Introduction

Bacopa is a creeping, prostrate, somewhat succulent perennial that grows naturally in moist or wet places such as the borders of irrigated fields, streams, water channels, and wells.^1,2,3 Native to India, Indochina, Sri Lanka, and the Mascarene islands of Mauritius, Reunion, and Rodrigues, this genus—which consists of 56 species—flourishes in tropical and subtropical regions of the world.⁴ The material of commerce is obtained primarily from wild collection in India, although some varieties have been developed by the Central Institute of Medicinal and Aromatic Plants (CIMAP), Lucknow, for cultivation as perennials.^5,6

While most common at lower elevations, bacopa can also grow at altitudes as high as 700-900 meters (2296-2952 feet) in western and central Nepal.⁷ In Bangladesh, bacopa occurs in coastal areas, fallow lands, and paddy fields.⁸ In China, it occurs near water, wet places, and sandy beaches below 1,100 meters (3,280 feet) in Fujian, Guangdong, Guangxi, Hainan, and Yunnan Provinces; it also grows on the island of Taiwan.⁹

Bacopa produces flowers and fruit throughout the growing season.10 The flowers have 5 white to pale blue or violet petals, with 1 petal larger than the others.3 Both the leaves and seed capsules are fleshy and smooth.⁴ All parts of the plant are used medicinally, either fresh or dried.^3,4,7,10,11 In the Indian traditional systems of medicine (Ayurveda, Siddha, and Unani), preparations are made primarily from the whole dried plant (root, stem, leaf, flower, and fruit). The United States Pharmacopeia (USP), however, has published a dietary supplement quality standards monograph specifying only the dried stems and leaves.¹²

A previous HerbalGram article on gotu kola (Centella asiatica, Apiaceae) noted that, in India, gotu kola is commonly adulterated or substituted with bacopa and that both are sold commonly in Indian markets under the same vernacular name Brahmi:¹³

Although official Ayurvedic texts are clear that Brahmi is the Sanskrit name for bacopa (whole plant) while Mandukaparni is the Sanskrit name for gotu kola (whole plant), Mandukaparni is also the regional name used for bacopa in the Hindi and Kanada languages, respectively, and both plant materials are named Brahmi in the Urdu language, among other vernacular confusions. However, bacopa can be recognized easily by both morphological characteristics and chemical assay.¹³

History and Cultural Significance

Bacopa monnieri (synonyms: B. monniera, Herpestis monniera, Moniera cureifolia, Lysimachia monnieria, Gratiola monnieria, Bramia monnieri, and Bramia indica)^3,4,7,11,14 is commonly called Brahmi in Ayurvedic medicine,¹⁵ Jal Brahmi in Unani medicine,¹⁶ Pirammi Valukkai in Siddha medicine,¹⁷ and numerous vernacular names across the Indian subcontinent and beyond. The Sanskrit name Brahmi means “expands consciousness.”² Bacopa is called Brahmi in the following languages: Assamese, Hindi, Malayalam, Marathi, Oriya, Sanskrit, and Urdu (also called Jal Brahmi in Urdu). In Punjabi it is called Brahmibuti; in Tamil, Brahmi vazhukkai; and in Bengali, Brahmishak.

Bacopa is an important ingredient in several Ayurvedic preparations, and is considered a Rasayana herb (rasa: primordial tissue or plasma; ayana: path), which are believed to prevent aging, re-establish youth, prevent disease, promote healthy longevity, and strengthen life, brain, and mind.^2,3,7,11 The entire plant (including root) is used in traditional Indian medicine for a wide array of conditions. In the Ayurvedic system of medicine, bacopa is indicated for treating skin diseases, fever, edema, anemia, increased frequency and turbidity of urine, and psychological disorders.¹⁵ In Siddha medicine, it is used for constipation, painful urination (dysuria), edema, nervous debility, and poor memory,¹⁷ and in Unani medicine for treatment of brain and nervous weaknesses.¹⁶

