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Nicergoline is a semisynthetic ergoline derivative used for the treatment of cognitive impairment in various forms of dementia, including Alzheimer's disease, vascular dementia and mixed dementia, and vestibular imbalance, including vertigo and dizziness. Animal studies indicate that the drug is endowed with a board spectrum of actions on cellular and molecular mechanisms. The drug increases the regional cerebral flow, activates protein synthesis, enhances cholinergic and catecholaminergic neurotransmitter functions and improves age-related cognitive deficits, stimulates phosphoinositide turnover, modulates translocation of protein-kinase C (PKC) and PKC-mediated α-secretase processing of amyloid-precursor protein. It protects neurons from death induced by oxidative stress or apoptosis, and interacts with endogenous nerve growth factor-mediated processed, providing trophic support to cholinergic neurons. Significant improvement of cognitive symptoms and overall clinical conditions have been observed in a number of placebo-controlled clinical trials in mild to moderately demented patients. Moreover, the drug was shown to have a consistent positive effect on ·concurrent symptoms of vertigo and dizziness. Nicergoline was well tolerated in all clinical studies. The type, frequency and severity of adverse events were generally comparable with those observed in the placebo control groups.
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