What are the benefits of bacopa monnieri? How does bacopa work on memory, concentration and attention? What are the contraindications and side effects of Bacopa? What dose should I take?
Bacopa monnieri or "water hyssop" or in Sanskrit "brāhmī" is a small plant of the Scrofulaceae family with white, blue or purple flowers and fleshy leaves. In India, it is known as Brahmi.
Employed for 3000 years in Ayurvedic medicine, bacopa is used to improve memory, learning and concentration. Bacopa is also advised to relieve symptoms related to anxiety and epilepsy.
An adaptogenic, nootropic and antioxidant plant
In recent years, studies conducted with Bacopa monnieri extracts have demonstrated its properties.
- a nootropic for its ability to improve cognitive functions such as memory and concentration
- an antioxidant by reducing oxidative stress and pro-inflammatory cytokine synthesis in the brain
- and an adaptogen by naturally increasing stress resistance and reducing mental fatigue.
The dry extract of the whole plant is used. According to the British Pharmacopeia (British Pharmacopeia, 2016), the main components responsible for pharmacological activity are bacosides A3, bacopasides X, I and II and bacopasaponin C.
PROPERTIES AND INDICATIONS
Bacopa helps to improve:
- memory, attention and learning in healthy adults and students.
- cognitive function in healthy older adults - transient (short-term)
- also attention, learning and behaviour in children and adolescents.
Cognitive functions and quality of life
Bacopa has an inhibitory effect on acetylcholinesterase, leading to an increase in acetylcholine in the brain.
This is why it has been studied to assess the effects of bacopa on memory loss and mild cognitive impairment in the early stages of Alzheimer's disease (Peth-nui 2010, Chaudari 2017, Nemetchek 2017, Sahoo 2018).
Label: Catechol- O-methyl transferase (COMT), Prolyl endopeptidase (PEP), Poly (ADP-ribose) polymerase (PARP), Oxygen radical absorbance capacity (ORAC) - after Dethe, 2016
In a prospective study, 39 patients over 65 years of age diagnosed with Alzheimer's disease (mild) were treated with 300 mg of standardised bacopa Bacognize® extract twice daily for six months.
Different cognitive abilities were assessed using the Mini-Mental State Examination Scale (MMSES) at baseline and the end of the study.
At the end of the study, scores were significantly better in aspects such as spatial-temporal disorientation, attention, reading, writing and comprehension. In addition, patients reported improved quality of life, and decreased irritability and insomnia (Goswami 2011).
Improved cognitive function and memory in adults
Several randomised, double-blind, placebo-controlled studies in healthy individuals demonstrate that bacopa improves memory.
The improvement was seen in both the acquisition of new concepts and the retention of previously learned concepts.
Bacopa also improved attention, concentration, and processing speed compared with the placebo group.
In two studies, the effect of 300 mg of standardised Bacopa extract per day for 12 weeks was assessed in 48 and 81 volunteers aged over 65 and 55 years, respectively, all without signs of dementia.
Significant improvement in cognitive performance was observed in the treated group compared to the placebo group (Calabrese, 2008 and Morgan, 2010). In another study, 107 healthy volunteers aged 18-60 took two daily doses of 150 mg of standardised extract or placebo.
The results show a significant improvement in visual information processing speed, learning speed, and memory consolidation. The authors also observed a reduction in anxiety status for the group taking bacopa compared to the placebo (Stough 2008).
Memory and learning capacities in students
The effectiveness of bacopa in improving memory and concentration has also been studied in young volunteers. In this case, a group of 60 medical students took two 150 mg capsules of bacopa Bacognize® extract or placebo daily for just six weeks.
Participant test results at the beginning and end of the study showed improved visual information processing speed, attention, and working memory for the group that took the bacopa extract (Kumar 2016).
Reducing stress & anxiety
In two randomised, double-blind, placebo-controlled trials, the acute effects (1 and 2 h after a single dose) of 320 and 640 mg of Bacopa extract on cognitive function, stress, and mood in healthy adults were studied by performing a battery of multitasking tests.
