Russian multicenter clinical-epidemiological program &quot;CALIPSO&quot;]. Zhurnal Nevrol i psikhiatrii Im SS Korsakova. 2010;110(12):49-52.
6. 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(5):425-430.
7. 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(1):31-43.
8. Thal LJ, Salmon DP, Lasker B, Bower D, Klauber MR. The safety and lack of efficacy of vinpocetine in Alzheimer’s disease. J Am Geriatr Soc. 1989;37(6):515-520.
9. Chukanova EI. [Cavinton in the complex treatment of patients with chronic cerebrovascular insufficiency]. Zhurnal Nevrol i psikhiatrii Im SS Korsakova. 2009;109(9):35-39.
10. Bönöczk 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.
11. Szilágyi 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;229-230:275-284. doi:10.1016/j.jns.2004.11.053
12. Feigin VL, Doronin BM, Popova TF, Gribatcheva E V, Tchervov D V. Vinpocetine treatment in acute ischaemic stroke: a pilot single-blind randomized clinical trial. Eur J Neurol. 2001;8(1):81-85.
13. Avetisov SE, Kiseleva TN, Lagutina IM, Kravchuk EA. [Effect of vasoactive agents on visual functions and ocular blood flow in patients with early manifestations of age-related macular degeneration]. Vestn Oftalmol. 123(3):26-28.
14. Végh S, Szikszay E, Bönöczk P, Cserjés Z, Kiss G. [Retrospective analysis of the effect of vinpocetine infusion in ophthalmologic disorders]. Orv Hetil. 2006;147(49):2361-2365.
15. Bodo D, Kotovskaia AR, Galle RR, Gavrilova LN, Gusakova GA. [Effectiveness of the preparation Gavinton in preventing motion sickness]. Kosm Biol Aviakosm Med. 16(3):49-51.
16. Dutov AA, Gal’tvanitsa GA, Volkova VA, Sukhanova ON, Lavrishcheva TG, Petrov AP. [Cavinton in the prevention of the convulsive syndrome in children after birth injury]. Zh Nevropatol Psikhiatr Im S S Korsakova. 1991;91(8):21-22.
17. Patyar S, Prakash A, Modi M, Medhi B. Role of vinpocetine in cerebrovascular diseases. Pharmacol Rep. 2011;63(3):618-628.
18. Hitzenberger G, Sommer W, Grandt R. Influence of vinpocetine on warfarin-induced inhibition of coagulation. Int J Clin Pharmacol Ther Toxicol. 1990;28(8):323-328.
19. Dany F, Merle L, Goudoud JC, et al. [Cardiac toxicity of vincamine: a seven cases report of ventricular arrhythmias by parenteral administration of vincamine (author’s transl)]. Therapie. 36(1):55-64.

See the WebMD entry for vinpocetine, the Examine.com entry for vinpocetine, the Michigan Medicine Health Library entry for periwinkle, or the RXList entry for vinpocetine for more information.