Bacopa

Bacopa

Bacopa

Clinical overview

Use

dosage

To improve short- and long-term memory, numerous Bacopa dosage forms and commercial products are available and marketed; There are differences between the products. In a meta-analysis and reviews of clinical trials evaluating the use of bacopa extracts to improve cognition and memory in adults, dosages typically ranged from 300 to 450 mg/day; The duration of therapy varied but was typically 12 weeks.

Contraindications

Avoid use in people with hypersensitivity to any of the components of Bacopa.

Pregnancy/breastfeeding

Avoid using. There is a lack of information on safety and effectiveness during pregnancy and breastfeeding.

Interactions

None are well documented.

Side effects

Commonly reported side effects include flu-like symptoms, gastrointestinal irritation, nausea, increased intestinal motility, and muscle fatigue.

toxicology

No data.

Scientific family

• Scrophulariaceae (Braunwurz)

botany

Bacopa is a small, perennial, creeping herb native to the entire Indian subcontinent, but widespread in the tropicsAbdul Manap 2019 and found in the Fujian, Taiwan, Guangdong, Yunnan and Sichuan provinces of China.Zhou 2007Bacopa grows in moist and swampy locations (elevation up to 1,500 m) and is common planted in freshwater aquariums. Gupta 2014, Kongkeaw 2014, Lojewski 2014 The herb has ascending branches, elongated and obovate leaves and solitary flowers. The calyx is 6 mm long and the white or pale purplish-blue corolla is 5 to 6 mm long. The leaves are light green and the stem is light green to brown; both are slightly aromatic and have a bitter smell and taste.Gubbannavar 2013 Synonyms for Bacopa include Herpestis monniera and Moniera cuneifolia.

The common name “Brahmi” has also been used for herbs unrelated to Bacopa species, including Centella asiatica (Gotu Kola) and Merremia gangetica.NISC 2007

Story

The name “Brahmi” comes from “Brahma”, the Hindu god of creation. Bacopa is a well-known herb in the Ayurvedic system of medicine and was prominently mentioned in Indian texts as early as the 6th century AD. Singh 1982 For more than 5,000 years, Bacopa has been traditionally used to treat epilepsy, insomnia and anxiety and is valued for its calming properties. The Indian Materia Medica documents the use of the herb to improve memory and concentration. Nadkarni 1955 Other reported uses include the treatment of skin diseases, fever, inflammation, anemia, urinary tract disorders, psychiatric disorders and hoarseness. It is also traditionally used to treat asthma and is considered a powerful nerve tonic, cardiac tonic and diuretic. Ethnobotanically, the leaves are used for speech disorders, premature ejaculation, flatulence, abdominal pain, coughs and colds. Fresh bacopa leaf juice has been used for rheumatism and as a mental revitalizer. Gupta 2014, Lojewski 2014, NISC 2007

Chemistry

The main components of Bacopa are bacosides (Chatterji 1963) and bacopasaponins (Garai 1996, Garai 1996), which are triterpene saponins of the dammaran class, each containing 2 or 3 sugars. Saponins are primarily responsible for the bioactivity of the plant. The bacosides include a family of 12 known analogues. Chatterji 1963 saponins, known as bacopasides I to XII, have been identified. Brahmin, nicotine and herpestine alkaloids have also been identified. Other components include D-mannitol, apigenin, hersaponin, monnierasides I to III, cucurbitacins and plantainoside B. Chatterji 1963, Zhou 2007. The most frequently studied components include the bacosides (bacoside A, bacoside B and bacopasides I to XII). Bacoside A contains a mixture of 4 saponins (bacoside A3, bacopaside II, bacopasaponin C and a jujubogenin isomer of bacosaponin C). Bacoside B contains 4 diglycosidic saponins. Aguiar 2013, Prasad 2008 Bacoside concentrations can vary depending on the part of the plant from which they are extracted. A Bacopa sample profile included bacopaside I (5.37%), bacopaside A3 (5.59%), bacopaside II (6.9%), bacopasaponin C isomer (7.08%), and bacopasaponin C (4.18%). Bacosin was identified as a free triterpene from Bacopa. Vohora 1997

