Vinpocetine

Evidence for vinpocetine in chronic cerebrovascular insufficiency is lacking. The 2003 Cochrane review found no convincing clinical efficacy. International guidelines from the AAN, ESC and AHA do not mention vinpocetine as a drug with confirmed efficacy in cerebrovascular disease. The diagnostic category «chronic cerebrovascular insufficiency» itself is absent from international classifications – most countries use the diagnoses of vascular cognitive impairment or vascular dementia.

For complaints of impaired memory and concentration without an established diagnosis, vinpocetine is not used. The FDA in 2019 explicitly removed vinpocetine from the dietary supplement category and warned of miscarriage risk in women of reproductive age. AAN 2018 recommends, for mild cognitive impairment, non-pharmacological intervention, vascular risk factor control and assessment of depression, sleep and drug side effects.

In vascular dementia, vinpocetine is not used. The 2003 Cochrane review showed no clinically meaningful effect on cognition or quality of life. The 2018 AAN practice guideline on mild cognitive impairment and vascular dementia management guidelines do not recommend nootropics of the vinpocetine class.

For vertigo, vinpocetine has no evidence base. International vertigo guidelines (Barany Society, AAO-HNS) do not mention the drug. Use «for dizziness» is in the unjustified category. Vertigo requires differential diagnosis and targeted treatment by cause (repositioning maneuvers for BPPV, betahistine for Meniere disease, psychotherapy for psychogenic dizziness).