The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    Huperzine A treatment of Alzheimer’s disease

    Most drugs used to treat Alzheimer’s disease are classified as cholinesterase inhibitors.


    Researchers in California and Washington DC studied huperzine A, a natural cholinesterase inhibitor derived from the Chinese herb Huperzia serrata.


    First, the details.

    • 210 people with mild to moderate Alzheimer’s disease were randomly assigned to a treatment group for at least 16 weeks.
      • Placebo
      • Huperzine A 200 mcg taken twice daily
      • Huperzine A 400 mcg taken twice daily
    • The cognitive effects of huperzine A 200 mcg at week 16 were compared to placebo.
    • Also, the effects of huperzine A 400 mcg were evaluated using a battery of tests.


    And, the results.

    • Huperzine A 200 mcg twice daily showed no effect.
    • Huperzine A 400 mcg twice daily showed significant improvement in ADAS-Cog at 11 and 16 weeks vs a decline with placebo group.
      • ADAS-cog is the most popular cognitive test used in research.
    • Changes in clinical global impression of change using the Neuropsychiatric Inventory (NPI) and activities of daily living were not significant at either dose.
      • NPI is a tool to assess psychopathology in patients with dementia and other neuro-psychiatric disorders.


    The bottom line?

    In this “dose-ranging study,” the primary endpoint of the research was any response to huperzine A 200 mcg. Based on this the authors concluded, “The primary efficacy analysis did not show cognitive benefit with huperzine A 200 mcg twice daily.”


    Any future research is likely to focus on the 400 mcg twice daily dose.


    A review from 2008 by researchers at the Mayo Clinic, in Rochester, Minnesota, listed several characteristics of huperzine A that suggest it might be beneficial in these patients.

    • A potent, reversible, and selective inhibitor of acetylcholine esterase
    • Rapid absorption and penetration into the brain in animal studies.
    • Compared to the current cholinesterase inhibitors, huperzine A has a longer duration of action.
    • Some studies suggest better tolerability due to fewer peripheral cholinergic side effects.
    • Animal data and clinical safety tests to date have not identified any unexpected toxicity.
    • Gastrointestinal complaints have been reported.


    4/19/11 18:59 JR

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