Bacopa (Bacopa monnieri)

RELATED TERMS

Bacopa monniera Linn., Bacopa monniera Wettst., Bacopa monnieri, Bacopa monnieri L., bacopasapponin, bacopasaponin C, bacoside, bacoside A, bacoside A3, bacoside B, bacosine, betulinic acid, brahmi, Herpestis moniera cuneifolia, Herpestis monniera, Jalanimba, Jalnaveri, medhya rasayana, Moniera cuneifolia, oroxindin, sambrani chettu, Scrophulariaceae (family), thyme-leaved gratiola, water hyssop, wogonin.

BACKGROUND

Bacopa (Bacopa monnieri) leaf extract is called brahmi in Ayurvedic medicine and is widely used in India, especially for enhancing memory, analgesia (pain relief), and epilepsy. Bacopa has traditionally been used to treat asthma, hoarseness, and mental disorders, to help improve mental performance, epilepsy, and as a nerve tonic, cardiotonic (heart tonic), and diuretic (increases urine flow). Bacopa was prominently mentioned in Indian texts as early as the 6th Century.

Most research on bacopa has concentrated on its effects on learning. Bacopa may also be helpful in managing pediatric attention deficit hyperactivity disorder (ADHD), but clinical evidence is lacking.

EVIDENCE TABLE

Conditions

Uses disclaimer: These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.	Grade*
Cognition Although bacopa is traditionally used in Ayurvedic medicine to enhance cognition, current evidence is lacking in this area. More research is needed before bacopa can be recommended for enhancing brain function in adults or children.	B
Anxiety (clinical) Bacopa has traditionally been used in Ayurvedic medicine to treat anxiety. Although early evidence is promising, more study is needed.	C
Epilepsy Although bacopa is traditionally used in Ayurvedic medicine for epilepsy, additional study is needed before a strong recommendation can be made.	C
Irritable bowel syndrome (IBS) Preliminary evidence suggests that bacopa and bael fruit used in combination may treat irritable bowel syndrome (IBS). However, additional studies using bacopa alone are needed before bacopa can be recommended for IBS.	C
Memory Although bacopa is traditionally used in Ayurvedic medicine to enhance memory, additional study is needed before a firm conclusion can be drawn.	C
*Key to grades: A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).

TRADITION

The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below. Analgesia, anti-aging, anti-inflammatory, antimicrobial, antioxidant, antipyretic (fever reducer), asthma, attention deficit hyperactivity disorder (ADHD), back pain, bronchitis, cardiotonic, cardiovascular (heart) disease, diuretic (increases urine flow), fatigue, gastric ulcers, H. pylori, hoarseness of voice, immunomodulation, insomnia, laryngitis, learning, mental disorders, mental illness, nerve disorders, rheumatism, sedative, sexual dysfunction, stress.

DOSING

disclaimer: The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

There is no proven safe or effective dose for bacopa in adults. According to tradition, 50-150 milligrams two or three times a day has been used. For anxiety, 30 milliliters of bacopa syrup per day in two divided doses (representing 12 grams of dry crude drug) for four weeks has been used. Other preparations that have been used include 2 ounces of crude aqueous extract of bacopa daily for up to five months or 2-4 milligrams per kilogram of body weight of defatted alcoholic bacopa extract dissolved in distilled water daily for up to five months.

Children (younger than 18 years)

There is no proven safe or effective dose for bacopa in children. Nevertheless, based on traditional use, 350 milligrams per teaspoonful of dried plant extracted in a syrup has been taken three times daily for three months in children ages six to eight.

SAFETY

disclaimer: The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in individuals with a known allergy or hypersensitivity to Bacopa monnieri, its constituents, or any member of the Scrophulariaceae (figwort) family.

Side Effects and Warnings

Side effects of bacopa may include nausea, dry mouth, thirst, and fatigue. Bacopa has been reported to cause palpitations (irregular heartbeats); patients with heart problems should use with caution.

Use cautiously in patients taking drugs or herbs that are metabolized by cytochrome P450 enzymes, as bacopa may negatively affect these enzymes.

Use cautiously in patients taking thyroid drugs, as bacopa may increase thyroid hormones.

Use cautiously in patients taking calcium blocking drugs, as bacopa may additively interact with them.

Use cautiously in patients taking sedatives, as bacopa may additively interact with them.

Pregnancy and Breastfeeding

Bacopa is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.

