April 2, 2001

Jane Dixon

ove over ginkgo. There's a new kid in town -- a plant-derived product that may offer adults a mental tune-up. Vinpocetine, a little-known dietary supplement synthesized from the common periwinkle plant, has shown promise in treating vascular-related memory loss in older adults.

But don't let the "dietary supplement" label fool you. While most commercially available ginkgo biloba, also a supplement, has been made by purifying and processing the dried leaf of the ginkgo plant, vinpocetine is created by chemically altering a derivative of the periwinkle plant and is sometimes fully synthesized in the laboratory. In Europe, it's been sold as the prescription drug Cavinton for the past 20 years.

While the jury's still out on vinpocetine's long-term safety, the supplement shows a great deal of promise and may one day rival ginkgo as an over-the-counter memory booster.

More blood to the brain

How does vinpocetine work? Experiments in monkeys show that it permeates the blood-brain barrier and then performs several complex chemical reactions -- among them, removing toxic free radicals and increasing brain metabolism. Like its well-known "cousin," ginkgo, vinpocetine is a blood thinner and vasodilator; that is, it works by relaxing the smooth muscles of blood vessels, thereby enlarging the arteries. This increases circulation to the brain and boosts the delivery of oxygen and glucose, thus enhancing memory.

"Taking herbs and nutrients to improve memory is more of an art than a science at this point, and it will be that way for a long time," says Dr. Sahelian.

Vinpocetine has also been shown to significantly improve speech, language, and learning functions -- more quickly than ginkgo, in fact. In one double-blind study of 203 patients with dementia, vinpocetine significantly improved intellectual function, especially when the brain damage was caused by tiny strokes. For that reason, vinpocetine has been widely used in the treatment of acute and chronic stroke patients.

Unlike ginkgo, however, vinpocetine has not been shown to be an effective treatment for Alzheimer's disease. In a study of 15 Alzheimer patients at the Veteran's Administration Medical Center in San Diego, no improvement in mental performance took place when patients were given 30-60 milligrams of vinpocetine daily.

Who, when, and how much?

You don't have to be seriously ill to benefit from vinpocetine, studies and clinical use show. When a dozen healthy women took 40 milligrams of vinpocetine three times a day, it revved up their mental motors. They performed better on certain psychological tests. "You're sharper, more focused, and more alert," says Ray Sahelian, M.D., author of Mind Boosters: A Guide to Natural Supplements that Enhance Your Mind, Memory, and Mood (St. Martin's, 2000). "Vinpocetine also improves visual perception."

Dr. Sahelian, who is certified by the American Board of Family Practice, tell patients age 50 and over to start a daily regimen of 5-10 milligrams of the supplement. He suggests combining it with other moderate amounts of memory-improving herbs, such as acopa and huperzine A, to avoid any possible "cumulative toxicity." For example, he recommends taking 5 milligrams of vinpocetine and 40 milligrams of ginkgo daily. Other "smart" supplements you can try: choline, vitamin B, omega-3 fatty acids, and acetyl-L-carnitine, or ALC.

On the other hand, biochemist James South, editor of Optimal Health Review and nutritional consultant for International Anti-Aging Systems of London (suppliers of pharmaceuticals, hormones, and other products that treat aging), maintains that age 40 is a good "start date" for vinpocetine, since it can minimize the damage to brain neurons, which often accompanies gradually developing arteriosclerosis. For people already diagnosed with vascular-induced memory loss, experts recommend taking 5-10 milligrams three times daily, with food.

Heed cautionary advice, and follow doctor's orders

The long-term effects of vinpocetine are not yet known, and since it's sold as a dietary supplement (rather than a drug) in the United States, it falls outside of federal safety regulations. "It's not for everyone," advises Alan P. Mintz, M.D., an anti-aging practitioner and the chief executive officer of Cenegenics anti-aging centers. "It's not for people with attention deficit disorder or anxiety problems or who have trouble sleeping or concentrating." Also, mild short-term side effects -- such as skin eruptions, flushing, and gastrointestinal discomfort -- have been documented.

Still, vinpocetine has fewer side effects than many prescribed vasodilators, says Parris Kidd, Ph.D., a biomedical consultant and nutrition educator. Dr. Sahelian agrees, maintaining that vinpocetince "is a lot safer than aspirin" in terms of its potential side-effects.

People taking high doses of aspirin or other anti-clotting drugs, such as warfarin (Coumadin), must be extremely cautious about using vinpocetine due to its blood-thinning action. And vinpocetine should not be used by people with blood-clotting disorders. It also should be discontinued a few days before any surgery.

For these reasons and others, be sure to consult your doctor before taking vinpocetine. "Initial results indicate cognitive improvement with no significant side effects," says Bernd Wollschlaeger, M.D., professor of family medicine at the University of Miami School of Medicine. "But before doctors encourage patients to take this supplement, we need to run long-term trials with larger numbers of healthy individuals to determine its efficacy and long-term safety."

Dr. Wollschlaeger reached in this conclusion in a paper scheduled for publication this spring in the Journal of the American Nutraceutical Association. After reviewing 36 human studies of vinpocetine involving 1,912 subjects, Dr. Wollschlaeger, an associate editor at the journal and a reviewer for the American Botanical Council's Herbalgram, found "it all boiled down to three trials of 309 patients." He explains that "while these studies show positive results, they do not answer definitively whether vinpocetine makes a difference in healthy people or if it could have long-term detrimental effects."

Like many supplements, vinpocetine is in the trial-and-error stage, say experts. "Taking herbs and nutrients to improve memory is more of an art than a science at this point, and it will be that way for a long time," says Dr. Sahelian. "People will respond differently, and it can't be predicted what combination of nutrients will be ideal for each person."

The bottom line? Don't expect miracles from vinpocetine, emphasizes Dr. Wollschlaeger. "Talk with your physician and see if it's worth taking."

Related links:

• Rx.magazine feature story: Unnatural Results from Natural Remedies: Herbs and Drugs Don't Always Mix

• Rx.magazine feature story: Supplements: Lost in Lingo Limbo?

• Rx.magazine feature story: The Rhythm Method for Overall Health

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