Use and Pharmacology

Bacopa is traditionally used for various medical conditions, but is best known as a neural tonic and for improving cognitive abilities and memory. There is evidence that Bacopa works through the following mechanisms: antioxidant neuroprotection (via redox and enzyme induction), acetylcholinesterase inhibition and/or choline acetyltransferase activation, beta-amyloid reduction, increased cerebral blood flow and neurotransmitter modulation (acetylcholine, 5-hydroxytryptamine, dopamine). ).(Aguiar 2013) Long-term administration of bacoside (200 mg/kg orally per day for 3 months) can lead to a decrease in pro-inflammatory cytokines (interleukin 1beta and tumor necrosis factor alpha [TNF-alpha], but not interferon gamma), a significant induction of inducible ones Nitric oxide synthase expression and a significant reduction in total nitrite and lipofuscin content in the cortex. (Cicero 2018) Bacopa is a known neuroprotective herb, and it has been hypothesized that Bacopa might be effective in overcoming tau-mediated pathology in neurons. Since tau protein aggregates are the primary cause of Alzheimer's disease, it has been suggested that the nootropic herb bacopa may be helpful in treating the symptoms and pathology of Alzheimer's disease. (Dubey 2019) Bacopa extract supplementation is likely to support antioxidant defense pathways. It alters redox status, vital for normal function, while improving cognitive abilities. It is believed that with age the antioxidant system weakens and glutathione levels decrease. Bacopa extract has the potential to reduce oxidative stress and improve cognitive performance as a therapeutic antioxidant. (Simpson 2015)

Antioxidant activity

Animal and in vitro data

In vitro, several Bacopa extract fractions exhibit blood clot lysis activity. (Emran 2015) Antioxidant activity may explain the neuroprotective role of bacoside A in increasing brain levels of glutathione and vitamins C, E and A in rats exposed to cigarette smoke. Zinc and selenium levels in the brain were also restored. (Anbarasi 2006) Oral Bacopa supplementation at 50 mg/kg/day reversed memory impairment in a colchicine-treated rat model of Alzheimer's disease; The neuroprotective effects of Bacopa supplement reduced colchicine-induced cognitive decline due to oxidative stress and neuronal death in the subventricular zone, dentate gyrus and basal forebrain. (Saini 2012) Animal models also suggest that Bacopa protects against neurodegeneration. Bacopa may increase antioxidant activity by protecting central and peripheral neuronal systems, as documented in healthy 3-month-old female Wistar rats and 4-week-old male mice. (Priyanka 2013, Shinomol 2011) A neuroprotective effect against brain injury-induced injury Ischemia has been reported for bacopaside I. (Liu 2013) Some animal models report that bacoside components have an antioxidant effect on the hippocampus, frontal cortex and striatum. (Aguiar 2013, Verma 2014)

CNS effects

Analgesic effect

In vitro data

Bacosin, a free triterpene isolated from the aerial parts of B. monnieri, has shown analgesic effects through opioidergic pathways. (Vohora 1997) According to a review article, the anti-inflammatory effect of Bacopa in chronic pain is mediated by the inhibition of cyclooxygenase-2. (Rauf 2013)

Antidepressant effect

Animal data

In a study in mice, B. monnieri demonstrated antidepressant effects via interaction with the serotonergic, dopaminergic, and noradrenergic systems (i.e., according to screening models such as tail suspension and forced swimming tests). The mixture of bacopaside I and bacoside A isolated from B. monnieri also inhibited the activity of the isoenzymes monoamine oxidase A and B. (Martins 2018) In a study in rats, bacoside A from a methanolic extract of B. monnieri inhibited the effects of morphine withdrawal–induced depression. (Rauf 2014)

Antiepileptic activity

Animal data

Researchers have suggested, based on animal studies, that high doses of bacopa extract administered via intraperitoneal injection for 15 days result in an antiepileptic effect. Aminobutyric acid (GABA) receptors in the cerebral cortex. (Mathew 2012)

