Bacopa monnieri is a botanical frequently used in Ayurvedic medicine. It is a medicinal creeping perennial in the Scrophulariaceae family. https://www.ncbi.nlm.nih.gov/books/NBK589635/
Bacopa is native to India, Australia, Indochina, and Sri Lanka. The active components are a combination of triterpenoid saponins, alkaloids, flavonoids, glycosides, Phytochemicals , and sapogenin[3] The saponins are believed to be responsible for much of the pharmacological actions.[4][5]
The main indications for using Bacopa in Ayurvedic medicine are memory improvement, anxiety, and insomnia. There have been a number of clinical studies that have demonstrated improvements in memory, verbal learning, and word recall.
Bacopa has been documented in Ayurvedic medical texts as a treatment for various mental conditions.[4] These include its use to improve general mental health, memory, and intellect and promote rejuvenation and longevity.[3][2] It is also used for insomnia, epilepsy, and as an anti-anxiety agent.[6] Many clinical studies demonstrate improvements in verbal learning, delayed word recall, memory acquisition, as well as reducing anxiety. It has been described as a “calming cognitive enhancer.”
Bacopa can be used on its own or in combination with the nootropic herb Gotu Kola (Centella asiatica). Bacopa monnieri and Centella asiatica both possess neuroprotective properties and have nootropic activity being used for patients with memory loss.[2] In numerous scientific studies, Bacopa has demonstrated beneficial effects on cognition, verbal learning, word recall, and memory acquisition.
Bacopa is generally well-tolerated with only minor temporary GI side effects.This article reviews the indications for its use, its physiological actions, adverse effects and contraindications.
Research Studies on Bacopa Monnieri
Bacopa monnieri functioning as a cognitive performance enhancer was demonstrated in a 17 patient randomized control trial published in 2014. They noted statistically significant improvement in cognitive performance (mental arithmetic, Stroop, letter search, visual tracking), improved mood, and a decreased cortisol response from stress. The best effect was observed with the 640 mg dose rather then with study subjects given half that amount .[8] It seems that some help with anxiety may be easier to show at a relatively lower dose than required for cognitive effects.[9]
A meta-analysis which reviewed nine randomized controlled trials with a total of over 400 subjects documented improved speed of attention and cognition and a decreased reaction time was seen [10] In one randomized, double-blinded, placebo-controlled study of adult patients who were given a 300 mg standardized extract of either Bacopa or placebo, the treated group showed enhanced delayed word recall memory scores relative to placebo.[11]Measurements were obtained by evaluating tasks of attention, memory, and psychological state at the start and at the end of the 12-week study period.
In another study of memory acquisition -a randomized, double-blinded study of 81 adults 55 years and older- reported that a 12-week period of the use of Bacopa significantly improved memory acquisition and retention in healthy older Australians.[12]
Bacopa has shown anxiolytic effects in people with cognitive decline as well as in healthy adults. Bacopa, in combination with Gotu kola (Centella asiatica), has also been shown in double-blind, randomized clinical trials to significantly reduce general anxiety symptoms.[14][15]
How Does Bacopa Work?
The sedative actions of Bacopa lend an overall calming effect. Bacopa has been shown to support GABA production, which reduces neuron excitability, thereby improving rapid response decision-making.[2] GABA (Gamma-aminobutyric acid) is a neurotransmitter that provides a calming effect on the brain. Bacopa monnieri has been shown to increase GABA by enhancing the GABA A receptor.[38]
Other possible mechanisms which may be responsible for cognitive improvement include modulation of acetylcholine release, muscarinic cholinergic receptor binding, and choline acetylase activity.[15][31] The saponins in Bacopa modulate the HPA axis ( hypothalamic-pituitary-adrenal) output, protecting the hippocampal area of the brain. Bacopa causes an anti-inflammatory effect on the nervous system cells called microglia.[32]
Bacopa monnieri has been found to have many pharmacological actions, including antioxidant, anti-inflammatory, anticonvulsant, and cardiotonic activity.[27][28][25] The leaf powder of Bacopa has been shown to have antioxidant effects.[29] The cognitive-enhancing properties of Bacopa are likely from the presence of a group of saponins collectively referred to as bacosides. Purified bacosides A and B, may facilitate learning ability, memory, and cognitive performance.[3 Other research related to brain function and possible association with dementia shows mechanisms of action o=f Bacopa including acetylcholinesterase inhibition, beta-amyloid reduction, and increased cerebral blood flow.[1]
Many neuroprotective aspects of Bacopa have been the subject of scientific study. Bacopa has been shown to protect against oxidative damage in both the cell cytosol and in the mitochondria of all areas of the brain.[33] In the presence of free radicals, a crucial line of defense is the antioxidant SOD ( superoxide dismutase), which increases with oxidative stress. Bacopa may decrease the level of SOD to normal suggesting an improvement in the homeostasis between pro- oxidant and antioxidant molecules .[35] In animal studies Glutathione has been shown to be depleted in diabetic rats[36] Bacopa may increase the level of glutathione.[37] Bacopa also normalizes monoamine levels and corticosterone in stress.[12]
The typical dose range of Bacopa monnieri used in traditional medicine, and in scientific studies are from 300 to 450 mg per day. It has also been shown that Bacopa may be used in children from 6-12 years of age at a dose of 225 mg per day. [39]
Adverse Effects
Bacopa monnieri is generally well-tolerated. The most common side effects are gastrointestinal, including increased stool frequency, nausea, and abdominal cramps, which may be temporary and resolve with further use, dosage adjustment and/ or being taken with food.
Contraindications
Animal research has shown that Bacopa increases the level of the T4 hormone thyroxine in mice. It should be used with caution in those with a thyroid condition or taking thyroid hormone medication.[42]
