24 h retention. Assessment of turnover of
biogenic amines (norepinephrine, dopamine,
and serotonin) showed significant reductions
of these amines and their metabolites in the
brain following oral administration of a fresh
juice (1 mL¼0.38 g fresh leaves), at a dose of
0.18 g/kg for 15 days. The decrease of amine
levels was correlated to improved learning
and memory in rats.^18 The nootropic effect
(enhancement of cognition, learning, and
memory) ofC. asiaticaaqueous extract was
further demonstrated in twoin vivoexperi-
ments in rats and mice.19,20
C. asiaticahas an antioxidant effect that
directly impacts its usefulness as a neuropro-
tective nerve tonic, nootropic agent, and in
wound healing (mentioned above) and cardio-
myopathy.11,21–24
Awater-soluble fraction was shown to have
an antianxiety effect in animals comparable to
diazepam and to inhibit hepatic enzymes re-
sponsible for barbiturate metabolism, and
hence may prolong pentobarbitone-induced
sleep.^25 The same effect was exhibited by the
methanolic and ethyl acetate extracts as well
as by asiaticoside in a number of rat behavioral
models.^26
Other reported activities include anti-in-
flammatory, CNS-depressant, anticonvulsant,
antidepressant, and analgesic;^4 antitumor;2,27
immunomodulatory;^28 radioprotective;^29 and
to improve circulation in microangiopathy.30–
(^32) The chemistry, pharmacology, and clinical
applications of C. asiatica have been
reviewed.^33
TOXICOLOGY
Three cases of hepatotoxicity and jaundice
due toC. asiaticahave been recently reported.
Treatment with ursodeoxycholic acid and dis-
continuation of C. asiatica resulted in a
marked improvement in all patients.^34
USES
Medicinal, Pharmaceutical, and Cosmetic.
Oralextracts,injectableextracts,andointments
standardized to asiaticoside have been used
successfully in India for the treatment of mal
perforant lesions in leprosy patients; in Europe
used clinically for leg ulcers in postphlebitic
patients (injectable extract); accelerating
healing of superficial postsurgical wounds;
inhibitinghypertrophicformationofscartissue
in the treatment of second- and third-degree
burns; and general use in wounds, ulcer, and
scleroderma.^1
Leaf extracts used in cosmetics, including
hand creams and lotion, hair conditioners, and
shampoos.
Food. In Bangladesh, Thailand, and Sri Lan-
ka,theleavesaresoldasaleafyvegetable,richin
digestible protein, carotene, and vitamin C.^35
Dietary Supplements/Health Foods. In the
United States, various gotu kola leaf prepara-
tions or crude leaves are sold as dietary sup-
plements in the form of tablets, capsules,
tincture, standardized extracts, tea, and so on,
used for memory improvement; topically for
the treatment of wounds (WEISS;WREN).
Traditional Medicine. In Chinese folk med-
icine, a decoction of the whole aboveground
herb is used for treatment of colds, sunstroke,
tonsillitis, pleurisy, urinary tract infections,
infectious hepatitis, jaundice, and dysentery;
as an antidote for arsenic poisoning, poisoning
byGelsemium elegans, and toxic mushrooms;
external poultice for snakebites, scabies, trau-
matic injuries, and herpes zoster (JIANGSU).
In India, used as a folk remedy for leprosy,
lupus, syphilis, tuberculosis, improving men-
tal function, and others (CSIR II).
In Uttar Pradesh, fresh leaf juice used
externally for elephantiasis, inflammations,
swelling; whole plant decoction used for skin
diseases, such as itching and fungal infections,
chronic rheumatism, amenorrhea, and as
‘‘blood purifier.’’^36
In East Africa, leaf used for fevers, bowel
complaints, and syphilitic and scrofulous con-
ditions; in Central Africa, widely used as a
folk medicine, particularly for leprosy (WATT
AND BREYER-BRANDWIJK).
340 Gotu kola