Chronic Cerebrovascular Insufficiency Treated With Papaverine

Abstract

A sustained‐release papaverine preparation (Pavavid Plateau Cape) was evaluated for is efficacy in relieving symptoms related to cerebrovascular insufficiency. The overall improvement rate in 37 patients whose ages ranged from 45 to 80 years, was 70 per cent. The most consistent benefit was obtained in patients whose symptoms were caused by cerebral ischemia but who did not show evidence of advanced arteriosclerosis or other cerebral damage. The symptom most frequently relieved was the most disturbing one—loss of memory or amnesia. Other symptoms relieved in over 50 per cent of the involved patients were vertigo, dizziness, incoordination and confusion. The younger patients and those whose symptoms were of shorter duration responded better than those with advanced cerebral circulatory disease. Since the aging process is progressive, therapy which is effective in delaying the cerebrovascular insufficiency associated with aging should be started immediately upon the appearance of signs of cerebral ischemia. The results obtained in this series indicate that papaverine has a place in the management of such patients because of its pronounced cerebral vasodilator action. Even in patients in whom the cause of the symptoms is in doubt, papaverine merits consideration for a therapeutic trial.

Cerebrovascular Agents in Gerontopsychopharmacotherapy

“…Although this finding has never been confirmed beyond doubt and McHENRY (1972) demonstrated an increase in regional cerebral blood flow in both healthy and ischemic areas in patients, the notion of the "steal phenomenon" as an inevitable consequence of pharmacogenic cerebral vasodilation greatly influenced clinical-pharmacologic and therapeutic attitudes toward cerebral vasodilation as means of pharmacologic intervention in cerebrovascular disease (HOYER, p. 533, this volume). The therapeutic effect of papaverine in geriatric patients with chronic cerebrovascular disease has been investigated repeatedly (DUNLOP, 1968;SMITH et aI., 1968;RITTER et aI., 1971). Favorable effects in those patients have been reported, but due to the poor design of these studies no conclusions as to the efficacy or nonefficacy of the compound can be drawn.…”

An Ergot Alkaloid Preparation (Hydergine) versus Papaverine in Treating Common Complaints of the Aged: Double‐Blind Study

“…We know of only one published report (11) of a controlled study of papaverine in geriatric patients; Stern found that 300 mg of papaverine daily in sustained release form relieved 13 of 15 symptoms (e.g., aggression, excitability, lack of cooperation, and apathy) significantly more effectively than did placebo. Although several reports (12–15) of uncontrolled papaverine studies have appeared in the literature, none showed consistently favorable results. So far as we know, the double‐blind study reported here is the first directly comparing the efficacy and safety of Hydergine and papaverine in geriatric patients.…”