Vinpocetine for acute ischaemic stroke

Stroke is a life-threatening event in which part of the brain does not receive enough oxygen, usually because of a blood clot blocking an artery in the brain. Stroke is the third leading cause of death and is an important cause of long-term disability. Vinpocetine is a synthetic drug that is based on a herbal vinca alkaloid; it may protect nerves by increasing blood flow in the brain. Randomised placebo-controlled studies have reported improved cognitive function after vinpocetine administration to people with long-term brain circulation disorders. Vinpocetine is also used in people with stroke, mostly in East European and Asian countries. This review set out to determine whether giving vinpocetine in the first two weeks after onset of stroke symptoms decreased the number of people who died or became dependent on others for care and activities of daily living. The review authors searched the medical literature but found only two controlled studies including 70 participants. There was no significant difference in the rate of death and dependency at one and three months between the treatment and placebo groups. No adverse effects were reported. This review did not provide any evidence that vinpocetine benefits patients with acute ischaemic stroke.

Authors' conclusions: 

There is not enough evidence to evaluate the effect of vinpocetine on survival or dependency in patients with acute ischaemic stroke.

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Background: 

Vasoactive and neuroprotective drugs such as vinpocetine are used to treat stroke in some countries.

Objectives: 

To assess the effect of vinpocetine in acute ischaemic stroke.

Search strategy: 

We searched the Cochrane Stroke Group Trials Register (last searched February 2007), MEDLINE (1966 to February 2007) and Scopus (1960 to February 2007). We also searched the Internet Stroke Center Stroke Trials Registry, Google Scholar, the science-specific search engine Scirus and Wanfang Data, the leading information provider in China. We contacted researchers in the field and four pharmaceutical companies that manufacture vinpocetine. Searches were complete to February 2007.

Selection criteria: 

Unconfounded randomised trials of vinpocetine compared with placebo, or any other reference treatment, in people with acute ischaemic stroke. We included trials if treatment started no later than 14 days after stroke onset.

Data collection and analysis: 

Two review authors independently applied the inclusion criteria. One review author extracted the data, which was then checked by the second review author. We assessed trial quality. The primary outcome measure was death or dependency.

Main results: 

We included two trials, involving a total of 70 participants. Data for 63 participants were reported in the two trials combined. The rate of death or dependency did not differ between the treatment and placebo groups at one and three months. The 95% confidence intervals for the outcome measures were wide and included the possibility of both significant benefit and significant harm. No adverse effects were reported.

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