The leaves in particular are used to treat asthenia (lack or loss of strength), nervous breakdown, threadworms, and other low adynamic conditions (those characterized by loss of strength or vigor).^3,4 A poultice made of the boiled plant (aerial parts and root) is used to treat children with acute bronchitis and other coughs.³ Both the fresh juice and a paste made of the leaves are applied topically to relieve the pain of inflamed joints, specifically that joint pain caused by arthritis.^10,11

In Nepal, the fresh juice is used to treat burns.⁷ The Bhil people of Rajasthan apply the boiled leaves to the abdomens of women who have recently given birth to relieve postnatal pain, and the warmed leaves are used as a poultice to relieve swelling.¹⁰

In Maharashtra, tribal inhabitants believe that stuttering can be improved by eating 5 leaves daily for a 1-month period.¹⁰

In countries where the Ayurvedic, Siddha, and/or Unani systems of medicine are part of the national healthcare system (e.g., Bangladesh, India, Malaysia, Pakistan, Sri Lanka), bacopa is regulated as an active ingredient of medicinal products and prescriptions. In Australia, the Therapeutic Goods Administration regulates bacopa as an active ingredient of listed medicines with approved Ayurvedic use statements including “Bacopa monnieri has a tradition of use in Ayurvedic medicine for weakness of memory. It may help normal memory function.”¹⁸ While it is not classified as generally recognized as safe (GRAS) for use in food products by the US Food and Drug Administration (FDA), it is acceptable as a dietary supplement component under provisions of the Dietary Supplement Health and Education Act of 1994.¹⁹ As such, quality standards monographs are available from the USP that provide specifications for the dried stems and leaves containing not-less-than (NLT) 2.5% of triterpene glycosides as well as the powdered extract of the stems and leaves at a 10–20:1 drug-to-extract ratio range.¹²

Modern Research

The primary chemical components in B. monnieri are alkaloids (brahmine and herpestine), flavonoids (glucuronyl-7-apigenin, glucuronyl-7-luteolin, luteolin-7-glucoside, and luteolin), and saponins (bacogenins, bacosides, and bacopasides), and bacopasaponins.^4,11,20,21 Additionally, the plant contains hersaponin, monnierin, and triterpines (betulic acid, bacosine, B-sitosterol, stigmastanol, and stigmasterol).¹¹

Bacopa has been found to have adaptogenic, anticancer, antidepressant, antioxidant, astringent, anxiolytic, cardiotonic, cholinergic (activated, stimulated, or transmitted by choline/acetylcholine), cognitive-enhancing, diuretic, mildly laxative, refrigerant, sedative, and vasoconstrictive properties.^3,11,22

Most of the recent clinical studies on bacopa investigated its effect on cognition, memory, anxiety, and/or depression in healthy volunteers (either elderly or of unspecified age) or in Alzheimer’s patients. In one 2011 open-label, prospective, uncontrolled, non-randomized study, 39 Alzheimer’s patients (60-65 years) were give 300 mg Bacognize^® (alcohol extract standardized by HPLC for 10-20% bacopa glycosides; Verdure Sciences, Noblesville, Indiana) twice daily for 6 months.²³ Patients showed significant improvements in various areas, including attention, orientation of person, place, and time, and in reading, writing, and comprehension.

