The brain is a complex organ in the human body that relies on neurotransmitters and other compounds to function normally. Many supplements and even prescription drugs have been proposed for the use in conditions such as poor recall and working memory, reduced ability to concentrate, and even in cases such as a stroke or brain injury, in order to assist with the recovery.

Citicoline is a chemical that is naturally found within the human body but also made in laboratories in recent times to produce certain benefits in the human body. The chemical is especially abundant within organs of the human body. Supplementation with the chemical has been suggested to aid in improving memory, reducing symptoms of certain brain-related diseases, and producing improvements in conditions that affect blood flow to the brain.

Originally, Citicoline has developed a prescription drug to assist in the treatment of patients who had suffered a stroke. The drug has also been approved for use in the treatment of neurological disorders and head trauma in Japan, as well as Europe1. Today, however, the chemical has become useful for other purposes as well, thanks to an increased number of scientific studies focusing on the drug’s mechanisms of action.

How Does Citicoline Work?

It has been suggested that the utilization of citicoline can assist with increasing the density of dopamine receptors in the human brain. There are five sub-types of dopamine receptors that all play crucial functions in the brain. A review paper by the Duke University Medical Center explains that dopamine, an important neurotransmitter, is involved in functions such as as2:

  • Locomotion control, resulting in improved control over limb movement coordination and muscular contraction
  • Neuroendocrine secretion
  • Cognition, including functions such as long-term memory

Furthermore, citicoline may also increase the level of phosphatidylcholine within the brain. This chemical has been proven in scientific studies to be a precursor to the neurotransmitter acetylcholine3, making it a vital part of neurotransmitter synthesis.

Acetylcholine is known to play vital roles in the central nervous system, as well as the visceral motor system4. Additionally, the neurotransmitter is also thought to have functions in memory, concentration, and possibly other cognitive abilities.

What Are The Benefits Of Citicoline?

1. Helps Symptoms Of ADD

Studies have been conducted to monitor how the use of citicoline would affect patients with conditions like ADD (Attention-Deficit Disorder) and ADHD (Attention Deficit Hyperactivity Disorder). A study by the University of Missouri St. Louis5 included a large group of participants who all suffered from problems related to their concentration, sustained attention, and working memory. A caffeine beverage was provided to a group of the participants, with added natural citicoline supplementation. Improvements in attention, brain activation, and working memory were noted among participants.

2. Synergizes With Racetams

The chemical structure of citicoline has made it an ideal drug to be utilized with a class of other chemicals known as racetams. Improved synergizing has been observed when patients are administered a combination of the drugs. Possible side-effects of drugs are often also minimized through the right combination. One review paper6 explains that combining citicoline with piracetam reduces the risk of the possible periods of depression that is sometimes observed among patients who take citicoline alone. At the same time, adding citicoline to piracetam reduces the risk of headaches caused as a side-effect of piracetam.

3. Increases Muscular Strength

A study7 by the Rafsanjan University of Medical Sciences in Iran found that citicoline administered to patients with nontraumatic cerebral hemorrhage may also be helpful in improving muscular strength. The study was conducted on 32 patients. The participants were divided into two equal groups. 16 patients were treated with 250mg of citicoline intravenously, two times each day. The second group was treated with a placebo drug. The study was conducted over a 14-day period. At the end of the study, muscular strength ratings among patients in the citicoline group improved, on average, from 2.5 to 4.0. A less significant improvement in muscular strength was observed in the placebo group.

 

4. Improves Working Memory & Executive Functions

Studies have also proven the usefulness of citicoline in the treatment of cognitive impairments, as well as in improving memory and general cognitive performance. One study8 by the EuroEspes Biomedical Research Center in Spain found that the administration of citicoline in doses ranging from 300mg per day to 1,000mg per day significantly improved delayed object recall, immediate object recall, and word recall among elderly patients.

 

5. Assists With Stroke Recovery

Citicoline was originally developed in Japan to be used as a treatment for patients who had a stroke. Today, the drug still offers a useful way to provide a treatment for poststroke recovery. One review9 paper explains that the use of citicoline provides a neuroprotective feature in the patient who had suffered from a stroke and may help to improve their recovery. Additionally, the paper notes that the safety profile of the drug is excellent compared to some other drugs. It is, however, vital for patients and physicians to understand that the first dose of citicoline needs to be administered within the first day (24 hours) following the event (the stroke) for the drug to be effective.

 

6. Might Reduce Cocaine Cravings In Substance Abuse Patients

Some studies have suggested that citicoline might be a viable option for the treatment of addiction among patients who have a dependency toward the drug cocaine. One study10, in particular, found that cocaine cravings among participants in an outpatient program were significantly reduced after being treated with 500mg citicoline during a 14-day study period. Data regarding cocaine cravings were recorded before the study started, as well as after the 14-day period had passed. In addition to being a seemingly effective drug in the treatment of cocaine addiction, no serious adverse reactions were reported among the patients who participated in the study.

 

Suggested Dosages

The suggested dosage for the administration of citicoline depends on the administration method, as well as the condition that is being treated with the drug. In the majority of cases, the patient will be provided with a dose between 500mg and 2,000mg of citicoline on a daily basis.

