(i.e. anticoagulants, such as warfarin (Coumadin®)) because of drug interactions: when combined with warfarin or even aspirin, Ginkgo can dangerously increase bleeding times, putting a person at risk of hemorrhagic stroke.

A phytonutrient found in the periwinkle (Vinca minor) and originally developed by the Hungarian pharmaceutical giant Gedden Richte transcends these limitations. Vinpocetine is a true cerebral metabolic enhancer. While Vinpocetine, like Ginkgo biloba, enhances cerebral microcirculation, Vinpocetine is especially remarkable in this regard, as it does so without reducing blood flow elsewhere in the body, by reducing the resistance of fine blood vessels within the brain. It accomplishes this by reducing excessive activity by a form of the enzyme type 1 phosphodiesterase in the brain - a mechanism similar to Viagra®, which acts on another form of the same enzyme in the penis. In effect, Vinpocetine is Viagra® for the brain.

But Vinpocetine also supports brain metabolism by mechanisms not related to its effects on microcirculation, and thus in no way shared by Ginkgo. First, by enhancing red blood cells' ability to "flex" their shape so as to more easily cross the blood-brain barrier (the layer of tight cell-to-cell contacts that protects the brain from a potentially-toxic environment), Vinpocetine directly supports the delivery of oxygen to the brain. Additionally, Vinpocetine facilitates the take-up and release of blood sugar across the blood-brain barrier, supporting optimal partitioning of fuel supplies. And studies in red blood cells and damaged neurons show that Vinpocetine directly increases ATP levels in these cells, supporting optimal brain energy levels.

Vinpocetine also demonstrates powerful neuroprotective effects. By subjecting experimental animals to simulated strokes, scientists have been able to show that Vinpocetine provides protection against the brain damage that follows the cutting off of oxygen and glucose delivery, reducing the ravaging cerebral edema that follows the stroke and prolonging survival of both brain cells and the organism as a whole.

These neuroprotective effects can be partly attributed to Vinpocetine's ability to maintain brain cell metabolism during the ischemic crisis, but also to Vinpocetine's role as a powerful antioxidant scavenger of hydroxyl radicals. More recently, research has demonstrated Vinpocetine's power to regulate the flow of ions across neuron membranes, notably voltage-dependent neuronal sodium-ion channels and some of the molecular cascades initiated by the flood of calcium ions into the cell. These ion flows are upset in moments of crisis such as excitotoxicity and during a stroke, and lead to brain cell death. Thus, by regulating sodium channels, and moderating the downstream effects of opened calcium floodgates, Vinpocetine delivers another important mechanism of brain cell protection.

Vinpocetine, like Ginkgo, has a mild anticoagulant effect, which can protect the brain against the formation of killer blood clots, which can cut off circulation in the brain, triggering a stroke. But unlike Ginkgo, Vinpocetine has no clinically significant interactions with "blood-thinning" drugs, making it safe for users of aspirin, warfarin, and other common anticoagulants.

Vinpocetine also has more direct effects on brain function. Most importantly, Vinpocetine increases long-term potentiation (LTP), the increase in the strength of neuroelectrical transmission between neurons, which happens when the same association is made repeatedly, and which helps move information from short-term memory into long-term memory. In other words, Vinpocetine facilitates the more permanent storage of information in the brain by stimulating the central cellular mechanism, which forms the basis of learning and memory.

Many clinical trials have demonstrated Vinpocetine's ability to support brain function. Most of these trials have been performed in stroke victims, but research also supports Vinpocetine's positive impact on cognitive function in organic dementias and in normal, healthy adults. A meta-analysis of seven double-blind clinical trials involving a total of 731 people suffering from age-related dementias or cognitive deficits following a stroke found that Vinpocetine improved cognitive and neurological function on a wide variety of measures, including scores tests of memory and mental function like the Sandoz Clinical Assessment-Geriatric (SCAG) and the Mini-Mental Status Questionnaire (MMSQ), neurological symptoms such as coordination and repetitive speaking patters (palilalia), and overall functional status as evaluated using the Clinical Global Impression (CGI) scale. Furthermore, there were no serious side effects related to Vinpocetine use. Overall, the investigators concluded, the results of these trials prove that patient users of Vinpocetine "become more vivid, the cognitive performance improves, and the daily activity is more intense."

