Of the 30 species in the Rhodiola genus, R. rosea has been the most extensively studied. The following discussion draws on decades of Soviet research (Saratikov and Krasnov 1987), based on translations by Zakir Ramazanov (personal written communication, July 2001). (For reviews, see Brown and Gerbarg 2002; Brown et al. 2004, 2009; Petkov et al. 1986). Root extracts of R. rosea have been approved for medicinal uses in the Russian pharmacopoeia since the 1960s. Soviet investigators observed therapeutic effects (improvements in energy, alertness, cognitive function, and memory) in posttraumatic and vascular brain lesions, especially in early postinjury stages (Saratikov and Krasnov 1987). Rhodiola species contain many compounds that scavenge superoxide and hydroxyl radicals (Furmanowa et al. 1998). In animal studies, R. rosea increased and maintained higher levels of ATP and creatine in brain, muscle, liver, and blood (Kurkin and Zapesochnaya 1986; Saratikov and Krasnov 1987). It also increased brain norepinephrine, DA, and 5-HT and stimulated nicotine cholinergic systems (Petkov et al. 1986). In healthy individuals, R. rosea enhanced intellectual work capacity, abstract thinking, accuracy on tedious tasks, and reaction time (see Table 39–7). In a double-blind, placebo-controlled study of 60 first-year college students under stress, those given low-dose R. rosea (100 mg/day) showed significant improvement in mental fatigue, psychomotor function, and overall well-being (self-evaluation) (Spasov et al. 2000). We have observed that in patients with brain injury, R. rosea has a mild cognitive stimulant effect while it is also emotionally calming. No significant drug interactions have been reported. In our experience, R. rosea, particularly when combined with Eleutherococcus senticosus, Schizandra chinensis, Panax ginseng, Ginkgo biloba, Withania somnifera (Ashwaganda), and/or piracetam, can be beneficial for memory and cognition in TBI, age-associated memory impairment, stroke, and dementia patients. Patients often report improved energy, mental clarity, and memory. Response takes 1–12 weeks. Highly anxious patients may not tolerate higher doses because the activating effects sometimes exacerbate anxiety. R. rosea should be given 20 minutes before breakfast and lunch, starting with 150 mg/day and increasing by 150 mg every 3–7 days up to a maximum of 300 mg bid. Elderly, medically ill, or anxious patients should start by taking one-fourth to one-half of a capsule (37–75 mg) per day dissolved in tea or juice and increased slowly. We use R. rosea in a wide range of disorders of memory, cognition, and fatigue with generally good results. Combining treatments that target multiple aspects of neuronal repair can significantly improve recovery.