  • Patients with age-related memory and thinking problems can take between 1,000mg and 2,000mg per day.
  • Patients with the chronic cerebrovascular disease should take 600mg per day.
  • Patients who suffered an ischemic stroke should be administered up to 2,000mg per day. The first dose needs to be administered within the first 24 hours after the patient had the stroke.

In cases where a patient has cerebrovascular disease, a doctor may also decide to administer the chemical through injection or intravenously. In such a case, the doctor would determine the most appropriate dosage to provide the patient with.

Possible Side Effects Of Citicoline

Numerous studies have been conducted on the safety and effectiveness of citicoline, administered orally, through an injection, and intravenously. Studies often note improvements in several symptoms experienced by participants after citicoline has been administered and usually specifies that the drug seemed to be safe and did not produce any significant side-effects. One clinical review11 of the drug also specifies that no side-effects that are considered serious or harmful to the patient have yet been associated with the use of citicoline.

This, however, only applies to the administration of citicoline within the recommended doses. Furthermore, additional research is still required in order to provide more accurate data on the safety of citicoline among individuals who are pregnant.

Overall Summary

Citicoline is an intermediate chemical that is the result of the phosphatidylcholine being generated from choline. While already present naturally within the body, choline has been developed as a prescription drug, or a dietary supplement in the United States, and promoted to assist with improving several brain-related functions. Studies suggest that the chemical, in supplement form, may help to improve recovery after stroke, reducing cravings in cocaine-dependant patients, improving working memory, and even be helpful in the treatment of ADD. Regulations regarding the use of the chemical defer between countries. While no prescription is needed for supplements containing choline in the United States, patients need to obtain the chemical as a prescription drug in European countries.

References

1 K.J. D’Orlando, B.W. Sandage Jr. Citicoline (CDP-choline): mechanisms of action and effects in ischemic brain injury. Journal of Neurological Research. August 1995. https://www.ncbi.nlm.nih.gov/pubmed/7477743

2 M. Jaber, S.W. Robinson, C. Missale, M.G. Caron. Dopamine receptors and brain function. Journal of Neuropharmacology. 1996. https://www.ncbi.nlm.nih.gov/pubmed/9025098

3 J.K. Blusztajn, M. Liscovitch, C. Mauron, U.I. Richardson, R.J. Wurtman. Phosphatidylcholine as a precursor of choline for acetylcholine synthesis. Journal of Neural Transmission. 1987. https://www.ncbi.nlm.nih.gov/pubmed/3316498

4 D. Purves, G.J. Augustine, D. Fitzpatrick. Acetylcholine. Neuroscience. 2nd edition. 2001. https://www.ncbi.nlm.nih.gov/books/NBK11143/

5 S.E. Bruce, K.B. Werner, B.F. Preston, L.M. Baker. Improvements in Concentration, Working Memory, and Sustained Attention Following Consumption of Natural Citicoline-Caffeine Beverage. HHS Public Access. 1 December 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4517431/

6 R.C. Doijad, A.B. Pathan, N.B. Pawar, S.S. Baraskar, V.D. Maske, S.L. Gaikwad. Therapeutic Applications of Citicoline and Piracetam as Fixed-Dose Combination. 2012. http://www.alliedacademies.org/abstract/therapeutic-applications-of-citicoline-and-piracetam-as-fixed-dose-combination-4810.html

7 F. Iranmanesh, A. Vakilian. The efficiency of citicoline in increasing muscular strength of patients with nontraumatic cerebral hemorrhage: a double-blind randomized clinical trial. Journal of Stroke and Cerebrovascular Diseases. 2008. https://www.ncbi.nlm.nih.gov/pubmed/18436157

8 X.A. Alvarez, M. Laredo, D. Corzo, L. Fernandez-Novoa, R. Mouzo, J.E. Perea, D. Daniele, R. Cacabelos. Citicoline improves memory performance in elderly subjects. Journal of Methods and Findings in Experimental and Clinical Pharmacology. April 1997. https://www.ncbi.nlm.nih.gov/pubmed/9203170

9 S.A. Mousavi, F. Khorvash, T. Hoseini. The Efficacy of Citroline in the Treatment of Ischemic Stroke and Primary Hypertensive Intracerebral Haemorrhage; A Review Article. ARYA Atherosclerosis. 2010. https://www.ncbi.nlm.nih.gov/pubmed/17171187

10 P.F. Renshaw, S. Daniels, L.H. Lundahl, V. Roers, S.E. Lukas. Short-term treatment with citicoline (CDP-choline) attenuates some measures of craving in cocaine-dependent subjects: a preliminary report. Journal of Psychopharmacology. February 1999. https://pdfs.semanticscholar.org/b209/eb908715589c5d541117ef0ba4b52dfd094b.pdf b

11 J.J. Secades, J.L. Lorenzo. Citicoline: pharmacological and clinical review, 2006 update. Journal of Methods and Findings in Experimental and Clinical Pharmacology. September 2006. https://www.ncbi.nlm.nih.gov/pubmed/17171187

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