Vinpocetine may also have important benefits outside of the brain. Studies in persons who have suffered damage to the nerves of the ears after exposure to high-intensity noise levels have reported that Vinpocetine improves hearing and reduces tinnitus, especially if initiated within the first week after trauma. Vinpocetine also appears to support visual health by improving microcirculation in the eye in the capillaries of the retina itself, the central arteries feeding the retina, and the layer of the eye between the retina and the white outer coat of the eyeball. Studies using closely-related Vinca alkaloids suggests that Vinpocetine may be of specific use in normal-tension glaucoma, and Vinpocetine itself was reported to enhance the effectiveness of drugs that lower intraocular pressure in the treatment of glaucoma in an open study. Finally, Vinpocetine was reported to remove calcification of the kidneys associated with long-term calcification; similar removal of soft-tissue calcifications has been demonstrated in other tissues in animal models.

The standard dose used in clinical trials is 15 to 45 milligrams of Vinpocetine daily.

References

Nagy Z, Vargha P, Kovács L, Bönöczk P. Meta-analysis of Cavinton. Praxis. 1988 Sep; 7(9):63-8.

Subhan Z, Hindmarch I. Psychopharmaco-logical effects of vinpocetine in normal healthy volunteers. Eur J Clin Pharmacol. 1985;28(5):567-71.

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 May;35(5):425-30.

Fischhof PK, Moslinger-Gehmayr R, Herrmann WM, et al. Therapeutic efficacy of vincamine in dementia. Neuropsychobiology. 1996;34(1):29-35.

Molnar P, Gaal L, Horvath C. The impairment of long-term potentiation in rats with medial septal lesion and its restoration by cognition enhancers. Neurobiology (Bp). 1994;2(3):255-66.

Kiss B, Karpati E. Mechanism of action of vinpocetine. Acta Pharm Hung. 1996 Sep;66(5):213-24.

Konopka W, Zalewski P, Olszewski J, et al. Treatment results of acoustic trauma. Otolaryngol Pol. 1997;51 Suppl 25:281-4.

Ueyoshi A, Ota K. Clinical appraisal of vinpocetine for the removal of intractable tumoral calcinosis in haemodialysis patients with renal failure. J Int Med Res. 1992 Sep;20(5):435-43.

Kahan A, Olah M. Use of ethyl apovincaminate in ophthalmological therapy. Arzneimittelforschung. 1976;26(10a):1969-72.

Pliushko DG, Sobko EG. Drug therapy of initial open-angle glaucoma. Oftalmol Zh. 1989;(2):72-4.

Meta-analysis of Cavinton.
Praxis. 1988 Sep; 7(9):63-8.
Nagy Z, Vargha P, Kovács L, Bönöczk P.

The meta-analysis of seven trial carried out in two groups proves the efficacy of per os applied vinpocetine in the assessed groups of subjects (gross number of patients 731). On the basis of recent PET investigations (in press), the obtained clinical results are interpreted by the improved blood flow and enhanced metabolism of healthy brain areas. The patients become more vivid, the cognitive performance improves, and the daily activity is more intense - in summary, the patients give account of improvement of their condition during treatment.


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 May; 35(5): 425-30.
Balestreri R, Fontana L, Astengo F.

In a double-blind clinical trial, vinpocetine, a synthetic ethyl ester of apovincamine, was shown to effect significant improvement in elderly patients with chronic cerebral dysfunction. Forty-two patients received 10 mg Vinpocetine three times a day (tid) for 30 days, then 5 mg tid for 60 days. Matching placebo tablets were given to another 42 patients for the 90 day trial period. Patients on vinpocetine scored consistently better in all evaluations of the effectiveness of treatment including measurements on the Clinical Global Impression (CGI) scale, the Sandoz Clinical Assessment-Geriatric (SCAG) scale, and the Mini-Mental Status Questionnaire (MMSQ). There were no serious side effects related to the treatment drug.


