Bacopa

Bacopa is said to improve or maintain memory, learning retention, concentration, focus, and overall cognitive function and performance. Some people take bacopa to help relieve or delay symptoms of Alzheimer disease and attention deficit-hyperactivity disorder (ADHD).

There are no high-quality studies demonstrating that bacopa is effective for improving memory or cognitive function or treating any disorder.

While some small trials appear to show a modest benefit in healthy adults, higher-quality evidence is needed to confirm these findings. For example, a small randomized trial including 60 medical students in India who were treated with either 150 mg of standardized extract of bacopa or matching placebo twice a day for 6 weeks reported a statistically significant improvement in some memory and cognitive function tests, but no difference in other neuropsychological tests (1). Another small randomized trial with 54 adults aged 65 or older (mean age 73.5) without clinical signs of dementia found that patients who received 300 mg daily of bacopa demonstrated statistically significant improvements from baseline memory tests when compared with those who received placebo (2). Similarly, another trial with 98 healthy Australian adults over 55 years of age reported that those treated with 300 mg daily of bacopa for 12 weeks demonstrated statistically significant improvements in verbal learning, memory acquisition, and delayed recall compared to placebo (3).

Bacopa has also been studied in patient's with Alzheimer disease. A systematic review of 5 randomized trials comparing bacopa to placebo or donepezil in patient's with Alzheimer disease reported no difference between treatments although the included trials exhibited extensive heterogeneity and other study quality limitations (Bacopa has also been studied in patient's with Alzheimer disease. A systematic review of 5 randomized trials comparing bacopa to placebo or donepezil in patient's with Alzheimer disease reported no difference between treatments although the included trials exhibited extensive heterogeneity and other study quality limitations (4).

Common adverse effects of bacopa include gastrointestinal upset, nausea, and dry mouth.

Bacopa can increase acetylcholine and, therefore, may decrease the effect of anticholinergic medications or increase the adverse effects of cholinergic medications that increase acetylcholine (eg, medications for glaucoma or Alzheimer disease ).

Bacopa may increase thyroid hormone levels; therefore, people taking thyroid hormone medications should not take bacopa.

Bacopa may change the blood levels of medications metabolized by the cytochrome P450 system (eg, warfarin, some calcium channel blockers, antiseizure medications).Bacopa may change the blood levels of medications metabolized by the cytochrome P450 system (eg, warfarin, some calcium channel blockers, antiseizure medications).

(See also table Some Possible Dietary Supplement–Medication Interactions.)

1. 1. 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. 4103423, 2016. doi:10.1155/2016/4103423

2. 2. 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. 14(6):707-713, 2008. doi:10.1089/acm.2008.0018

3. 3. 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. 16(7):753-759, 2010. doi:10.1089/acm.2009.0342

4. 4. Basheer A, Agarwal A, Mishra B, et al. Use of Bacopa monnieri in the Treatment of Dementia Due to Alzheimer Disease: Systematic Review of Randomized Controlled Trials. Interact J Med Res. 2022;11(2):e38542. Published 2022 Aug 1. doi:10.2196/38542