What are the recommendations for using Neuriva (phosphatidylserine and B vitamin complex) for cognitive support?

Neuriva for Cognitive Support: Limited Evidence and Not Recommended

Based on current clinical guidelines, Neuriva (containing phosphatidylserine and B vitamins) is not recommended for cognitive support as there is insufficient evidence supporting its effectiveness for improving cognitive function or preventing cognitive decline.

Evidence Assessment

Guideline Recommendations

• The European Society for Clinical Nutrition and Metabolism (ESPEN) explicitly recommends against using various supplements for cognitive enhancement in persons with dementia due to insufficient evidence 1
• ESPEN specifically does not recommend phosphatidylserine for cognitive decline, noting that studies have not observed significant results 2
• ESPEN does not recommend B vitamins (including B6 and B12) for prevention or correction of cognitive decline when there is no deficiency 2, 1

Research on Neuriva and Phosphatidylserine

• A 2023 manufacturer-sponsored study reported some improvements in specific cognitive tasks after 42 days of Neuriva supplementation compared to placebo 3
• However, earlier studies on phosphatidylserine show conflicting results:
  • A 2001 study found that soybean-derived phosphatidylserine did not affect memory or cognitive functions in older individuals with memory complaints 4
  • A 2003 review noted only "modest increases in recall of word lists" for phosphatidylserine in older adults with moderate cognitive impairment, with inconsistent benefits across other memory tests 5

Clinical Decision-Making Algorithm

1. Rule out nutrient deficiencies first

   • Test for specific vitamin deficiencies (B12, folate, vitamin D) before considering supplements
   • Only supplement specific nutrients when deficiencies are identified through appropriate testing 1

2. Consider evidence-based approaches instead

   • Focus on providing adequate essential nutrients through a balanced dietary pattern rather than supplements 1
   • Be aware of potential risks of high doses of supplements, which may have toxic effects 1

3. If patient insists on trying Neuriva:

   • Explain the limited evidence for efficacy
   • Monitor for any adverse effects
   • Set clear expectations about limited potential benefits
   • Consider discontinuation if no improvement after 1-2 months

Important Considerations and Caveats

• The most recent and highest quality evidence (clinical guidelines) consistently recommends against using supplements like phosphatidylserine for cognitive enhancement 2, 1
• While a recent manufacturer-sponsored study showed some positive effects of Neuriva 3, this single study does not outweigh the broader body of evidence and clinical guidelines
• There is a significant risk of placebo effect with cognitive supplements
• Money spent on unproven supplements might be better directed toward evidence-based interventions for cognitive health

Alternative Evidence-Based Approaches for Cognitive Health

• Regular physical exercise
• Cognitive stimulation activities
• Mediterranean diet or MIND diet
• Adequate sleep
• Management of cardiovascular risk factors
• Social engagement

In conclusion, while Neuriva contains ingredients that theoretically could support brain function, current clinical guidelines and the preponderance of evidence do not support its use for cognitive enhancement or prevention of cognitive decline.