Psychopharmacological effects of vinpocetine in normal healthy volunteers.
Eur J Clin Pharmacol 1985; 28(5): 567-71.
Subhan Z, Hindmarch I.

Twelve healthy female volunteers received pre-treatments with vinpocetine 10, 20, 40 mg and placebo (t.d.s.) for two days according to a randomised, double-blind crossover design. On the third day of treatment and 1 h following morning dosage, subjects completed a battery of psychological tests including Critical Flicker Fusion (CFF), Choice Reaction Time (CRT), Subjective Ratings of Drug Effects (LARS) and a Sternberg Memory Scanning Test. No statistically significant changes from placebo were observed on CFF, CRT or subjective ratings of drug effects. However, memory as assessed using the Sternberg technique was found to be significantly improved following treatment with vinpocetine 40 mg when compared to placebo and results suggested a localised effect of the drug on the serial comparison stage of the reaction process.


Therapeutic efficacy of vincamine in dementia.
Neuropsychobiology 1996; 34(1): 29-35.
Fischhof PK, Moslinger-Gehmayr R, Herrmann WM, Friedmann A, Russmann DL.

This trial was performed to investigate the therapeutic efficacy of vincamine in the treatment of primary degenerative and vascular dementia. 152 male and female patients aged between 50 and 85 years from two psychogeriatric centers and two nursing homes were initially included in the trial and screened for eligibility. 142 patients completed the trial. Clinical diagnosis was established according to DSM-III-R criteria. Allocation of the patients to the primary degenerative dementia of the Alzheimer type (DAT) group or the multi-infarct dementia (MID) group was based on computed tomography scans, electroencephalographic findings and the Hachinski Ischemic Score. In a 12-week double-blind treatment either 30 mg vincamine or placebo was given twice daily. Confirmatory statistics included item 2 of the Clinical Global Impression (CGI), the total score of the Sandoz Clinical Assessment Geriatric (SCAG) scale, the subscale 'need for help' of the nurse's rating of geriatric patients (Beurteilungsskala fur geriatrische Patienten; BGP) and the total score of the Short Cognitive Performance Test (Syndrom-Kurztest; SKT). In addition, data on tolerance and on therapy response were evaluated based on descriptive statistics. The therapeutic efficacy of vincamine was clearly demonstrated by confirmatory analysis as the drug was statistically significantly superior to placebo in all four target variables. The clinical relevance of the outcome was further underlined by the results of the responder analysis of the variables SCAG, BGP and SKT. Based on the results of this trial, it can be accepted that the therapeutic effect of vincamine is superior to placebo in patients with mild to moderate dementia of degenerative and vascular etiologies.


The impairment of long-term potentiation in rats with medial septal lesion and its restoration by cognition enhancers.
Neurobiology (Bp) 1994; 2(3): 255-66.
Molnar P, Gaal L, Horvath C.

The effect of medial septal lesion on long-term potentiation (LTP) and the action of four cognition enhancers were studied in rat dentate gyrus, in vivo. The medial septum was partially lesioned by a radiofrequency lesion generator. The effect of lesion was studied on hippocampal function measuring two parameters; the amplitude of the maximal population spikes and the increase in population spikes evoked by high frequency stimulation of the perforant path (LTP). Both parameters were found to be significantly lower in the lesioned group than in the non-lesioned one. Four drugs (physostigmine, piracetam, vinpocetine and Hydergine), known to be effective in dementia and/or in cognitive impairments, were administered 1 h after the lesion procedure and thereafter once a day for 6 days after the operation. LTP was induced and measured at day 7. All drugs produced a complete restoration of the measured parameters affected by the lesion. These findings provided further evidence that the medial septum plays an important role in the induction of LTP in the dentate gyrus. This experimental model might be useful for studying new drugs against dementia.


Mechanism of action of vinpocetine.
Acta Pharm Hung 1996 Sep; 66(5): 213-24.
Kiss B, Karpati E.

