Citicoline (also known as CDP-choline; cytidine 5'-diphosphocholine) is a naturally occurring compound and a building block of cell membranes. It is a common ingredient in supplements marketed for brain support. In Alzheimer's disease, choline levels decrease; this affects the brain cell's ability to produce acetyl-choline, a neurotransmitter important for memory. Brain cells may instead break down cell membranes to produce acetyl-choline, and taking citicoline is thought to prevent this break down. No serious safety issues have been reported with citicoline treatment.
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Short-term treatment with citicoline was beneficial in individuals with lower cognition at the beginning of studies, but there is insufficient evidence that it is beneficial in healthy people with otherwise good cognition. No studies examined whether citicoline can prevent dementia.
One small study in adolescent males reported that one month of citicoline supplementation improved speed in cognitive tasks . However, another small study in adult males reported that citicoline administered in a single dose was only beneficial for processing speed, memory, and executive function in those who were low-performers at baseline and might actually be slightly detrimental to high-baseline performers . A study in healthy middle-aged women reported that one month of citicoline improved attention . In healthy, elderly people, citicoline treatment over 90 days improved memory, but this was largely due to improvements in people with memory problems at the beginning of the study .
A small pilot study in people with the APOE4 gene reported that citicoline treatment for three months improved cognition compared to patients on a placebo . For more information on what the APOE4 gene allele means for your health, read our APOE4 information page.
Pilot studies suggest that citicoline may provide cognitive benefits in patients with Alzheimer's disease, but no large randomized controlled trials have been conducted [5-8]. Two observational studies also reported benefits when citicoline is added to standard-of-care Alzheimer's treatments. Both examined patients over nine months and reported improvements in cognition in patients who took citicoline compared to those who did not take it . Some studies also suggest citicoline may be beneficial for patients with vascular cognitive impairment .
No serious safety issues have been reported with citicoline treatment . In fact, in a meta-analysis of trials for cerebral dysfunction in elderly people, citicoline tended to be more tolerable than the placebo . However, the safety of long-term (>9 months) citicoline supplementation is not known. Drug interactions with citicoline are not well studied, though it may interact with Parkinson's drugs such as levodopa (drugs.com).
NOTE: This is not a comprehensive safety evaluation or complete list of potentially harmful drug interactions. It is important to discuss safety issues with your physician before taking any new supplement or medication.
Citicoline is available as a single supplement or as one ingredient in some supplements marketed to promote brain health. Typical doses are 250–1000mg/day. For healthy individuals, lower doses (e.g. 250mg/day) may provide more benefit than higher doses .
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United States Pharmacopeial Convention (USP) and FDA Information on Dietary Supplements offer information on the quality of specific supplements and can assist in finding a trusted brand.