A randomized, double-blind, placebo-controlled (RDBPC) study in 2010 investigated bacopa’s efficacy in improving memory performance in older healthy people.²⁴ Ninety-eight participants over 55 years of age were randomized to receive 300 mg/day BacoMind™ (20:1 alcohol extract standardized to contain 40-50% bacosides; Natural Remedies Pvt. Ltd., Bangalore, India) or placebo for 12 weeks. The bacopa group showed significantly improved memory acquisition and retention. An additional study on the safety of BacoMind resulted in no major adverse effects.²⁵

In 2008, Calabrese et al. studied the effects of a whole plant standardized dry extract of bacopa (methanol-extracted extract with a minimum of 50% bacosides A and B; MediHerb Pty. Ltd., Warwick, Queensland, Australia) on cognitive function and safety.26 In a RDBPC trial, each of 48 healthy participants, 65 years or older (mean 73.5 years), who completed the study were given either 300 mg once a day of the bacopa extract or placebo for 12 weeks. Over the course of the study, the bacopa group had improved delayed recall memory and Stroop task reaction times, while the placebo group experienced no change. The bacopa group also experienced decreased depression and anxiety while the placebo recipients increase in both. The authors concluded that the mechanism of action of the chemical agents needed further exploration.

In another 2008 RDBPC study, 62 healthy volunteers were given either 300 mg KeenMind^® (a dry extract standardized to at least 55% bacosides; Flordis Pty. Ltd, Crows Nest, NSW, Australia) or placebo daily for 90 days.²⁷ Participants underwent a cognitive assessment at baseline and at the end of the study. The bacopa group experienced significantly improved performance in spatial working memory accuracy.

Roodenrys et al. (2002) conducted a RDBPC study to test the effect of bacopa on anxiety and various memory functions.²⁸ Of the 76 healthy participants who completed the study (28 males and 48 females between 40 and 65 years of age), 37 were given 300 mg-450 mg KeenMind (based on body weight) and 39 were given placebo. Participants were tested before the trial began, at 6 weeks, and after the trial ended. Preliminary tests showed no differences between the groups but the KeenMind group experienced improved retention of new information in recall of word pairs in later testing. The authors posited that it was the antioxidant effect of bacopa on the hippocampus that was responsible for the improved retention.

In an earlier DBPC study, also using the KeenMind bacopa product, 46 healthy adults aged between 18 and 60 years took 300 mg daily of KeenMind or placebo for 12 weeks.²⁹ Participants were subjected to baseline neuropsychological testing and were retested at 5 and 12 weeks. The bacopa group experienced statistically significant changes in learning rate, information processing speed, and reduced anxiety at 12 weeks, but not at 5.

In a comparative study of bacopa and gotu kola in 1975, bacopa was shown to have significant psychotropic action as evidenced by excessive sleep, as well as changes in the brain and blood.³⁰ The authors observed what they considered to be a significant barbiturate hypnosis potentiation effect along with reductions in acetylcholine and cholinesterase content of the blood and brain tissue.

These findings are contrasted by a study done on a lower potency bacopa extract’s effects when combined with standardized Ginkgo biloba (Ginkgoaceae) leaf extract (Blackmores, Balgowlah NSW, Australia).³¹ This study showed no significant effects on cognition.

Future Outlook

Of the estimated 960 medicinal plant species that form the source of 1,289 botanical raw drugs in trade in India, bacopa is among the top 117 species whose annual domestic consumption exceeds 100 metric tons (MT). Ranking at number 19 in terms of volume, Indian domestic consumption of bacopa is estimated at 2,548 MT. In terms of trade volume and consumption, annual demand was estimated at between 2,000 to 5,000 MT in 2008. Most of the commercial supply is harvested from wild populations.⁵ CIMAP, Lucknow, has developed 3 varieties of bacopa named subodhak, pragyashakti, and CIM-jagriti, respectively, which can be cultivated as perennials with at least 2 harvests per year. The RRL (Regional Research Laboratory), Jammu, has also developed a cultivar with 1.8%–2.2% bacoside A content.⁶ The National Medicinal Plants Board (NMPB) of Government of India Ministry of Health and Family Welfare provides market prices for brahmi in its “Weekly Online Pricing System of Medicinal Plants” from various regional markets. Average local market prices in early 2011 have been ranging from about 45 to 95 Indian Rupees (INR) per kg (about USD $1.00-$2.13/kg).

—Gayle Engels and Josef Brinckmann

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