Theyrecommend prevention measures and provide medical advice to help people live without physical and mental illness.Types of Ayurvedic booksIf you are a beginner in Ayurveda, you should know that there are two types of books:Old books written in classical (ancient, Vedic) Sanskrit or some of the Indian languages derived from it.New books written in local languages or in English, accessible to ordinary people.Below we talk about the original Ayurvedic texts, which provide the basis and knowledge needed to create all modern versions.History of Ayurvedic booksThe Vedas are the oldest written document known to mankind, and Ayurveda developed significantly during the Vedic period.
Bacopa monnieri (often called brahmi) is a botanical frequently used in Ayurvedic medicine. The main indications for using Bacopa in Ayurvedic medicine are memory improvement, insomnia, epilepsy, and as an anxiolytic. Many clinical studies have demonstrated improvements in verbal learning, delayed word recall, memory acquisition, and anxiety reduction with using Bacopa. It has been described as a calming cognitive enhancer. The triterpenoid saponins are believed to be responsible for most of the herb's pharmacological actions. Bacopa has a high therapeutic index and is generally well-tolerated. The most common side effects are gastrointestinal, including increased stool frequency, nausea, and abdominal cramps. This activity reviews the indications, contraindications, activity, adverse events, and other key elements of the clinical use of the herb Bacopa monnieri in the care of patients with declining cognitive performance and anxiety.
Objectives:Describe the clinical indications for the use of the botanical Bacopa monnieri.Discuss possible mechanisms of action for Bacopa monnieri.Review adverse effects and contraindications for the use of Bacopa monnieri.Summarize the clinical studies on the effectiveness of Bacopa monnieri in improving cognitive performance, verbal learning, delayed word recall, memory acquisition, and decreasing anxiety.Access free multiple choice questions on this topic.
Bacopa monnieri is a medicinal creeping perennial in the Scrophulariaceae family with small oblong leaves and white to purple flowers frequently used in ayurvedic medicine. Other names for this herb include brahmi, water hyssop, thyme-leaved gratiola, and the herb of grace.[1] Brahmi is derived from Hindu mythology meaning "Brahma," or the "supreme creator." [2] The term Brahmi has been used to describe Bacopa monnieri,Centella asiatica (Gotu kola), or a combination of the two botanicals.[2]
Bacopa is native to India, Indochina, Australia, and Sri Lanka. The leaves are used medicinally and contain triterpenoid saponins (Bacoside A, bacoside B, bacopasaponins, D-mannitol, acid A, monnierin), alkaloids (brahmine, nicotine, herpestine, hydrocotyline), flavonoids (luteolin, apigenin), glycosides (asiaticoside, thanakunicide), Phytochemicals (betulinic acid, betulic acid, wogonin, oroxindin, stigmasterol, beta-sitosterol), sapogenin (jujubacogenin, pseudojujubacogenin) and other compounds (Brahmic acid, brahamoside, brahminoside, isobrahmic acid.)[3] The saponins are believed to be responsible for most of the pharmacological actions.[4][5]
Its use has been documented in the Ayurvedic text "Caraka Samhita" as a treatment for various mental conditions.[4] Ayurvedic medicine describes Bacopa as a "medhya rasayana," meaning a class of herbs believed to improve mental health, memory, and intellect and promote rejuvenation and longevity.[3][2] The main indications for using Brahmi in Ayurvedic medicine are memory improvement, insomnia, epilepsy, and as an anxiolytic.[6] Many clinical studies demonstrate improvements in verbal learning, delayed word recall, memory acquisition, and anxiety reduction with Bacopa. It has been described as a calming cognitive enhancer.
Bacopa can be used on its own or in combination with other nootropic herbs such as Gotu Kola (Centella asiatica). Bacopa monnieri and Centella asiatica both possess neuroprotective properties and have nootropic activity with therapeutic uses for patients experiencing memory loss.[2] Gotu kola is used in Ayurvedic medicine and in combination with other herbs in traditional Chinese medicine to combat symptoms of anxiety and depression.[7] In human studies, Bacopa has demonstrated beneficial effects on cognitive performance, verbal learning, delayed word recall, memory acquisition, and decreasing anxiety. The FDA's position is that Bacopa monnieri products are not approved for any medical purposes, and in 2019 issued a warning to dietary supplement manufacturers who produce products containing Bacopa monnieri regarding making any therapeutic claims about the herb.
