Role of vinpocetine in ischemic stroke and poststroke outcomes: A critical review

• Published in: Brain circulation Vol. 6; no. 1; pp. 1 - 10
• Main Authors: Al-Kuraishy, Hayder, Al-Gareeb, Ali, Naji, Marwa, Al-Mamorry, Farah
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-01-2020; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Alkaloids; Anopheles; anti-inflammatory; Anti-inflammatory agents; antioxidant; Antioxidants; Antioxidants (Nutrients); Apoptosis; Bioavailability; Cognitive ability; Cytokines; Dopamine; Drug dosages; Epilepsy; Fatalities; Free radicals; Inflammation; Ischemia; Metabolism; Metabolites; Neurons; Oxazepam; Oxidative stress; phosphodiestrase type 1; poststroke; Proteins; Review; Risk factors; Seizures (Medicine); Stroke; Studies; Thrombosis; Tumor necrosis factor-TNF; vinpocetine; Virtual private networks; Viscosity; antioxidant; phosphodiestrase type 1; poststroke; Anti-inflammatory; stroke; vinpocetine
• ISSN: 2394-8108; 2455-4626; 2455-4626
• DOI: 10.4103/bc.bc_46_19

Vinpocetine (VPN) is a synthetic ethyl-ester derivative of the alkaloid apovincamine from Vinca minor leaves. VPN is a selective inhibitor of phosphodiesterase type 1 (PDE1) that has potential neurological effects through inhibition of voltage-gated sodium channel and reduction of neuronal calcium influx. VPN has noteworthy antioxidant, anti-inflammatory, and anti-apoptotic effects with inhibitory effect on glial and astrocyte cells during and following ischemic stroke (IS). VPN is effective as adjuvant therapy in the management of epilepsy; it reduces seizure frequency by 50% in a dose of 2 mg/kg/day. VPN improves psychomotor performances through modulation of brain monoamine pathway mainly on dopamine and serotonin, which play an integral role in attenuation of depressive symptoms. VPN recover cognitive functions and spatial memory through inhibition of hippocampal and cortical PDE1 with augmentation of cyclic adenosin monophosphate and cyclic guanosin monophosphate ratio, enhancement of cholinergic neurotransmission, and inhibition of neuronal inflammatory mediators. Therefore, VPN is an effective agent in the management of IS and plays an integral role in the prevention and attenuation of poststroke epilepsy, depression, and cognitive deficit through direct cAMP/cGMP-dependent pathway or indirectly through anti-inflammatory and antioxidant effects.