Cavinton was introduced into the clinical practice some twenty years ago in Hungary for the treatment of cerebrovascular disorders and related symptoms. Since then, its active ingredient, vinpocetine, beside its therapeutical utilization, has become a reference compound in the pharmacological research of cognitive deficits caused by hypoxia and ischaemia as well as in the cellular and biochemical investigations related to cyclic nucleotides. In this review a survey is given on the experimental data obtained with vinpocetine and an attempt is made to outline the drug's mechanism of action. Early experiments with vinpocetine indicated five main pharmacological and biochemical actions: (1) selective enhancement of the brain circulation and oxygen utilization without significant alteration in parameters of systemic circulation, (2) increased tolerance of the brain toward hypoxia and ischemia, (3) anticonvulsant activity, (4) inhibitory effect on phosphodiesterase (PDE) enzyme and (5) improvement of rheological properties of the blood and inhibition of aggregation of thrombocytes. Later studies in various laboratories confirmed the above effects and clearly demonstrated that vinpocetine offers significant and direct neuroprotection both under in vitro and in vivo conditions. Evidence has been obtained that neuroprotective action vinpocetine is related to the inhibition of operation of voltage dependent neuronal Na(+)-channels, indirect inhibition of some molecular cascades initiated by the rise of intracellular Ca(2+)-levels and, to a lesser extent, inhibition of adenosine reuptake. Vinpocetine has been shown to be selective inhibitor of Ca (2+)-calmodulin dependent cGMP-PDE. It is assumed that this inhibition enhances intracellular a GMP levels in the vascular smooth muscle leading to reduced resistance of cerebral vessels and increase of cerebral flow. This effect might also beneficially contribute to the neuroprotective action.


Treatment results of acoustic trauma.
Otolaryngol Pol 1997; 51 Suppl 25: 281-4.
Konopka W, Zalewski P, Olszewski J, Olszewska-Ziaber A, Pietkiewicz P.

20 patients aged from 18 to 42 treated in the past few years because of acoustic trauma. Together the investigations concerned 24 years. Therapeutic schema comprised intravenous infusion--Sermion (Nicergoline--amp. a 4 mg) or Cavinton (Vinpocetine--amp. a 10 mg) 1 amp.--twice a day for 10 days. The treatment of 60% of the patients started in the first week after the trauma occurred, of 20% in the second week and the remaining 20% later on after 15 days when the trauma took place. The obtained results of treatment both of improvement of hearing (79.2%) and tinnitus (66.6%), support the necessity of treatment of acoustic trauma independently from the time that passed after trauma had occurred. Better results of audiometric improvement of hearing (54.2%) and tinnitus disappearance (50%) were obtained in the patients whose treatment started in the first week after trauma. The improvement of hearing and tinnitus disappearance was more observed in patients after treatment by using Sermion than Cavinton.


Clinical appraisal of vinpocetine for the removal of intractable tumoral calcinosis in haemodialysis patients with renal failure.
J Int Med Res 1992 Sep; 20(5): 435-43.
Ueyoshi A, Ota K.

Previous studies have shown that vinpocetine [14-ethoxycarbonyl-(3 alpha, 16 alpha-ethyl)-14,15-eburnamenine] scavenges minerals and/or metals in the soft tissues of rabbits with artificially induced arteriosclerosis. The present study was carried out to determine whether or not vinpocetine would bring about the removal of intractable tumoral calcinosis in haemodialysis patients with renal failure. After administration of 15 mg/day vinpocetine for 3-12 months in haemodialysis patients with X-ray evidence of tumoral calcinosis, calcinosis was completely eliminated in all eight cases. Serum alkaline phosphatase and bone osteocalcin concentrations tended to decrease after treatment with Vinpocetine compared with before treatment. Vinpocetine thus appears to be an effective scavenger of tumoral calcinosis in haemodialysis patients with renal failure without any side-effects during treatment.


Use of ethyl apovincaminate in ophthalmological therapy.
Arzneimittelforschung 1976; 26(10a): 1969-72.
Kahan A, Olah M.