Bacopa monnieri functioning as a cognitive performance enhancer was demonstrated in a small (17 patient) randomized control trial published in 2014. They noted statistically significant improvement in cognitive performance (mental arithmetic, Stroop, letter search, visual tracking), improved mood, and a decreased cortisol response from stress after one dose of Bacopa (320 mg and 640 mg). A stronger effect was observed with the 640 mg dose.[8] In contrast, another small study (30 subjects) evaluated a daily dose of 450mg over a 12-week period in healthy adults, which demonstrated no significant change in cognitive testing scores (learning and memory, information processing), but a trend for decreased anxiety in the Bacopa group.[9]
A meta-analysis incorporating nine randomized controlled trials (437 subjects) demonstrated an improved speed of attention and cognition and decreased reaction time.[10] In a randomized, double-blinded, placebo-controlled study, patients (54 adults) were given a 300 mg standardized extract of either Bacopa or placebo. Measurements were obtained by evaluating tasks of attention, memory, and psychological state at baseline and following a 12-week trial. The treated group demonstrated enhanced delayed word recall memory scores and increased ability to ignore irrelevant information (Stroop's test) relative to placebo.[11]
In a study of memory acquisition, there was a randomized, double-blinded study (81 adults 55 years and older) that reported a 12-week cycle of Bacopa significantly improved memory acquisition and retention in healthy older Australians.[12] A meta-analysis incorporating results from six studies with 12 weeks or greater duration found that Bacopa improved memory-free recall but did not improve other aspects of cognition. These studies used a 300 to 450 mg dose of Bacopa extract standardized to 10 to 20% bacopa glycosides [13].
Bacopa has shown anxiolytic effects in people with cognitive decline. Bacopa, in combination with Gotu kola (Centella asiatica), has been shown in double-blind, randomized clinical trials to effectively reduce general anxiety symptoms.[14][15]
In a study on male albino mice, Bacopa monniera extract was administered along with phenytoin in the second week of a two-week trial. There was a significant reversal of phenytoin-induced cognitive impairment with improved acquisition and retention of memory and no effect on the anticonvulsant activity.[16] Some animal studies suggest a benefit from Bacopa monnieri for Alzheimer disease,[3][17] epilepsy,[18][19] Parkinson disease,[20][21] and cerebral ischemia/infarct.[22][23][24] It has been shown to cure gastric ulcers in animals and have anti-Helicobacter pylori activity in human colonic tissue.[25][26]
Bacopa monnieri has many pharmacological actions, including antioxidant, anti-inflammatory, anticonvulsant, cardiotonic, bronchodilator, and peptic ulcer protection.[27][28][25] The leaf powder of Bacopa has been shown to have antioxidant effects.[29] The cognitive-enhancing properties of Bacopa are likely from the presence of a group of saponins collectively referred to as bacosides. Purified bacosides A and B, as well as bacopa alcoholic extract, may facilitate learning ability, memory, and cognitive performance.[30]
Some possible mechanisms which may lead to cognitive improvement include modulation of acetylcholine release, muscarinic cholinergic receptor binding, and choline acetylase activity.[15][31] The saponins in Bacopa modulate hypothalamic-pituitary-adrenal (HPA) axis output and protect the hippocampus. Bacopa causes an anti-inflammatory effect on activated microglial cell cultures.[32] The microglial cells respond to any injury by transforming into either a neuroprotective or neurotoxic phenotype that releases pro-inflammatory cytokines.
In one study, tea, infusion, and alkaloid extracts of Bacopa, as well as bacoside A administration, was shown to significantly inhibit the release of TNF alpha and IL-6 from activated N9 microglial cells in vitro.[32] Other research demonstrates several mechanisms of action, including acetylcholinesterase inhibition, beta-amyloid reduction, choline acetyltransferase activation, increased cerebral blood flow, and monoamine potentiation.[1] Many neuroprotective aspects of Bacopa have been studied.
Bacopa has been reported to protect against oxidative damage via decreased protein carbonyl levels in both cytosol and mitochondria in all brain regions.[33] There is evidence of the inhibitory activity of Bacopa in the prevention of lipid peroxidation in the prefrontal cortex, striatum, and hippocampus of rats.[34] In the presence of free radicals, the first line of defense is the antioxidant superoxide dismutase, which increases with oxidative stress. One study reported decreased superoxide dismutase activity to normal levels in treated diabetic rats. This suggested homeostasis between the oxidant and antioxidant species.[35] Reduced glutathione was significantly depleted in diabetic rats compared to non-diabetic rats due to oxidative stress.[36] Bacopa has been reported to increase the level of reduced glutathione.[37]
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