Can Huperzine A Help Treat Alzheimer's Disease?

Doctors are naturally skeptical of alternative treatments — most of these compounds have never undergone formal clinical trials, and they may never have been proven to be effective, or even safe.

True, many medications we now rely on are derived from natural compounds, but will typically cost more compared to the alternative options. One such compound goes by the name of huperzine A.

What exactly is huperzine A? 

Huperzine is a compound with similar properties as gold-standard medication therapies for Alzheimer's — donepezil and rivatigmine. These cholinesterase inhibitors are typically used as a first-line treatment for Alzheimer's and dementia.

They work by blocking an enzyme called cholinesterase that is responsible for the digestion of Acetylcholine. If you aren't quite sure what Acetylcholine is, it's the compound responsible for nerve conduction and transmission. When a neuron communicates with another neuron to send a signal, such as to move a muscle, it releases Acetylcholine to transmit the signal.

As the brain begins to deteriorate, like in Alzheimer's disease, these pathways are unable to function as smoothly as they once did and the acetylcholine is unable to find the neuron to continue the message.

That is why doctors like to prescribe acetylcholinesterase inhibitors. The idea behind these types of drugs is to block the destruction of acetylcholine so it has a chance to bind to the next neuron. By blocking the digesting enzyme for a few fractions of a second, more acetylcholine will be able to bind onto the next neuron, and messages will still be transferred from one neuron to another.

As you can imagine, the message will still not be transferred as smoothly, but at least someone will be able to function independently. Patients may have shakier movements and fine motor skills will be nearly impossible, but they are still are able to do most things by themselves.

Can huperzine A be an effective treatment for Alzheimer's disease? 

Since huperzine A targets the same mechanisms as the gold-standard therapy currently on the market for Alzheimer's, it stands to reason that it could be a viable option to treat patients. The application of this alternative therapy has been put to the test in multiple different studies. The results thus far have been inconclusive. 

As of now, a few larger studies are in progress to determine whether huperzine could be an effective agent with a more controlled study design. These results are expected in the next few months so at that time, perhaps a more clear-cut recommendation can be given with supporting evidence. 

At this time, I would caution against using huperzine — it has not been fully tested to understand potential risks and side effects. It seems that the drug is well-tolerated in the small group of patients it has been tested on already, but when thousands of participants are tested instead of a few hundred, it is much more likely for undesirable side effects to manifest. 

Another fact that forces me to presently advise against taking this alternative therapy is that there is a very similar agent on the market already that has undergone clinical testing and has been proven to work.

I understand those who feel that doctors automatically dismiss alternative agents without any consideration and in reality, in some cases, alternative therapies may provide better results for patients without some of the bothersome side effects of traditional pharmacology. In this particular example, however, most acetylcholinesterase inhibitors on the market will have similar side effects of nausea and stomach pain as seen in huperzine.

The difference is that these drugs are a pure form of the medication, because they have undergone processing so a patient would only need to have a smaller dose of the drug compared to an alternative option to create the same effect. 

The last reason that I am hesitant to ever recommend a patient an alternative therapy when a medication is available that does the same thing is because of the potential ingredients that these alternative therapies could contain. Medications that are sold with a prescription are thoroughly tested and doctors know exactly what is in them.