Ethyl apovincaminate (RGH-4405, Cavinton) has been administered to 100 predominantly arteriosclerotic patients to increase circulation in the eyeground. Visual acuities improved in 88 cases, by 73% in average; in twelve cases there was no change, but deterioration did not occur. Improvement was still more significant (267%) in occlusions and retinopathies associated with atherosclerosis of the central retinal artery. The dose of Cavinton was 20 mg in drop infusion or three times daily 10 mg i.v. Side-effects, if any, disappeared spontaneously upon reduction of the dose. The improvement paralleled the increases of the blood pressures in the central retinal arteries. This increase of pressure head is suggested to dilate passively the vessels.


Drug therapy of initial open-angle glaucoma.
Oftalmol Zh 1989; (2): 72-4.
Pliushko DG, Sobko EG.

The paper analyses results of long-term general and local medicamentous treatment of 86 patients with open-angle initial glaucoma. The hypotensive preparations were miotics, sympathomimetics, beta-blockers, carbonic anhydrase inhibitors. Regulation of intraocular pressure by means of miotics was achieved in 30% of cases and by means of sympathomimetics--in 53%. The best hypotensive effect with a long-term regulation of intraocular pressure was achieved by means of beta-blockers. In order to correct vascular disturbances, angioprotectors, cavinton, rheopolyglucin, 2 courses a year were used. A systematic, pathogenetically grounded medicamentous treatment of initial glaucoma allows to achieve stabilization of glaucomatous process in 88% of cases.


[Treatment results of acoustic trauma]
Otolaryngol Pol 1997; 51 Suppl 25: 281-4.
Konopka W, Zalewski P, Olszewski J, Olszewska-Ziaber A, Pietkiewicz P.

20 patients aged from 18 to 42 treated in the past few years because of acoustic trauma. Together the investigations concerned 24 years. Therapeutic schema comprised intravenous infusion--Sermion (Nicergoline--amp. a 4 mg) or Cavinton (Vinpocetine--amp. a 10 mg) 1 amp.--twice a day for 10 days. The treatment of 60% of the patients started in the first week after the trauma occurred, of 20% in the second week and the remaining 20% later on after 15 days when the trauma took place. The obtained results of treatment both of improvement of hearing (79.2%) and tinnitus (66.6%), support the necessity of treatment of acoustic trauma independently from the time that passed after trauma had occurred. Better results of audiometric improvement of hearing (54.2%) and tinnitus disappearance (50%) were obtained in the patients whose treatment started in the first week after trauma. The improvement of hearing and tinnitus disappearance was more observed in patients after treatment by using Sermion than Cavinton.


Clinical appraisal of vinpocetine for the removal of intractable tumoral calcinosis in haemodialysis patients with renal failure.
J Int Med Res 1992 Sep; 20(5): 435-43.
Ueyoshi A, Ota K.

Previous studies have shown that vinpocetine [14-ethoxycarbonyl-(3 alpha, 16 alpha-ethyl)-14,15-eburnamenine] scavenges minerals and/or metals in the soft tissues of rabbits with artificially induced arteriosclerosis. The present study was carried out to determine whether or not vinpocetine would bring about the removal of intractable tumoral calcinosis in haemodialysis patients with renal failure. After administration of 15 mg/day vinpocetine for 3-12 months in haemodialysis patients with X-ray evidence of tumoral calcinosis, calcinosis was completely eliminated in all eight cases. Serum alkaline phosphatase and bone osteocalcin concentrations tended to decrease after treatment with Vinpocetine compared with before treatment. Vinpocetine thus appears to be an effective scavenger of tumoral calcinosis in haemodialysis patients with renal failure without any side-effects during treatment.


Use of ethyl apovincaminate in ophthalmological therapy.
Arzneimittelforschung 1976; 26(10a): 1969-72.
Kahan A, Olah M.

