Huperzine A

If you know about Alzheimer’s disease (AD), chances are you’ve heard about Aricept. Aricept is one of the few drugs approved for the treatment of AD, and it is generally the first drug prescribed after a patient is diagnosed with the disease. But did you know there is a natural version of Aricept?

Before describing the natural version, let’s briefly discuss what Aricept is and what it does. Aricept belongs to a class of drugs called [take a deep breath] acetylcholinesterase inhibitors, sometimes abbreviated [not much more helpfully] as AChEIs. This is quite a mouthful, but if we break it down, you can easily understand what these drugs do.

The brain is made up of specialized cells called neurons, and neurons send signals to one another using neurotransmitters. There are several different kinds of neurotransmitters, but one that is especially important for memory is acetylcholine. Patients with AD are known to have reduced levels of acetylcholine in their brains, a finding that prompted what is called the “acetylcholine hypothesis” of AD [1], which postulates that the memory loss in AD is due (at least partly) to the loss of neurons secreting acetylcholine.

If acetylcholine levels are reduced in AD, then boosting them should boost memory, right? This turns out to be correct. Importantly, it is also true for perfectly normal people who do not have AD. In other words, you don’t have to have AD to benefit from boosting acetylcholine levels.

So how do we boost acetylcholine levels? Well, one way is to create more of it. You may have heard of choline supplements. Choline is simply a precursor of acetylcholine, and supplementation with it is thought to increase acetylcholine levels (this idea remains controversial, however, as it does not enter the brain readily).

There is, however, another rather clever way accomplishing the same goal: by blocking the breakdown of acetylcholine. After neurons release neurotransmitters, they are rapidly removed and recycled for future use. Acetylcholine is removed by a specialized enzyme that chops it into pieces, known as [you guessed it] acetylcholinesterase. Aricept works by blocking this enzyme: that is, Aricept boosts acetylcholine levels by preventing it from being broken down.

It turns out that Aricept is not the only game in town. There are other AChEIs that can do the same job.  Importantly, some of these alternative AchEIs are derived from natural sources. One such “natural AchEI” is called Huperzine A, derived from a plant called Chinese club moss (Huperzia serrata). Huperzine A has been shown to have beneficial effects in animal models of AD [2], and several relatively recent meta-analyses of studies in humans, including patients with early AD, suggest that Huperzine A is both effective and well tolerated [3,4] (but please see precautions below).

With certain caveats, and provided certain precautions are taken, the AD Foundation recommends Huperzine A for the treatment of mild memory loss you might be experiencing (see precautions below). Please be sure to purchase the product from a reliable source and start with a low dose (50 mcg (micrograms) once per day, initially) to assess the potential for side effects.

IMPORTANT PRECAUTIONS:  Consult your physician before taking Huperzine A. It is a powerful drug that can cause side effects such as nausea and dizziness. Do not take Huperzine A if you’re already taking a prescribed acetylcholinesterase inhibitor, such as donepezil (Aricept), rivastigmine (Exelon) or galantamine (Razadyne). Taking both could increase your risk of serious side effects.

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  1. Wesson Ashford J. Treatment of Alzheimer’s Disease: The Legacy of the Cholinergic Hypothesis, Neuroplasticity, and Future Directions. J Alzheimers Dis. 2015;47(1):149-56. Link
  2. Ratia M, Giménez-Llort L, Camps P, Muñoz-Torrero D, Pérez B, Clos MV, Badia A. Huprine X and huperzine A improve cognition and regulate some neurochemical processes related with Alzheimer’s disease in triple transgenic mice (3xTg-AD). Neurodegener Dis. 2013;11(3):129-40. Link
  3. Xing SH, Zhu CX, Zhang R, An L. Huperzine a in the treatment of Alzheimer’s disease and vascular dementia: a meta-analysis. Evid Based Complement Alternat Med. 2014;2014:363985.  Link
  4. Yang G, Wang Y, Tian J, Liu JP. Huperzine A for Alzheimer’s disease: a systematic review and meta-analysis of randomized clinical trials. PLoS One. 2013 Sep 23;8(9):e74916. Link