Nicergoline

http://www.ncbi.nlm....t_uids=15222138

[Nicergoline-induced Prinzmetal angina. "Heartache" instead of headache.]

[Article in Hungarian]

Tomcsanyi J, Vecsey T, Tatrai T.

Budai Irgalmasrendi Korhaz, Kardiologia. tomcsanyi.janos@axelero.hu

A 56 year old woman was admitted to our hospital with crescendo chest pain in the last ten days. Her past history included hypertension treated by 100 mg metoprolol for more than ten years and right carotid endarterectomy. She complained headache and a treatment of 20 mg nicergoline (ergoline derivate) daily was started. Her chest pains started always one hour after the nicergoline intake. The chest pain was accompanied by breathing difficulties and sweating of 5 min duration at first but the next days it lasted longer and longer. Next morning following her admission, one hour after the nicergoline administration she had severe chest pain again. The ECG showed ST-segment elevation in inferior leads resolved after nitroglycerin administration. The angiogram revealed normal coronary artery. Nicergoline was stopped. The patient was treated with felodipine and remains free of symptoms. Nicergoline was good for head but worse for heart in this case.

Publication Types:
Case Reports

PMID: 15222138 [PubMed - indexed for MEDLINE]

Any thoughts?

Ya, I'll have to add nicergoline to my list of vasodilators.

Cosmos,

what it happening is known as a "steal" phenomenon. This could happen with any nootropic(s) which acts as a cerebral vasodilator. If you take a patient with narrowed blood vessels to their heart, and preferentially dilate the blood vessels in their head (or anywhere outside the heart) you create a relative steal and the heart gets less blood then it needs and the patient develops chest pain (angina).

This is not likely to happen in a patient with normal blood supply to the heart (unless you really overdo the cerebral vaodilation) and in fact this principle is used in a test to look for disease of those coronary arteries.

For those like me who had to look it up:
http://www.antiaging...nicergoline.htm

Nicergoline has alpha-adrenolytic action which activates the brain's metabolism and improves arterial flow, lowers vascular resistance and improves the use of glucose and oxygen. Furthermore, it is known that Nicergoline inhibits platelet aggregation. Interestingly, animal experiments have shown that Nicergoline increases nerve growth factor in the aged brain.

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We are talking here about a case report, right? Sorry, but that is immediately disqualified from consideration; not only that, we are talking about n=1.

Nootropi,

I'm not sure of your meaning.

This is not an idiosyncratic unexpected reaction. This is totally expected and predictable reaction based on the mechanism of how nicorgoline works i.e. if you give anyone with coronary artery disease a potent cerebral vasodilator this is a very possible outcome.

Nootropi,

I'm not sure of your meaning. 

This is not an idiosyncratic unexpected reaction. This is totally expected and predictable reaction based on the mechanism of how nicorgoline works  i.e. if you give anyone with coronary artery disease a potent cerebral vasodilator this is a very possible outcome.

Scott, I have to be brief.

Case reports are not scientific; they are subjective opinion, therefore, as scientific data, they are always discarded.

If you take a patient with narrowed blood vessels to their heart, and preferentially dilate the blood vessels in their head (or anywhere outside the heart) you create a relative steal and the heart gets less blood then it needs and the patient develops chest pain (angina).

Spot on. I recall reading this 2 years ago in one of my physiology books.

If you have a single case of something that you can't explain based on the mechanism of how the drug works, then it might be unrelated to the drug. But the drug is a vasodilator and would be expected to do this (in high enough doses in susceptable patients).


OK for my infomation, I realize that nicergoline has other benefits but anyone know how strong a vasodilator it is e.g

ginko < vinpocetine < picamillion

Thanks.

Edited by scottl, 13 October 2004 - 02:46 PM.

Scott thanks for filling me in, I am not going to stray away from Nicergoline in the future. I specifically wrote that it was a case report in the title because I knew the significance (or lack thereof), understanding the reason behind her response to Nicergoline does cause me not to worry about having a similar response.

edit: fixed

Edited by cosmos, 13 October 2004 - 07:46 PM.

Cosmos,

This is only an issue because the patient had narrowing of her coronary arteries. You are...is it under 30 years old? So this issue is irrelevant for you.

Now standard recommendations for people over 50 or 60 is another issue.

Scott, I missed typing a word in my last post:

"understanding the reason behind her response to Nicergoline does NOT cause me to worry about having a similar response."

One missing word can change the whole meaning of my statement.

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I really feel I would benefit from a Vinpocetine /quercetin/ Resveratrol / nicergoline INTRANET stack but I need so more bio essays and or anecdotals not studies from nbi or pub med but longecity based user reports nicergoline looks too good too be true