Attention Deficit Hyperactivity Disorder

Clinical data

In a randomized, double-blind, placebo-controlled study of children with attention-deficit/hyperactivity disorder (ADHD) (N=36), fresh bacopa plant extract was administered at a dosage of 50 mg twice daily for 12 weeks. and a battery of cognitive function tests were performed at baseline and 4, 8, 12, and 16 weeks (i.e., 4 weeks post-trial). Improvements were reported in the active treatment group (n=19) at 12 weeks as measured by tests of sentence repetition, logical memory, and paired associated learning tasks. (Mathew 2010) In an open-label study with no placebo or control group, 31 children ages 6 to 12 years diagnosed with ADHD received 225 mg/day of a standardized bacopa extract for 6 months. Seventy-four percent of children experienced a 20 percent improvement in overall subtest scores for ADHD symptoms. Attention deficit symptoms (e.g., restlessness, self-control, learning problems, impulsivity, psychiatric problems) were reduced in 85% of children. (Dave 2014) A systematic review of clinical trials examined the use of bacopa extract as monotherapy for at least 1 month in children or adolescents; Of the 5 studies that met the inclusion criteria, 2 were double-blind, randomized, placebo-controlled trials conducted in children with ADHD (n=76; age range, 6 to 12 years). In these two studies, 100 mg/day B. monnieri extract was administered for 3 months. Significant treatment effects were observed with Bacopa compared to placebo on logical memory, sentence memory, paired association learning, digit span, word recall, delayed response learning, attention, and hyperactivity. The dropout rate was 22.5% in each experiment. No adverse effects were reported by participants. (Kean 2016)

CNS inflammation

In vitro data

According to in vitro studies, Bacopa inhibits the release of inflammatory cytokines from microglial cells and inhibits enzymes associated with inflammation in the brain. The tea, infusion and alkaloid extracts of Bacopa and bacoside A inhibited the release of TNF-alpha and interleukin 6 from activated N9 microglial cells in vitro. In addition, Bacopa tea, infusion and alkaloid extracts effectively inhibited caspases 1 and 3 as well as matrix metalloproteinase-3 in the cell-free assay. (Nemetchek 2017)

Cognitive effects

Some studies with Bacopa show suppression of acetylcholinesterase activity, resulting in improved cholinergic function and therefore improved attention and memory processing. (Peth-Nui 2012) In other studies, some bacopa compounds did not show inhibitory activity against acetylcholinesterase, but binding affinity toward the acetylcholinesterase D1 receptor was observed. (Ramasamy 2015) One of these studies showed that bacoside A is unlikely to be absorbed through the intestines or penetrate the blood-brain barrier. Thus, the bacosides can be converted in vivo, resulting in active metabolites that mediate memory-enhancing and cognitive activities.

Animal data

In an older study, oral treatment of rats with bacopa extract for 24 days facilitated the ability to learn mazes. (Dey 1976) The extract has shown improved performance of rats in various behavioral models of learning. (Singh 1982) In another study, a Bacopa alcohol extract improved learning ability in rats, including the retention of newly learned behavioral responses. The bacosides A and B can be associated with the cognition-promoting effect. Administration of standardized Bacopa extract to rats resulted in improved spatial learning and memory performance. Bacopa reversed diazepam-induced amnesia in mice and restored cognition in a pilocarpine-induced epilepsy rat model. Scopolamine-induced behavioral deficits in rats were attenuated due to the dose-dependent inhibitory effect of bacopa on acetylcholinesterase activity. (Shinomol 2011)

Clinical data

A systematic review of several randomized, double-blind clinical trials demonstrated the effectiveness of bacopa in improving memory and some cognitive functions. Bacopa extracts were administered (300 to 450 mg daily for 12 weeks) to adults without dementia or severe cognitive impairment. Although cognition was not as well documented as other effects, Bacopa improved 9 out of 17 free recall memory tasks. (Pase 2012)