INTERACTIONS

disclaimer: Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

Bacopa may additively interact with calcium blocking drugs. Caution is advised.

Bacopa may negatively affect cytochrome P450 enzymes and may interfere with the way the body processes certain drugs. As a result, the levels of these drugs may be altered in the blood. Patients taking any medications should check the package insert and consult with a qualified healthcare professional, including a pharmacist, about possible interactions.

Bacopa may increase thyroid hormones and could interact additively with hypothyroid medicine.

Bacopa, when taken concomitantly with phenytoin, may reverse phenytoin-induced cognitive impairment. Consult with a qualified healthcare professional, including a pharmacist, to check for interactions.

Interactions with Herbs and Dietary Supplements

Bacopa may negatively affect cytochrome P450 enzymes and interfere with the way the body processes certain herbs or supplements. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplement possibly have on the P450 system.

ATTRIBUTION

This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

• Chaudhuri PK, Srivastava R, Kumar S, et al. Phytotoxic and antimicrobial constituents of Bacopa monnieri and Holmskioldia sanguinea. Phytother Res 2004;18(2):114-117. View abstract
• Chowdhuri DK, Parmar D, Kakkar P, et al. Antistress effects of bacosides of Bacopa monnieri: modulation of Hsp70 expression, superoxide dismutase and cytochrome P450 activity in rat brain. Phytother Res 2002;16(7):639-645. View abstract
• Goel RK, Sairam K, Babu MD, et al. In vitro evaluation of Bacopa monniera on anti-Helicobacter pylori activity and accumulation of prostaglandins. Phytomedicine 2003;10(6-7):523-527. View abstract
• Kar A, Panda S, Bharti S. Relative efficacy of three medicinal plant extracts in the alteration of thyroid hormone concentrations in male mice. J Ethnopharmacol 2002;81(2):281-285. View abstract
• Kishore K, Singh M. Effect of bacosides, alcoholic extract of Bacopa monniera Linn. (brahmi), on experimental amnesia in mice. Indian J Exp Biol 2005;43(7):640-645. View abstract
• Pawar R, Gopalakrishnan C, Bhutani KK. Dammarane triterpene saponin from Bacopa monniera as the superoxide inhibitor in polymorphonuclear cells. Planta Med 2001;67(8):752-754. View abstract
• Rao CV, Sairam K, Goel RK. Experimental evaluation of Bocopa monniera on rat gastric ulceration and secretion. Indian J Physiol Pharmacol 2000;44(4):435-441. View abstract
• Roodenrys S, Booth D, Bulzomi S, et al. Chronic effects of Brahmi (Bacopa monnieri) on human memory. Neuropsychopharmacology 2002;27(2):279-281. View abstract
• Russo A, Borrelli F. Bacopa monniera, a reputed nootropic plant: an overview. Phytomedicine 2005;12(4):305-317. View abstract
• Russo A, Izzo AA, Borrelli F, et al. Free radical scavenging capacity and protective effect of Bacopa monniera L. on DNA damage. Phytother Res 2003;17(8):870-875. View abstract
• Samiulla DS, Prashanth D, Amit A. Mast cell stabilising activity of Bacopa monnieri. Fitoterapia 2001;72(3):284-285. View abstract
• Stough C, Lloyd J, Clarke J, et al. The chronic effects of an extract of Bacopa monniera (Brahmi) on cognitive function in healthy human subjects. Psychopharmacology (Berl) 2001;156(4):481-484. View abstract
• Sumathy T, Govindasamy S, Balakrishna K, et al. Protective role of Bacopa monniera on morphine-induced brain mitochondrial enzyme activity in rats. Fitoterapia 2002;73(5):381-385. View abstract
• Sumathy T, Subramanian S, Govindasamy S, et al. Protective role of Bacopa monniera on morphine induced hepatotoxicity in rats. Phytother Res 2001;15(7):643-645. View abstract
• Vohora D, Pal SN, Pillai KK. Protection from phenytoin-induced cognitive deficit by Bacopa monniera, a reputed Indian nootropic plant. J Ethnopharmacol 2000;71(3):383-390. View abstract

disclaimer: Natural Standard Bottom Line Monograph, Copyright © 2011 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions. disclaimer: While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy. disclaimer: The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

Copyright © 2011 Natural Standard (www.naturalstandard.com)

Copyright © 2011 Natural Standard (www.naturalstandard.com)