Ethyl apovincaminate (RGH-4405, Cavinton) has been administered to 100 predominantly arteriosclerotic patients to increase circulation in the eyeground. Visual acuities improved in 88 cases, by 73% in average; in twelve cases there was no change, but deterioration did not occur. Improvement was still more significant (267%) in occlusions and retinopathies associated with atherosclerosis of the central retinal artery. The dose of Cavinton was 20 mg in drop infusion or three times daily 10 mg i.v. Side-effects, if any, disappeared spontaneously upon reduction of the dose. The improvement paralleled the increases of the blood pressures in the central retinal arteries. This increase of pressure head is suggested to dilate passively the vessels.


[Drug therapy of initial open-angle glaucoma]
Oftalmol Zh 1989; (2): 72-4.
Pliushko DG, Sobko EG.

The paper analyses results of long-term general and local medicamentous treatment of 86 patients with open-angle initial glaucoma. The hypotensive preparations were miotics, sympathomimetics, beta-blockers, carbonic anhydrase inhibitors. Regulation of intraocular pressure by means of miotics was achieved in 30% of cases and by means of sympathomimetics--in 53%. The best hypotensive effect with a long-term regulation of intraocular pressure was achieved by means of beta-blockers. In order to correct vascular disturbances, angioprotectors, cavinton, rheopolyglucin, 2 courses a year were used. A systematic, pathogenetically grounded medicamentous treatment of initial glaucoma allows to achieve stabilization of glaucomatous process in 88% of cases.


Meta-analysis of Cavinton.
Praxis. 1988 Sep; 7(9):63-8.
Nagy Z, Vargha P, Kovács L, Bönöczk P.

The meta-analysis of seven trial carried out in two groups proves the efficacy of per os applied vinpocetine in the assessed groups of subjects (gross number of patients 731). On the basis of recent PET investigations (in press), the obtained clinical results are interpreted by the improved blood flow and enhanced metabolism of healthy brain areas. The patients become more vivid, the cognitive performance improves, and the daily activity is more intense - in summary, the patients give account of improvement of their condition during treatment.

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 May; 35(5): 425-30.
Balestreri R, Fontana L, Astengo F.

In a double-blind clinical trial, vinpocetine, a synthetic ethyl ester of apovincamine, was shown to effect significant improvement in elderly patients with chronic cerebral dysfunction. Forty-two patients received 10 mg Vinpocetine three times a day (tid) for 30 days, then 5 mg tid for 60 days. Matching placebo tablets were given to another 42 patients for the 90 day trial period. Patients on vinpocetine scored consistently better in all evaluations of the effectiveness of treatment including measurements on the Clinical Global Impression (CGI) scale, the Sandoz Clinical Assessment-Geriatric (SCAG) scale, and the Mini-Mental Status Questionnaire (MMSQ). There were no serious side effects related to the treatment drug.


Psychopharmacological effects of vinpocetine in normal healthy volunteers.
Eur J Clin Pharmacol 1985; 28(5): 567-71.
Subhan Z, Hindmarch I.

Twelve healthy female volunteers received pre-treatments with vinpocetine 10, 20, 40 mg and placebo (t.d.s.) for two days according to a randomised, double-blind crossover design. On the third day of treatment and 1 h following morning dosage, subjects completed a battery of psychological tests including Critical Flicker Fusion (CFF), Choice Reaction Time (CRT), Subjective Ratings of Drug Effects (LARS) and a Sternberg Memory Scanning Test. No statistically significant changes from placebo were observed on CFF, CRT or subjective ratings of drug effects. However, memory as assessed using the Sternberg technique was found to be significantly improved following treatment with vinpocetine 40 mg when compared to placebo and results suggested a localised effect of the drug on the serial comparison stage of the reaction process.


Therapeutic efficacy of vincamine in dementia.
Neuropsychobiology 1996; 34(1): 29-35.
Fischhof PK, Moslinger-Gehmayr R, Herrmann WM, Friedmann A, Russmann DL.