In a clinical study of 76 healthy adults, weight-based dosing of bacopa extract resulted in improved retention of new information. However, the results showed no effects on attention, verbal and visual short-term memory, or retrieval of information from long-term memory. No adverse effects on subjective measures of mental status (e.g. depression, anxiety, stress, everyday memory) were reported. (Roodenrys 2002) A double-blind, placebo-controlled study conducted on 46 healthy adults showed statistically significant improvements in visual information processing (P=0.018), learning rate (P=0.042), memory proactive impairment (P=0.042) and forgetting rate (P=0.03) after 12 weeks Supplementation with Bacopa 300 mg/day compared to placebo. Anxiety was also significantly reduced with Bacopa (p = 0.001). Nausea, dry mouth, and fatigue occurred in a higher percentage of participants in the bacopa group. (Stough 2001) In two clinical trials using a crossover design to assess the short-term effects of bacopa on cognition, healthy subjects were administered two doses (320 mg or 640 mg) of bacopa extract. The first study documented no change in cardiovascular activity or task-related ratings of stress and fatigue. (Downey 2013) The second study documented some improvement in mood effects and a reduction in cortisol levels. (Benson 2014)

In a 12-week study, elderly patients received a single daily oral dose of 450 mg Bacopa standardized extract for 12 weeks, which resulted in improvement in cognitive functions (e.g., attention, verbal memory). (Harshad 2008) The hematological laboratory profile was comparable to that of the controls.

A systematic review included studies in children and adolescents in which bacopa extract monotherapy was used for at least one month; Age ranged from 4 to 12 years and dosage ranged from 100 to 1,050 mg/day for 3 to 6 months. Improvements in memory span, visual memory, meaningful memory, and visual perception have been reported in healthy children, children with ADHD, and children with low intelligence. (Kean 2016)

In another review of clinical trials evaluating the use of bacopa to improve cognition, B. monnieri 150 mg twice daily for 90 days improved performance on a spatial working memory task in healthy subjects; Three months of treatment with B. monnieri reduced the rate of forgetting newly acquired information in subjects aged 40 to 65 years; and standardized B. monnieri extract 300 mg/day for 12 weeks improved performance on a delayed recall and a Stroop task (assessment of the ability to ignore irrelevant information) in participants aged 65 years and older without dementia. In addition, treatment with B. monnieri 300 mg/day improved verbal learning, memory acquisition, and delayed recall in healthy subjects older than 55 years. (Farooqui 2018)

According to a meta-analysis of data from 9 chronic dosing (longer than 12 weeks) randomized controlled trials (N=518), supplementation with approximately 300 mg/day of bacopa extract (containing 50% triterpene bacosides) improved alertness. Task performance and processing speed. One of the included studies also demonstrated reduced latency of evoked potentials to stimuli (i.e., faster cerebroelectric processing) using electroencephalogram. (Kennedy 2019) In 437 subjects from the same meta-analysis, the time required to complete a task (Trail Making Test Part B) was improved (−17.9 ms; 95% CI, −24.6 to −11.2; P < 0.001) and choice reaction time was shortened (−10.6 ms; 95% CI, −12.1 to −9.2; P <0.001). . Overall, the tested extracts were well tolerated. (Cicero 2018, Kongkeaw 2014) The meta-analysis suggests that B. monnieri has the potential to improve cognition, particularly the speed of attention. (Kongkeaw 2014)

A compiled summary of various clinical studies evaluating the effects of bacopa extracts on cognition demonstrated the effective use of B. monnieri for cognition and neuroprotection mechanism. (Abdul Manap 2019) Furthermore, a review of key studies evaluating the effects of bacopa extracts on Alzheimer's disease shows Brahmi improves memory and cognitive functions, cardinal symptoms of Alzheimer's disease. (Chaudhari 2017)

Nerve tonics

Animal data

In mice, an ethanolic extract of B. monnieri increased GABA levels in the brain 15 minutes after administration. (Dey 1966) In a study examining the effects of the purified bacosides A and B on avoidance responses in rats, an increased new learning index was found and dose-dependent effects and taste aversion responses were observed. (Singh 1988) A saponin fraction from B. monnieri reduced spontaneous motor activity in rats and lowered rectal temperatures in mice. The same extract showed a calming effect in rats but did not block the conditioned avoidance response. It also protected against audiogenic seizures. (Ganguly 1967, Ganguly 1967) The ethanolic extract of B. monnieri relaxed smooth muscle preparations of the pulmonary arteries of guinea pigs and rabbits, the aorta of rabbits and the trachea of ​​guinea pigs through a mechanism thought to involve prostacyclins. (Dar 1997) The same researchers found that the spasmolytic effects of ethanol extract in the ileum of guinea pigs and the jejunum of rabbits were mediated nonspecifically through calcium channels. (Dar 1999)

