Label Review

cogniZINE™

Package Information

"For Absentmindedness"

"...when the mind is tired, performance can be compromised....a natural energizer that can help keep body and mind alert and responsive."

"...preserves healthy levels of acetylcholine by supporting its production and release."

Suggested Use

"Take two (2) tablets per day, one (1) in the morning upon awakening and one (1) prior to bedtime."

Supplement Facts

Serving Size: 1 Tablet

Servings Per Container: 60

Amount Per Serving % Daily Value

Folic Acid 200 mcg 50

Vitamin B-12 (as cyanocobalamin) 6 mcg 100

DMAE (dimethylaminoethanol from DMAE bitartrate) 50 mg *

Panax ginseng root standardized extract (provides 5 mg ginsenosides) 125 mg *

Huperzine A (from standardized Huperzia serrata leaf extract) 50 mcg *

L-Tyrosine 75 mg *

Bioperine® (standardized piperine from Piper nigrum fruit) 2.5 mg *

*No Daily Value Established

AMERIFITTM, 166 Highland Park Drive, Bloomfield CT 06002

Price: $14.89, 60 coated tablets (a 15-day supply when used as suggested)

Comments by Cydney E. McQueen, PharmD:

Both folic acid and vitamin B12 are essential to proper nerve functioning. Clinical trials have shown improvement in memory and cognitive function in very aged subjects with nutritional deficiencies, but no evidence was found to support improved memory in younger, healthy adults.

DMAE serves as a precursor to the neurotransmitter, acetylcholine. The p-acetamidobenzoate salt form (deanol) enzymatically metabolizes to phosphatidyl choline. Clinical studies in patients with Alzheimer’s, dementia, various dyskinesias, and hyperkinetic children have had differing results. Those with some positive results used doses of 0.9-2 g/d. Few studies have specifically looked at memory effects; one demonstrated minor improvement in senile patients. DMAE side effects include headache, vivid dreams, dyskinesia, drowsiness, increased BP, and cholinergic symptoms.

Panax ginseng, has complex pharmacological action—some components have CNS stimulating activity, others are CNS depressants. Some human studies have shown improvement in memory and cognitive performance in both healthy and debilitated patients. Ginseng affects adrenal, pituitary, and thymus glands. It is usually well tolerated, but a few reports exist of serious adverse events. Ginseng can prolong thrombin time and aPTT, thereby interacting with warfarin therapy.

Huperzine A, an alkaloid from an extract of Huperzia serrata, is a potent and selective acetylcholinesterase inhibitor. The dosage used in a clinical trial in patients with senile, presenile, and multi-infarct dementia with positive results was 50 mcg bid. Side effects reported have been mild (dizziness) to none.

L-tyrosine is a precursor to epinephrine, norepinephrine, and dopamine. A recent study on military cadets demonstrated benefit on cognitive function, task performance and memory, using 10 g/d. Other studies with minor positive results have used 150 mg/kg/d doses. A dose of 150 mg/d is unlikely to provide any benefit.

Piperine is extracted from ordinary pepper. It increases bioavailability of many drugs due to increased membrane permeability and non-selective inhibition of CYP 450 isoenzymes. Examples from published data include increased blood levels of propranolol and theophylline when given with piperine 20 mg daily.

The vitamin and tyrosine doses may or may not provide any benefit, but are certainly within safe ranges. Increased acetylcholine may aid patients with disease states involving decreased levels, but has not been shown to aid memory in otherwise healthy adults. Patients on prescription drugs may experience increased side effects due to higher blood levels. Recommend avoiding use by patients with hypertension or on warfarin or anticholinergic therapy.