This trial was performed to investigate the therapeutic efficacy of vincamine in the treatment of primary degenerative and vascular dementia. 152 male and female patients aged between 50 and 85 years from two psychogeriatric centers and two nursing homes were initially included in the trial and screened for eligibility. 142 patients completed the trial. Clinical diagnosis was established according to DSM-III-R criteria. Allocation of the patients to the primary degenerative dementia of the Alzheimer type (DAT) group or the multi-infarct dementia (MID) group was based on computed tomography scans, electroencephalographic findings and the Hachinski Ischemic Score. In a 12-week double-blind treatment either 30 mg vincamine or placebo was given twice daily. Confirmatory statistics included item 2 of the Clinical Global Impression (CGI), the total score of the Sandoz Clinical Assessment Geriatric (SCAG) scale, the subscale 'need for help' of the nurse's rating of geriatric patients (Beurteilungsskala fur geriatrische Patienten; BGP) and the total score of the Short Cognitive Performance Test (Syndrom-Kurztest; SKT). In addition, data on tolerance and on therapy response were evaluated based on descriptive statistics. The therapeutic efficacy of vincamine was clearly demonstrated by confirmatory analysis as the drug was statistically significantly superior to placebo in all four target variables. The clinical relevance of the outcome was further underlined by the results of the responder analysis of the variables SCAG, BGP and SKT. Based on the results of this trial, it can be accepted that the therapeutic effect of vincamine is superior to placebo in patients with mild to moderate dementia of degenerative and vascular etiologies.


The impairment of long-term potentiation in rats with medial septal lesion and its restoration by cognition enhancers.
Neurobiology (Bp) 1994; 2(3): 255-66.
Molnar P, Gaal L, Horvath C.

The effect of medial septal lesion on long-term potentiation (LTP) and the action of four cognition enhancers were studied in rat dentate gyrus, in vivo. The medial septum was partially lesioned by a radiofrequency lesion generator. The effect of lesion was studied on hippocampal function measuring two parameters; the amplitude of the maximal population spikes and the increase in population spikes evoked by high frequency stimulation of the perforant path (LTP). Both parameters were found to be significantly lower in the lesioned group than in the non-lesioned one. Four drugs (physostigmine, piracetam, vinpocetine and Hydergine), known to be effective in dementia and/or in cognitive impairments, were administered 1 h after the lesion procedure and thereafter once a day for 6 days after the operation. LTP was induced and measured at day 7. All drugs produced a complete restoration of the measured parameters affected by the lesion. These findings provided further evidence that the medial septum plays an important role in the induction of LTP in the dentate gyrus. This experimental model might be useful for studying new drugs against dementia.


Mechanism of action of vinpocetine.
Acta Pharm Hung 1996 Sep; 66(5): 213-24.
Kiss B, Karpati E.

Cavinton was introduced into the clinical practice some twenty years ago in Hungary for the treatment of cerebrovascular disorders and related symptoms. Since then, its active ingredient, vinpocetine, beside its therapeutical utilization, has become a reference compound in the pharmacological research of cognitive deficits caused by hypoxia and ischaemia as well as in the cellular and biochemical investigations related to cyclic nucleotides. In this review a survey is given on the experimental data obtained with vinpocetine and an attempt is made to outline the drug's mechanism of action. Early experiments with vinpocetine indicated five main pharmacological and biochemical actions: (1) selective enhancement of the brain circulation and oxygen utilization without significant alteration in parameters of systemic circulation, (2) increased tolerance of the brain toward hypoxia and ischemia, (3) anticonvulsant activity, (4) inhibitory effect on phosphodiesterase (PDE) enzyme and (5) improvement of rheological properties of the blood and inhibition of aggregation of thrombocytes. Later studies in various laboratories confirmed the above effects and clearly demonstrated that vinpocetine offers significant and direct neuroprotection both under in vitro and in vivo conditions. Evidence has been obtained that neuroprotective action vinpocetine is related to the inhibition of operation of voltage dependent neuronal Na(+)-channels, indirect inhibition of some molecular cascades initiated by the rise of intracellular Ca(2+)-levels and, to a lesser extent, inhibition of adenosine reuptake. Vinpocetine has been shown to be selective inhibitor of Ca (2+)-calmodulin dependent cGMP-PDE. It is assumed that this inhibition enhances intracellular a GMP levels in the vascular smooth muscle leading to reduced resistance of cerebral vessels and increase of cerebral flow. This effect might also beneficially contribute to the neuroprotective action.