Parkinson's disease

Animal data

In a review evaluating medicinal herbs in the pharmacotherapy of Parkinson's disease, bacopa extracts conferred antiparkinsonian effects in both transgenic and toxin-induced animal model systems, suggesting potential efficacy against Parkinson's disease. (Srivastav 2017)

schizophrenia

Animal data

In a rat model, Bacopa extracts reduced psychosis by decreasing brain dopamine levels in the frontal cortical region. (Jash 2014) In another study, Bacopa restored cognitive deficits in a phencyclidine rat model of schizophrenia. (Piyabhan 2014)

Clinical data

In a case study of a patient with schizophrenia, administration of olanzapine with additional bacopa extracts at 500 mg/day for one month resulted in a reduction in psychopathology. (Sarkar 2012)

Hepatoprotective effect

Animal data

An oral alcoholic bacopa extract protected against impaired antioxidant status in the liver of morphine-treated rats. (Shinomol 2011) In another study, a bacopa ethanol extract protected against nitrobenzene-induced liver damage in rats. (Menon 2010)

dosage

To improve short- and long-term memory, numerous Bacopa dosage forms and commercial products are available and marketed; There are fluctuations between products. Saini 2012 In a meta-analysis and reviews of clinical trials evaluating the use of bacopa extracts to improve cognition and memory in adults, dosages were typically between 300 and 450 mg/day; The duration of therapy varied, but was typically 12 weeks.Farooqui 2018, Harshad 2008, Kennedy 2019, Pase 2012

Pregnancy/breastfeeding

Avoid using. There is a lack of information on safety and effectiveness during pregnancy and breastfeeding.

Interactions

None are well documented. The standardized bacopa extract inhibited CYP-450 enzymes and the inhibition by the components bacoside A, bacoside A3, bacopaside II, bacopaside X, bacopasaponin C and bacopaside I was negligible. Bacopa may increase the concentration of drugs metabolized by these isoenzymes.Ramasamy 2014

Side effects

Commonly reported side effects include flu-like symptoms, gastrointestinal irritation, nausea, increased intestinal motility, and muscle fatigue. Calabrese 2008 A phase 1 safety study in 23 volunteers reported mild gastrointestinal side effects (e.g., upper abdominal burning, nausea, bloating, flatulence). . All side effects resolved spontaneously without the need to stop treatment. Pravina 2007

toxicology

There are no clinical data on toxicity. Toxicity studies in rats resulted in a mean lethal dose of 2,400 mg/kg. Histopathological evidence from a 90-day oral toxicity study in rats revealed no evidence of toxicity at bacopa doses of 85, 210, and 500 mg/kg. Joshua 2007

Index terms

• Bacopa monniera
• Centella asiatica
• Herpestis monniera
• Moniera cuneifolia
• Gotu Kola

References

Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been evaluated for safety or effectiveness by the FDA and is not subject to the quality and safety information collection standards that apply to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not confirm that this product is safe, effective, or approved to treat any patient or medical condition. This is just a brief summary of general information about this product. It does NOT contain all information about the possible uses, instructions, warnings, precautions, interactions, side effects or risks that may apply to this product. This information does not constitute specific medical advice and does not replace the information you receive from your healthcare provider. You should speak to your doctor to get complete information about the risks and benefits of using this product.

This product may interact negatively with certain health and medical conditions, other prescription and over-the-counter medications, foods or other dietary supplements. This product may be unsafe if used before surgery or other medical procedures. It is important to fully inform your doctor about the herbs, vitamins, minerals, or other supplements you are taking before any surgery or medical procedure. With the exception of certain products generally considered safe in normal amounts, including the use of folic acid and prenatal vitamins during pregnancy, this product has not been adequately studied to determine whether it is safe for use during pregnancy, breastfeeding, or in those younger than 2 years of age.

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