Scientific Name(s): Bacopa monniera (L.) Wettst.
Common Name(s): Brahmi, Jalanimba, Jalnaveri, Sambrani chettu, Thyme-leaved gratiola
Bacopa is used for its antioxidant activity. It has been investigated for use in improving cognition.
Numerous dosage forms and commercial products are available and marketed for improved short- and long-term memory. A typical commercially available regimen is 2 oral capsules (500 mg; herbal extract of bacopa ratio, 10:1) twice a day with water after meals. Each capsule contains 500 mg (herbal extract of bacopa ratio is 10:1). Bacopa extracts have been used in clinical trials at dosages of 100 to 1,050 mg/day with 225 mg/day given for up to 6 months.
Avoid use with hypersensitivity to any of the components of bacopa.
Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.
None well documented.
Commonly reported adverse effects are flu-like symptoms, GI irritation, nausea, increased intestinal motility, and muscle fatigue.
No clinical data are available regarding toxicity.
- Scrophulariaceae (figwort)
Bacopa is a small creeping herb that grows in wet and marshy locations (altitude of up to 1,500 m) and is frequently planted in freshwater aquaria.1, 2, 3 It is native throughout the Indian subcontinent but has spread throughout the tropics. It is also found in the Fujian, Taiwan, Guangdong, Yunnan, and Sichuan provinces of China.4 The herb has ascending branches, oblong and obovate leaves, and solitary flowers. The calyx is 6 mm long and the white or pale violet-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 odor and taste.5 Synonyms for bacopa include Herpestis monniera and Moniera cuneifolia.
The common name "brahmi" has also been applied to herbs unrelated to Bacopa species, including Centella asiatica (gotu kola) and Merremia gangetica.6
The name "brahmi" comes from Brahma, the Hindu god of creation. Bacopa is a well-known herb in the Ayurvedic medical system and was prominently mentioned in Indian texts as early as the sixth century AD.7 For more than 5,000 years, bacopa has been traditionally used to treat epilepsy, insomnia, and anxiety, and is valued for its sedative properties. Indian Materia Medica documents the herb’s use for improving memory and concentration.8 Other reported uses include treatment of skin diseases, fever, inflammation, anemia, urinary disorder, psychiatric disorders, and hoarseness. It has also been traditionally used to treat asthma and is considered a potent nerve tonic, cardiotonic, and diuretic. Ethnobotanically, the leaves are used in speech disorders, premature ejaculation, flatulence, abdominal pain, cough, and colds. Fresh bacopa leaf juice has been used in rheumatism and as a mental revitalizer.2, 3, 6
The principal constituents of bacopa, bacosides9 and bacopasaponins,10, 11 are triterpene saponins of the dammarane class, which contain 2 or 3 sugars each. The saponins are primarily responsible for the bioactivity of the plant. The bacosides include a family of 12 known analogs.9 Saponins known as bacopasides I–XII have been identified. Brahmine, nicotine, and herpestine alkaloids have also been identified. Other constituents include D-mannitol, apigenin, hersaponin, monnierasides I–III, cucurbitacins, and plantainoside B.4, 9
The constituents most studied include the bacosides (bacoside A, bacoside B, and bacopasides I-XII). Bacoside A contains a blend of 4 saponins (bacoside A3, bacopacide II, bacopasaponin C, and a jujubogenin isomer of bacosaponin C). Bacoside B contains 4 diglycosidic saponins.12, 13 Bacoside concentrations may vary depending on the plant part from which they are extracted. One bacopa sample profile included bacopaside I (5.37%), bacoside A3 (5.59%), bacopaside II (6.9%), bacopasaponin C isomer (7.08%), and bacopasaponin C (4.18%). Bacosine has been identified as a free triterpene from bacopa.14
Uses and Pharmacology
In a study review, high doses of bacopa extract administered via intraperitoneal injection for 15 days resulted in antiepileptic activity.23 In a rat model study, bacopa and bacoside A treatment reversed epilepsy-associated changes by decreasing GABA receptors in the cerebral cortex.38
In vitro data
Several bacopa extract fractions have blood clot lysis activity.15 Antioxidant activity may explain the neuroprotective role of bacoside A in increasing brain levels of glutathione, vitamin C, vitamin E, and vitamin A in rats exposed to cigarette smoke. Zinc and selenium levels were also restored in the brain.16 A bacopa 50 mg/kg/day oral supplement reversed memory impairment in a colchicine-treated rat model of Alzheimer disease.17 The neuroprotective effects of the bacopa supplement reduced colchicine-induced cognitive decline due to oxidative stress and neural death in the subventricular zone, dentate gyrus, and basal forebrain.