Treatment results of acoustic trauma.
Otolaryngol Pol 1997; 51 Suppl 25: 281-4.
Konopka W, Zalewski P, Olszewski J, Olszewska-Ziaber A, Pietkiewicz P.

20 patients aged from 18 to 42 treated in the past few years because of acoustic trauma. Together the investigations concerned 24 years. Therapeutic schema comprised intravenous infusion--Sermion (Nicergoline--amp. a 4 mg) or Cavinton (Vinpocetine--amp. a 10 mg) 1 amp.--twice a day for 10 days. The treatment of 60% of the patients started in the first week after the trauma occurred, of 20% in the second week and the remaining 20% later on after 15 days when the trauma took place. The obtained results of treatment both of improvement of hearing (79.2%) and tinnitus (66.6%), support the necessity of treatment of acoustic trauma independently from the time that passed after trauma had occurred. Better results of audiometric improvement of hearing (54.2%) and tinnitus disappearance (50%) were obtained in the patients whose treatment started in the first week after trauma. The improvement of hearing and tinnitus disappearance was more observed in patients after treatment by using Sermion than Cavinton.


Clinical appraisal of vinpocetine for the removal of intractable tumoral calcinosis in haemodialysis patients with renal failure.
J Int Med Res 1992 Sep; 20(5): 435-43.
Ueyoshi A, Ota K.

Previous studies have shown that vinpocetine [14-ethoxycarbonyl-(3 alpha, 16 alpha-ethyl)-14,15-eburnamenine] scavenges minerals and/or metals in the soft tissues of rabbits with artificially induced arteriosclerosis. The present study was carried out to determine whether or not vinpocetine would bring about the removal of intractable tumoral calcinosis in haemodialysis patients with renal failure. After administration of 15 mg/day vinpocetine for 3-12 months in haemodialysis patients with X-ray evidence of tumoral calcinosis, calcinosis was completely eliminated in all eight cases. Serum alkaline phosphatase and bone osteocalcin concentrations tended to decrease after treatment with Vinpocetine compared with before treatment. Vinpocetine thus appears to be an effective scavenger of tumoral calcinosis in haemodialysis patients with renal failure without any side-effects during treatment.


Use of ethyl apovincaminate in ophthalmological therapy.
Arzneimittelforschung 1976; 26(10a): 1969-72.
Kahan A, Olah M.

Ethyl apovincaminate (RGH-4405, Cavinton) has been administered to 100 predominantly arteriosclerotic patients to increase circulation in the eyeground. Visual acuities improved in 88 cases, by 73% in average; in twelve cases there was no change, but deterioration did not occur. Improvement was still more significant (267%) in occlusions and retinopathies associated with atherosclerosis of the central retinal artery. The dose of Cavinton was 20 mg in drop infusion or three times daily 10 mg i.v. Side-effects, if any, disappeared spontaneously upon reduction of the dose. The improvement paralleled the increases of the blood pressures in the central retinal arteries. This increase of pressure head is suggested to dilate passively the vessels.


Drug therapy of initial open-angle glaucoma.
Oftalmol Zh 1989; (2): 72-4.
Pliushko DG, Sobko EG.

The paper analyses results of long-term general and local medicamentous treatment of 86 patients with open-angle initial glaucoma. The hypotensive preparations were miotics, sympathomimetics, beta-blockers, carbonic anhydrase inhibitors. Regulation of intraocular pressure by means of miotics was achieved in 30% of cases and by means of sympathomimetics--in 53%. The best hypotensive effect with a long-term regulation of intraocular pressure was achieved by means of beta-blockers. In order to correct vascular disturbances, angioprotectors, cavinton, rheopolyglucin, 2 courses a year were used. A systematic, pathogenetically grounded medicamentous treatment of initial glaucoma allows to achieve stabilization of glaucomatous process in 88% of cases.