In some trials, Bacopa monnieri was studied as a combination supplement, with the goal of enhanced therapeutic benefits. Bacopa monnieri has been used alongside a number of other herbs and vitamins, with mixed results. For example, a 4-week trial combining 300 mg of bacopa monnieri with 120 mg of ginkgo biloba found no improvements in any cognitive outcomes when compared to placebo, but the study was relatively short in duration and may not have used an optimal dose of ginkgo biloba.[1] Conversely, a 2-month pilot study examining a nutraceutical containing 320 mg of Bacopa monnieri, 100 mg of L-theanine, 30 mg of saffron, 2 mg of copper, and some vitamins (9.5 mg of vitamin B6, 450 mcg of biotin, 400 mcg of folic acid, 33 mcg of vitamin B12, and 25 mcg of vitamin D), reported cognitive improvements with supplementation in participants with cognitive impairment.[2]
Bacopa monnieri is also used in two polyherbal formulations. Protandim is combination supplement made up of ashwagandha, Bacopa extract, green tea extract, silymarin, and curcumin.[3] Perment is a combination supplement made up of Bacopa monnieri, ashwagandha, butterfly pea, and Asparagus racemosus.[4] There is little research on either of these polyherbal supplements. It is possible they provide more benefit than Bacopa on its own, but, without well-designed human trials, it is difficult to determine their clinical efficacy.
Bacopa monnieri may also work synergistically with rosemary. One in vitro study found that Bacopa monnieri in combination with rosemary (Rosmarinus officinalis) had stronger antioxidant effects than either supplement on its own.[5] Similarly, a study using a rat model of Alzheimer’s disease found that oral administration of Bacopa monnieri and Rosmarinus officinalis could have neuroprotective effects.[6] There is no human evidence to support these findings.
Keep in mind that although there is nothing inherently wrong with combination supplements, it is a challenge to deduce which components of these supplements are actually causing any beneficial effects. Thus, any benefits cannot be directly attributed to Bacopa monnieri.