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 in 4-week-old male mice.18, 19 A neuroprotective effect against injury caused by cerebral ischemia was reported for bacopaside I.20 Some animal models report that bacoside constituents have an antioxidant effect on the hippocampus, frontal cortex, and striatum.12, 21
Attention deficit hyperactivity disorder
In an open study without a placebo or control group, 31 children (6 to 12 years of age and diagnosed with attention deficit hyperactivity disorder [ADHD]) received 225 mg/day of a standardized bacopa extract for 6 months. Seventy-four percent of children experienced a 20% improvement in total subtest scores for ADHD symptoms. Attention deficit symptoms, including restlessness, self-control, learning problems, impulsivity, and psychiatric problems, were reduced in 85% of children.37 A systematic review was conducted of clinical trials published up to August 2015 that investigated the use of bacopa extract as monotherapy for at least 1 month in children or adolescents. Of the 5 studies that met inclusion criteria, 2 were double-blind, randomized placebo-controlled trials (N=76) conducted in children with ADHD. Significant treatment effects for bacopa compared to placebo were observed in logical memory, sentence memory, paired associate learning, digit span, word recall, delayed response learning, attention, and hyperactivity. Children ranged in age from 6 to 12 years and were administered B. monnieri 100 mg/day for 3 months; drop-out rates were 22.5% in each trial. No side effects were reported by participants.51
In vitro and animal data
Oral treatment with bacopa extract for 24 days facilitated an ability to learn mazes in rats.22 The extract improved performance of rats in various behavioral models of learning.7 A bacopa alcoholic extract enhanced learning ability in rats, including retention of newly learned behavioral responses. Bacosides A and B may be associated with the cognition-facilitating effect.23 Administration of bacosides in mice induced anterograde amnesia and improved memory. Administration of standardized bacopa extract in rats resulted in improvement of spatial learning and enhanced memory retention. Bacopa reversed diazepam-induced amnesia in mice and restored cognition in a pilocarpine-induced epilepsy rat model. Scopolamine-induced behavior deficits in rats were attenuated due to dose-dependent inhibitory effects of bacopa on acetylcholinesterase activity.
A systematic review of several randomized, double-blind clinical trials demonstrated efficacy of bacopa in improving memory and some cognitive functions. Adults without dementia or serious cognitive impairment were administered bacopa extracts (300 to 450 mg daily over a 12-week period). Although cognition was not as well-documented as other effects, bacopa improved 9 of 17 free recall memory tasks.24
In another clinical trial of 76 healthy adults, weight-based dosing of bacopa extract resulted in improved retention of new information. However, the results indicated no effect on attention, verbal and visual short-term memory, or retrieval of information from long-term memory. No adverse effects were reported on subjective measures of psychological state—such as depression, anxiety, stress—or everyday memory.25 In a 12-week trial, elderly patients received a single oral dose of bacopa standardized extract 450 mg/day, which resulted in improved cognitive functions such as attention and verbal memory.26 The hematological lab profile was comparable to that of controls.
