Huperzine A: benefits, dosage, contraindications

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Huperzine A, an alkaloid derived from the clubmoss Huperzia serrata, a fern native to China, is renowned for its centuries-long use in traditional Chinese medicine under the name "Qian Ceng Ta". Historically, it has been used to treat various conditions, including memory disorders and inflammation. Huperzine A effectively crosses the blood-brain barrier and acts as a selective, reversible, and competitive inhibitor of acetylcholinesterase (AChE), an enzyme that catalyzes the breakdown of acetylcholine, a neurotransmitter essential for cognitive functions and memory. Acetylcholine plays a key role in modulating neuronal activity and intercellular communication in the nervous system. By inhibiting AChE, Huperzine A prevents the breakdown of acetylcholine, thereby increasing its availability and potentially improving cognition and memory function. This property makes Huperzine A particularly relevant for the treatment of neurodegenerative diseases such as Alzheimer's disease, where cholinergic deficiency is evident. Clinical studies and in vitro research have shown that Huperzine A may play a protective role against neurodegeneration by interacting with molecular pathways that modulate amyloid deposits and the formation of plaques characteristic of Alzheimer's disease. In addition to its cholinergic effects, Huperzine A has demonstrated mitochondrial protective capabilities and modulation of phosphorylated tau proteins, thereby contributing to its ability to improve symptoms of Alzheimer's disease. Approved in China as a drug of choice for the treatment of Alzheimer's disease and available as a dietary supplement in France, Huperzine A continues to be the subject of in-depth research to fully assess its therapeutic potential and clinical applications.

Other name(s) 

Huperzia serrata

Scientific name(s)

Huperzine A

Family or group: 

Phytochemicals


Indications

Scoring methodology

EFSA approval.

Several randomized, double-blind, controlled clinical trials (> 2), including a significant number of patients (>100), with consistently positive conclusions for the indication.
Several randomized, double-blind, controlled clinical trials (> 2), including a significant number of patients (>100), with positive conclusions for the indication.
One or more randomized studies, or several cohorts or epidemiological studies, with positive conclusions for the indication.
Clinical studies exist but are uncontrolled, with conclusions that may be positive or conflicting.
No clinical studies to date that can demonstrate the indication.


Alzheimer's disease
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The meta-analyses of clinical studies, mainly conducted in China where huperzine A is approved for the treatment of Alzheimer's disease, show that huperzine A administered at doses of 200 to 800 mcg divided into 2-3 daily doses over 8 to 36 weeks improves cognitive function, measured by the Mini-Mental State Examination (MMSE). However, the results are inconsistent with other scales. Meta-analyses also indicate an improvement in overall behavior and performance in activities of daily living compared with placebo. A clinical trial in the United States showed that huperzine A at 200 mcg twice daily for at least 16 weeks does not improve cognition measured by the ADAS-Cog in patients with mild to moderate Alzheimer's disease, but provides a modest benefit on the MMSE. A higher dose of 400 mcg twice daily shows a modest benefit on both scales. Long-term, large-scale clinical trials are needed to confirm these results.

Posologie

posologieOral

posologie200 - 500 µg

duration6 months


Cognitive performance
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Huperzine A has shown promising results in strengthening cognitive functions across various clinical studies. In a study conducted on Chinese adolescents, daily administration of 100 micrograms of Huperzine A for four weeks significantly improved memory quotient scores compared with placebo. Another, more recent, randomized, placebo-controlled Phase II study aimed to evaluate the efficacy of Huperzine A for improving memory and learning in individuals who had suffered moderate to severe traumatic brain injury. Participants were randomly assigned to receive either Huperzine A or placebo for 12 weeks, and were assessed using the California Verbal Learning Test – 2nd Edition (CVLT-II). The results indicate that there was no significant difference in memory performance between the Huperzine A and placebo groups after 12 weeks of treatment.

Posologie

posologieOral

posologie100 - 300 µg

duration12 weeks


Properties


Neurological

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Huperzine A is widely studied for its benefits on cognitive and neurological functions. It acts mainly as an acetylcholinesterase inhibitor (AChE), an enzyme that breaks down acetylcholine, a neurotransmitter essential for memory and information processing in the brain. By blocking this enzyme, Huperzine A increases the levels of available acetylcholine, which improves communication between neurons, particularly in the frontal and parietal cortices, areas crucial for thinking and planning.nnIn comparison with other drugs such as tacrine (Cognex) or donepezil (Aricept), also used in the treatment of Alzheimer's disease, Huperzine A proves to be more specific for AChE and has a longer duration of action. nnFurthermore, Huperzine A is recognized for its neuroprotective effects. It helps protect nerve cells against oxidative stress and damage induced by the beta-amyloid peptide, often associated with Alzheimer's disease. This protection is partly due to its antioxidant and anti-apoptotic action, downregulating genes that promote apoptosis, or programmed cell death. In addition, Huperzine A stimulates the production of nerve growth factor and its receptors, thereby supporting neuronal survival and repair. nnThese mechanisms of action give Huperzine A significant therapeutic potential, particularly in the treatment of neurodegenerative diseases such as dementia and Alzheimer's disease.nn

Usages associés

Alzheimer's Disease, Cognitive Performance


Safe dosage

Adult: 200 µg - 800 µg

Huperzine A has been used in clinical trials lasting up to 6 months.


Interactions

Médicaments

Anticholinesterases: minor interaction

Huperzine A has inhibitory effects on acetylcholinesterase. Theoretically, huperzine A could reduce the effects of anticholinergic drugs.

Cholinergics: moderate interaction

In theory, concurrent use of huperzine A and cholinergic drugs may increase the side effects of these medications.


Precautions

Pregnant women: avoid

Insufficient data, avoid as a precaution.

Breastfeeding women: avoid

Insufficient data, avoid as a precaution.nn


Contraindications

Epilepsy: contraindicated

In theory, huperzine A could exacerbate seizure disorders. nn

Intestinal obstruction: contraindicated

Theoretically, huperzine A could worsen gastrointestinal obstruction due to its pro-secretory effects.nn

Gastric ulcer: contraindicated

Theoretically, huperzine A could worsen gastroduodenal ulceration due to its pro-secretory effects. Huperzine A inhibits acetylcholinesterase (AChE) and may cause cholinergic adverse effects due to increased gastric acid secretions.nn