After taking Bacopa, work function, reaction time, feeling calm (less stress), and mood (less anxiety) were improved for both determinations 1 and 2 hours later. Stress was assessed by cortisol levels in saliva. This study also confirms bacopa's adaptogenic and nootropic properties in the short term (Benson, 2013 and Downey, 2013).
Behaviour and attention in children and teenagers
The clinical diagnosis of attention deficit hyperactivity disorder (ADHD) and medication use for its treatment have increased in recent years to become the most common disorder in children and adolescents.
In recent years, clinical trials have shown that bacopa improves memory, attention and mood. It is, therefore, an interesting avenue to help these children. In an open study, 31 children aged 6 to 12 years with ADHD were given a dose of 225 mg per day of standardised Bacopa extract for six months. The children well tolerated the treatment, and no side effects occurred (Dave, 2014).
The results of this study (Dave, 2014) are as follows:
- Hyperactivity and excitability symptoms were reduced in 93% of children,
- Self-control improved in 89% of children.
- Inattention deficit was reduced in 85% of cases,
- Learning difficulties by 78%.
- Impulsivity and psychiatric problems in 67% and 52% of children, respectively.
Finally, another randomised controlled trial was conducted in 120 children and adolescents aged 6-14 years with ADHD and no medical treatment.
The control group was treated with a standardised bacopa extract (1 capsule of 160 mg per day for children of 20-35 kg body weight and two capsules of 160 mg per day for children over 35 kg) for 16 weeks.
Bacopa was effective and safe in helping to improve inattention, hyperactivity and impulsivity (Kean, 2015).
Bacopa: contraindications, precautions and side effects
Bacopa monnieri is a safe herb with no contraindications described. However, there are some precautions:
- Theoretically, bacopa could amplify the effects of phenothiazines (neuroleptics).
- Bacopa has also been shown, albeit inconsistently, to have a mild sedative (calming) effect, so caution is advised in combination with other known sedatives.
- In high doses and mice, Bacopa monnieri appears to stimulate the activity of the thyroid hormone thyroxine (T4). It is, therefore, possible that bacopa may potentiate the action of thyroid drugs (Kar 2002)
Pregnancy and breastfeeding: it is best not to use it as no studies have been done on pregnant or breastfeeding women. Known cases of side effects are gastrointestinal problems such as nausea, stomach pain and increased intestinal motility (Morgan 2010, Kongkeaw 2013, Kean 2016).
A bacopa and turmeric dietary supplement for memory and concentration
Optim Memory is a natural and effective supplement with bacopa and Turmeric extracts. These two herbs help to improve concentration and mental clarity in students and older people.
Benson S, Downey LA, Stough C, Wetherell M, Zangara A, Scholey A. An acute, double-blind, placebo-controlled cross-over study of 320 mg and 640 mg doses of Bacopa monnieri (CDRI 08) on multitasking stress reactivity and mood. Phytother Res. 2014 Apr;28(4):551-9.
British Pharmacopoeia, Bacopa Monnieri – BP 2016
Calabrese C, Gregory WL, Leo M, Kraemer D, Bone K, Oken B. Effects of a standardized Bacopa monnieri extract on cognitive performance, anxiety, and depression in the elderly: a randomized, double-blind, placebo-controlled trial. J Altern Complement Med. 2008 Jul;14(6):707-13.
Chaudhari KS, Tiwari NR, Tiwari RR, Sharma RS. Neurocognitive Effect of Nootropic Drug Brahmi (Bacopa monnieri) in Alzheimer's Disease. Ann Neurosci. 2017 May;24(2):111-122.