In 2 clinical trials employing a crossover design to assess the short-term effects of bacopa on cognition, healthy subjects were administered 2 doses (320 mg or 640 mg) of bacopa extract. The first trial documented no change in cardiovascular activity or task-related ratings of stress and fatigue.27 The second trial documented some improvement in mood effects and a reduction in cortisol levels.28
A systematic review of bacopa extract as monotherapy was published up to August 2015 that investigated the use of the herb for at least 1 month in children or adolescents. Significant improvements were reported in memory span, visual memory, meaningful memory, and visual perception in populations that included healthy, ADHD, and low intelligence children. Ages ranged from 4 to 12 years and doses ranged from 100 mg/day to 1,050 mg/day given for 3 to 4 months.51
Some studies of bacopa demonstrated suppression of acetylcholinesterase activity, which resulted in enhanced cholinergic function leading to improved attention and memory processing.29 In other studies, some bacopa compounds showed no inhibitory activity against acetylcholinesterase, but a binding affinity toward the D1 receptor was seen.30 One of these studies demonstrated that bacoside A is not likely to be absorbed through the intestine or to penetrate the blood-brain barrier. Thus, the bacosides may be transformed in vivo, resulting in active metabolites mediating memory-enhancing and cognitive activities.
An alcoholic extract of bacopa administered orally to rats protected against compromised morphine-induced antioxidant activity in the liver.23 A bacopa ethanol extract protected against nitrobenzene-induced liver damage in rats.39
In mice, the ethanolic extract of B. monnieri increased cerebral levels of gamma-aminobutyric acid (GABA) 15 minutes after administration,31 and the purified bacosides A and B showed dose-dependent effects in the same rat models, as well as in a taste aversion response test.32 A saponin fraction of B. monnieri reduced spontaneous motor activity in rats and lowered rectal temperatures in mice.33 The same extract showed tranquilizing effects in rats but did not block the conditioned avoidance response. It also protected against audiogenic seizures.34 The ethanolic extract of B. monnieri relaxed smooth muscle preparations of guinea pig and rabbit pulmonary arteries, rabbit aorta, and guinea pig trachea by a mechanism postulated to involve prostacyclins.35 The same investigators found spasmolytic effects of the ethanol extract in guinea pig ileum and rabbit jejunum to be nonspecifically mediated through calcium channels.36
Bacosine, a free triterpene isolated from the aerial parts of B. monnieri, was found to have analgesic effects through opioidergic pathways.40
According to a review article, bacopa’s anti-inflammatory effect is mediated via cyclooxygenase-2 (COX-2) inhibition.41 In rats, bacoside A inhibited the effects of morphine withdrawal–induced depression.42
In a rat model, bacopa extracts reduced psychosis by reducing brain dopamine levels in the frontal cortical region.43 In another study, bacopa restored cognitive deficits in a phencyclidine rat model of schizophrenia.44 In a case study of a patient with schizophrenia, administration of olanzapine with add-on bacopa extracts of 500 mg/day for 1 month resulted in reduction in psychopathology.45
Numerous dosage forms and commercial products are available and marketed for improved short- and long-term memory.46 A typical commercially available regimen is 2 oral capsules (500 mg; herbal extract of bacopa ratio, 10:1) twice a day with water after meals. Bacopa extracts have been used in clinical trials at dosages of 100 to 1,050 mg/day, with 1,050 mg/day given for 3 months and 224 mg/day given for up to 6 months.24, 51
Pregnancy / Lactation
Avoid use. Information regarding safety and efficacy in pregnancy and lactation is lacking.
None well documented. Bacopa standardized extract inhibited cytochrome P450 enzymes, and inhibition exhibited by the constituents 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.47
Commonly reported adverse effects are flu-like symptoms, GI irritation, nausea, increased intestinal motility, and muscle fatigue.48 A phase 1 safety study of 23 volunteers reported mild GI adverse effects, such as epigastric burning, nausea, and fullness and bloating. All adverse effects subsided spontaneously without discontinuation of treatment.49
No clinical data are available regarding toxicity. Toxicity studies in rats reported a median lethal dose of 2,400 mg/kg. Histopathological evidence from a 90-day oral toxicity study in rats did not reveal any evidence of toxicity at bacopa doses of 85, 210, and 500 mg/kg.
- Bacopa monniera
- Centella asiatica
- Herpestis monniera
- Moniera cuneifolia
- Gotu kola
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