Periwinkle

Common name:

• Lesser periwinkle

Botanical Names

Botanical name:

• Vinca minor

Parts used and where grown

The flower and leaf of lesser periwinkle are used medicinally. Periwinkle is an evergreen shrub that grows in Europe, northwestern Africa, central Asia, and some parts of North America.

Health Concerns

Periwinkle has been used in connection with the following conditions (refer to the individual health concern for complete information):

Rating	Health Concerns
	Alzheimer's disease
	Canker sores Dementia (vascular) Dialysis Diarrhea Glaucoma Hearing loss (presbyacusis) Menorrhagia Stroke Tinnitus
Reliable and relatively consistent scientific data showing a substantial health benefit. Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit. An herb is primarily supported by traditional use, or the herb or supplement has little scientific support and/or minimal health benefit.

Traditional Use

Historical or traditional use (may or may not be supported by scientific studies)

Periwinkle has likely been used for medicine for a long time; its Latin name, Vinca, is derived from the Latin word vincere, meaning "to overcome." European herbalists have used periwinkle for headaches, vertigo, and poor memory since medieval times.¹ It was also considered a helpful remedy for conditions with a watery or bloody discharge such as diarrhea, bleeding gums, or menorrhagia.²

Active Constituents

Active constituents

There are two classes of active compounds in lesser periwinkle-alkaloids and tannins. The major alkaloid is known as vincamine. A closely related semisynthetic derivative of vincamine most widely used as medicine is known as ethyl-apovincaminate or vinpocetine. It has vasodilating, blood thinning, and memory-enhancing actions. It has been shown in double-blind studies to help alleviate a type of dementia known as vascular dementia, in which the arteries supplying blood to the brain develop atherosclerotic plaques.^{3, 4, 5} A double-blind study found that vincamine can help people with Alzheimer's disease,⁶ while one open study did not.⁷ Vinpocetine has also been found to prevent the decline in short-term memory induced by the anti-anxiety benzodiazepine drug flunitrazepam in one preliminary study.⁸ Further study is needed to determine whether vinpocetine would be a helpful adjunct to use of benzodiazepines.

One double-blind study found that high amounts of vinpocetine (60 mg per day) could have a beneficial effect on hearing loss due to aging (presbyacusis).⁹ A preliminary study concluded that supplementation with ethyl-apovincaminate (a vinca alkaloid) may reduce symptoms of tinnitus (ringing in the ears) due to impaired blood flow to the inner ear.¹⁰ One review of the use of vinpocetine in people who have suffered strokes found that the only double-blind study did not show efficacy,¹¹ though previous uncontrolled studies have suggested there might be a benefit.^{12, 13}

Vinpocetine tends to act as a calcium-chelating agent. One uncontrolled study found that use of vinpocetine for 3 to 12 months could eliminate calcium buildup in people undergoing dialysis.¹⁴ Further research is needed to determine whether this could be helpful in other conditions associated with excess calcium, or whether vinpocetine might interfere with calcium's beneficial actions.

One double-blind and one preliminary study have found that brovincamine, a compound closely related to vinpocetine, was helpful in people with chronic glaucoma.^{15, 16} Until studies have been conducted using actual vinpocetine, it is unknown whether it would be as effective as brovincamine.

Crude periwinkle also contains tannins. These make it a mild astringent. It may relieve pain from canker sores or sore throats, according to traditional use. Clinical trials have not been conducted to confirm this.

Dosage

How much is usually taken?

The amount of vinpocetine used in most studies is 15 mg one to three times per day.¹⁷ Vinpocetine should be taken with food, as it has been shown to be better absorbed with meals than when taken away from meals.¹⁸ It may take three to six weeks before any improvement is noted.¹⁹

A tincture can be taken in the amount of 1 to 2 ml three times per day.²⁰ A tea can be made by infusing 1 teaspoon of herb into a cup of water for 10 to 15 minutes; three cups per day should be drunk.²¹ Research has not been conducted to determine whether a tincture or a tea provides enough periwinkle compounds to have the same effects as vinpocetine.

Side Effects

Are there any side effects or interactions?