Dave UP, Dingankar SR, Saxena VS, Joseph JA, Bethapudi B, Agarwal A, Kudiganti V. An open-label study to elucidate the effects of standardized Bacopa monnieri extract in the management of symptoms of attention-deficit hyperactivity disorder in children. Adv Mind Body Med. 2014 Spring;28(2):10-5
Dethe S, Deepak M, Agarwal A. Elucidation of Molecular Mechanism(s) of Cognition Enhancing Activity of Bacomind®: A Standardized Extract of Bacopa Monnieri.Pharmacogn Mag. 2016 Jul;12(Suppl 4):S482-S487.
Downey LA, Kean J, Nemeh F, Lau A, Poll A, Gregory R, Murray M, Rourke J, Patak B, Pase MP, Zangara A, Lomas J, Scholey A, Stough C. An acute, double-blind, placebo-controlled crossover study of 320 mg and 640 mg doses of a special extract of Bacopa monnieri (CDRI 08) on sustained cognitive performance. Phytother Res. 2013 Sep;27(9):1407-13.
Goswami S, Saoji A, Kuman N, Thawani V, Tiwari M, Thawani M. Effect of Bacopa monnieri on cognitive functions in Alzheimer’s disease patients. International Journal of Collaborative Research on Internal Medicine & Public Health. 2011;3(3):179.
Kean JD, Kaufman J, Lomas J, Goh A, White D, Simpson D, Scholey A, Singh H, Sarris J, Zangara A, Stough C. A Randomized Controlled Trial Investigating the Effects of a Special Extract of Bacopa monnieri (CDRI 08) on Hyperactivity and Inattention in Male Children and Adolescents: BACHI Study Protocol (ANZCTRN12612000827831).Nutrients. 2015 Dec 2;7(12):9931-45.
Kean JD, Downey LA, Stough C. A systematic review of the Ayurvedic medicinal herb Bacopa monnieri in child and adolescent populations. Complement Ther Med. 2016 Dec;29:56-62.
Kongkeaw C, Dilokthornsakul P, Thanarangsarit P, Limpeanchob N, Norman Scholfield C. Meta-analysis of randomized controlled trials on cognitive effects of Bacopa monnieri extract. J Ethnopharmacol. 2014;151(1):528-35.
Kumar N, Abichandani LG, Thawani V, Gharpure KJ, Naidu MU, Venkat Ramana G. Efficacy of Standardized Extract of Bacopa monnieri (Bacognize®) on Cognitive Functions of Medical Students: A Six-Week, Randomized Placebo-Controlled Trial. Evid Based Complement Alternat Med. 2016;2016:4103423.
Morgan A, Stevens J. Does Bacopa monnieri improve memory performance in older persons? Results of a randomized, placebo-controlled, double-blind trial. J Altern Complement Med. 2010 Jul;16(7):753-9.
Nemetchek MD, Stierle AA, Stierle DB, Lurie DI. The Ayurvedic plant Bacopa monnieri inhibits inflammatory pathways in the brain. J Ethnopharmacol. 2017 Feb 2;197:92-100.
Peth-Nui T, Wattanathorn J, Muchimapura S, Tong-Un T, Piyavhatkul N, Rangseekajee P, Ingkaninan K, Vittaya-Areekul S. Effects of 12-Week Bacopa monnieri Consumption on Attention, Cognitive Processing, Working Memory, and Functions of Both Cholinergic and Monoaminergic Systems in Healthy Elderly Volunteers. Evid Based Complement Alternat Med. 2012;2012:606424.
Sahoo AK, Dandapat J, Dash UC, Kanhar S. Features and outcomes of drugs for combination therapy as multi-targets strategy to combat Alzheimer's disease. J Ethnopharmacol. 2018 Apr 6;215:42-73.
Stough C, Downey LA, Lloyd J, Silber B, Redman S, Hutchison C, Wesnes K, Nathan PJ. Examining the nootropic effects of a special extract of Bacopa monniera on human cognitive functioning: 90 day double-blind placebo-controlled randomized trial. Phytother Res. 2008 Dec;22(12):1629-34.