Bacopa monnieri is a botanical frequently used in Ayurvedic medicine. https://www.ncbi.nlm.nih.gov/books/NBK589635/

Bacopa is used in Ayurvedic Medicine for anxiety, insomnia, memory improvement and dementia prevention and treatment. Many clinical studies using Bacopa have shown that it may improve memory, verbal learning, and word recall.

Bacopa can be found in Ayurvedic medical texts as a treatment  to improve mental health generally, to improve memory, and to promote rejuvenation and longevity.[3][2]  It is also used as an anti-anxiety treatment and for insomnia, and seizure disorder.[6] Clinical studies have documented improvements in word recall testing, verbal learning, memory acquisition, as well as reducing measured anxiety with standard psychological evaluation tests. Bacopa is called a “calming cognitive enhancer.”

Bacopa is used  in combination with the herb Gotu Kola (Centella asiatica). Bacopa and Gotu Kola possess neuroprotective properties and are being used for patients with memory loss.[2]  There have been a number of studies which have shown their beneficial effects on cognition, verbal learning, word recall, and memory acquisition.

Bacopa is generally well-tolerated with only minor temporary GI side effects.

Research Studies on Bacopa Monnieri

A randomized control trial of 17 study subjects published in 2014 showed that Bacopa monnieri made a significant difference when administered for cognitive performance enhancement. They noted statistically significant improvement in mental arithmetic, letter search, visual tracking, improved mood, and it decreased the cortisol response from stress. The best effect for cognitive enhancement was observed with a daily dose of 640 mg .[8]  Improvement in anxiety may be shown with a 300mg dose.[9]

Nine randomized controlled trials studying over 400 subjects were the subject of a meta analysis which documented improved speed of attention and cognition and a decreased reaction time. [10] In another randomized, double-blinded, placebo-controlled study of adult patients given 300 mg standardized extract of either Bacopa or placebo, showed that the treated group demonstrated enhanced delayed word recall memory relative to placebo.[11]Measurements were obtained at the start and at the conclusion of another 12 week study period evaluating the tasks of attention, memory, and psychological state-it also showed the efficacy of Bacopa.

In yet another study of 81 adults 55 years and older, memory acquisition reported that after a 12-week period of the use of Bacopa significantly improved memory acquisition and retention in healthy older Australians.[12]

Bacopa has shown to have anti-anxiety effects both in people with cognitive decline and in healthy adults. Bacopa, in combination with Gotu kola (Centella asiatica), has also been documented to be effective to significantly reduce general anxiety symptoms.[14][15]

How Does Bacopa Work?

Bacopa supports GABA production, which reduces neuron excitability, and thus improves rapid response decision-making.[2] GABA (Gamma-aminobutyric acid) is the  neurotransmitter that creates a calming effect in the brain. Bacopa monnieri has been shown to increase GABA by enhancing the GABA A receptor.[38]

Possible mechanisms which may lead to cognitive improvement and its effect in early dementia, are its modulation of acetylcholine release, cholinergic receptor binding, and choline acetylase activity.[15][31] 

Bacopa monnieri pharmacological actions, include its efficacy functioning as an  antioxidant, anti-inflammatory and  anticonvulsant treatment.[27][28][25] The cognition-enhancing properties of Bacopa are felt to be from the substances called  saponins or bacosides. Purified bacosides A and B, and bacopa alcoholic extract, facilitated learning ability, memory, and cognitive performance.[30]   Research has suggested a number of possible mechanisms of action, including acetylcholinesterase inhibition, beta-amyloid reduction, choline acetyltransferase activation, and increased cerebral blood flow, as well as monoamine potentiation.[1]

 The neuroprotective aspect of Bacopa has been repeatedly studied. Bacopa protects against oxidative damage in both the cell cytosol and in the  mitochondria in all brain regions.[33]  Reduced glutathione which may become depleted due to oxidative stress.[36] Bacopa has been shown to increase the level of reduced glutathione.[37]  

The typical doses for Bacopa used in traditional medicine range from 300 to 450 mg per day. Bacopa can be used for children from 6-12 years of age at a dose of 225 mg per day. [39]

Adverse Effects

Bacopa monnieri is generally well-tolerated. The most common side effects are gastrointestinal, – increased stool frequency, nausea, and abdominal cramps. These  may be temporary and resolve dosage adjustment  and/ or being taken with food.

CAUTION: Animal research has shown that Bacopa may increase the level of the thyroid hormone thyroxine (T4) in mice. It should be used cautiously, or avoided in those with a thyroid condition, taking thyroid hormone medication.[42]