Vinpocetine has been reported to occasionally cause an upset stomach, flushing of the skin, and a skin rash;²² these effects are mild and rarely cause anyone to stop taking it. The whole periwinkle herb may also cause minor stomach upset. This may be remedied by taking the herb with food. Neither vinpocetine nor periwinkle should be taken during pregnancy or breast-feeding until more information is available. The Commission E of the German government states that some animal studies suggest periwinkle could suppress the immune system.²³ This problem has not been observed to date in studies involving vinpocetine.

At the time of writing, there were no well-known drug interactions with periwinkle.

References

1. Weiss RF. Meuss AR, trans. Herbal Medicine. Gothenberg, Sweden: Ab Arcanum and Beaconsfield: Beaconsfield Publishers Ltd, 1985:180-2.
2. Hoffmann D. The New Holistic Herbal, 3rd ed. Shaftesbury, Dorset, UK: Element, 1990:223.
3. Fischhof PK, Moslinger-Gehmayr R, Herrmann WM, et al. Therapeutic efficacy of vincamine in dementia. Neuropsychobiology 1996;34:29-35.
4. 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;35:425-30.
5. Hindmarch I, Fuchs H, Erzigkeit H. Efficacy and tolerance of vinpocetine in ambulant patients suffering from mild to moderate organic psychosyndromes. Int Clin Psychopharmacol 1991;6:31-43.
6. Fischhof PK, Moslinger-Gehmayr R, Herrmann WM, et al. Therapeutic efficacy of vincamine in dementia. Neuropsychobiology 1996;34:29-35.
7. Thal LJ, Salmon DP, Lasker B, et al. The safety and lack of efficacy of vinpocetine in Alzheimer's disease. J Am Geriatr Soc 1989;37:515-20.
8. Bhatti JZ, Hindmarch I. Vinpocetine effects on cognitive impairments produced by flunitrazepam. Int Clin Psychopharmacol 1987;2:325-31.
9. Reinecke M. Double-blind comparison of vincamine and placebo in patients with presbyacusis. Arzneimittelforschung 1977;27:1294-8 [in German].
10. Ribarti O, Zelen B, Kollar B. Ethyl apovincaminate in the treatment of sensorineural impairment of hearing. Arzneimittelforschung 1976;26:1977-80.
11. Bereczki D, Fekete I. A systematic review of vinpocetine therapy in acute ischaemic stroke. Eur J Clin Pharmacol 1999;55:349-52.
12. Otomo E, Atarashi J, Araki G, et al. Comparison of vinpocetine with ifenprodil tartrate and dihydroergotoxine mesylate treatment and results of long-term treatment with vinpocetine. Curr Ther Res 1985;37:811-21.
13. Thiery E, Otte G, Vander Eecken H. Comparative study of the clinical effect of vincamine versus papaverine given parenterally in the acute phase of stroke. Arzneimittelforschung 1979;29:671-4.
14. 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;20:435-43.
15. Koseki N, Araie M, Yamagami J, et al. Effects of oral brovincamine on visual field damage in patients with normal-tension glaucoma with low-normal intraocular pressure. J Glaucoma 1999;8:117-23.
16. Sawada A, Kitazawa Y, Yamamoto T, et al. Prevention of visual field defect progression with brovincamine in eyes with normal-tension glaucoma. Ophthalmology 1996;103:283-8.
17. Kidd PM. A review of nutrients and botanicals in the integrative management of cognitive dysfunction. Alt Med Rev 1999;4:144-61.
18. Lohmann A, Dingler E, Sommer W, et al. Bioavailability of vinpocetine and interference of the time of application with food intake. Arzneimittelforschung 1992;42:914-7.
19. Weiss RF. Meuss AR, trans. Herbal Medicine. Gothenberg, Sweden: Ab Arcanum and Beaconsfield: Beaconsfield Publishers Ltd, 1985:180-2.
20. Hoffmann D. The New Holistic Herbal, 3rd ed. Shaftesbury, Dorset, UK: Element, 1990:223.
21. Hoffmann D. The New Holistic Herbal, 3rd ed. Shaftesbury, Dorset, UK: Element, 1990:223.
22. Kidd PM. A review of nutrients and botanicals in the integrative management of cognitive dysfunction. Alt Med Rev 1999;4:144-61.
23. Blumenthal M, Busse WR, Goldberg A, et al, eds. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998:364.

Last Review: 09-01-2007

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2008.