Supplements for Memory Support — Focus on Prevagen
Betty Chaffee, PharmD, is owner and sole proprietor of BetterMyMeds, a Medication Management service devoted to helping people get the maximum benefit from their medications.
Where did I put my keys? Did I remember to lock the front door? Why did I come into this room?
I'm guessing everyone reading this can relate to at least one of those questions. No matter how old we are, we forget things sometimes. And it's true that as we age we may notice changes in our ability to recall or process information. Are these memory lapses normal or are they an omen of something more concerning?
Research shows that it's normal for healthy, older adults to experience some decreases in memory. But we may worry about it anyway. Understandably, we want our brains to remain as sharp as possible as we get older. And the dietary supplement industry is ready and willing to sell us products marketed to improve memory. We discussed dietary supplements in the prevention of dementia about a year and a half ago. But recently I've had several people ask me about Prevagen, which is being marketed pretty aggressively. Lots of people are seeing advertisements for this product and wondering If it really works. So while Prevagen isn't the only memory support supplement out there, it'll be the focus of this post.
Dietary Supplements and Memory Support
Let me start with a reminder that dietary supplements aren't regulated by the FDA in the same way that medications are. Manufacturers don't have to prove that a dietary supplement is effective for anything before putting it on the market. And since dietary supplements bring in lots of revenue, manufacturers have little incentive to perform expensive research studies that might show (or not) that their product is effective.
The labeling of dietary supplements has restrictions - for example, a label can't say the product prevents memory loss. But it CAN say it "supports memory". Marketing and advertising, though, are a different matter. Marketers are great at convincing us that we need their product, whether it's a floor cleaner or a dietary supplement. It's always on us to make sure we've weighed the evidence carefully before purchasing.
My favorite place to go for objective information about dietary supplements is the Natural Medicine Database. Information about supplements, including research that's been done, is analyzed by experts and summarized for health professionals. That same database is available to you, free of charge, at www.Rxlist.com, where the summaries are geared toward non-health professionals. You can learn about the uses of many supplements, as well as the dose, side effects, interactions, and lots more. Here's what that database and other expert publications have to say about Prevagen.
What is Prevagen?
The active ingredient in Prevagen is a chemical called "apoaequorin". Apoaequorin is a protein that was originally found in jellyfish. It's been studied for many years, for lots of different reasons. It turns out that apoaequorin is similar in structure to proteins in the human body that protect brain cells from damage. Researchers have theorized that apoaequorin might be able to slow or reduce memory loss and problems with processing information (cognitive decline).
The Research Behind the Marketing
It turns out that there has been some research to find out whether apoaequorin improves memory. You can find a summary of that research on the product's website. People who said they were concerned about their memory or thinking ability took either 10mg of Prevagen or a matching placebo daily for three months. The patients didn't know if they were getting the active drug; the researchers didn't, either. Specific types of tests were used to follow changes in memory or ability to think quickly. And the summary on their website states that Prevagen was proven to be effective.
But when experts in the field looked closely at the study methods, analysis, and results, they found real problems. The first was that the studies were designed, conducted, and analyzed by researchers working for Quincy Biosciences, the company who makes and sells Prevagen. They didn't use well-known, validated tests used to measure memory and thinking skills. And though the summary on the product website indicates that Prevagen was effective, when the study was published in a peer-reviewed journal, the results weren't so positive. The peer-review process is important, because other experts in the field can look objectively at study methods and results. Reviewers often catch problems in study methods or analysis that invalidate or modify the results. In this case, it appears that this research didn't meet expected standards, and the results stated on the website couldn't be supported.
As with so many dietary supplements, we need more research on apoaequorin. In contrast to the studies already done, new studies should be designed, carried out, and analyzed not by those who sell the product, but by researchers who don't have a stake in the outcome.
I'm not willing to say that Prevagen isn't effective - maybe further well-done research will show that it is. But I will say that the research doesn't support the marketing claims at this time.
Safety of Prevagen
On the other hand, though, apoaequorin has relatively few safety concerns. There are no known drug interactions. Side effects have been reported, but it's not clear whether they were actually due to the supplement or just coincidental. Overall it appears to be a relatively safe supplement.
So What's the Bottom Line?
Those of you who know me, know that when it comes to dietary supplements I have four categories.
Safe and effective- I encourage the use of supplements in this category.
Possibly unsafe, but effective - I talk about risks and benefits with patients who want to use supplements in this category
Possibly unsafe, and questionably effective -- I discourage the use of supplements in this category.
Safe, but questionably effective -- I talk with patients about the pros and cons of using supplements in this category.
In my mind, Prevagen falls into the last category. It seems pretty safe for most people, but it may not do anything to improve health or quality of life. And it can be costly -- a month's supply of Prevagen can cost $40-$60 or more. Of course, the decision to try it (or not) is an individual one.
Don't forget, though, that there ARE things you can do to keep your memory sharp and your thinking clear. Here are a few:
Stay physically active
Learn a new skill
Get enough sleep
Eat a healthy diet
Manage chronic health conditions
If you'd like to talk more about this issue (or any other medication or health-related subject!) contact us at Better My Meds. Or leave your comments for others to see in the space below.