Supplements like Citicoline

Citicoline

  • Vitamins & Supplements
  • Updated November 30, 2017

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.

Evidence

Our search identified:

  • 1 meta-analysis of randomized controlled trials (in patients with vascular cognitive impairment or dementia)
  • 2 randomized controlled trials (1 in patients with mild vascular cognitive impairment and 1 in Alzheimer's patients)
  • 4 small clinical studies (2 in young, healthy people and 3 in healthy middle-aged or elderly people)
  • 3 open-label pilot studies in dementia patients
  • 2 observational studies in Alzheimer's patients

Potential Benefit

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 [1]. 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 [2]. A study in healthy middle-aged women reported that one month of citicoline improved attention [3]. 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 [4].

APOE4 Carriers:

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 [5]. For more information on what the APOE4 gene allele means for your health, read our APOE4 information page.

For Dementia Patients

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 [9][10]. Some studies also suggest citicoline may be beneficial for patients with vascular cognitive impairment [11][12].

Safety

No serious safety issues have been reported with citicoline treatment [13]. In fact, in a meta-analysis of trials for cerebral dysfunction in elderly people, citicoline tended to be more tolerable than the placebo [11]. 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.

How to Use

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 [3].

Learn More

Find out more on Examine.com.

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.

References

  1. McGlade E, Agoston AM, DiMuzio J et al. (2015) The Effect of Citicoline Supplementation on Motor Speed and Attention in Adolescent Males. J Atten Discord.
  2. Knott V, de la Salle S, Choueiry J et al. (2015) Neurocognitive effects of acute choline supplementation in low, medium and high performer healthy volunteers. Pharmacology, biochemistry, and behavior 131, 119-129.
  3. McGlade ea (2012) Improved Attentional Performance Following Citicoline Administration in Healthy Adult Women. Food and Nutrition Sciences 3.
  4. Spiers PA, Myers D, Hochanadel GS et al. (1996) Citicoline improves verbal memory in aging. Archives of neurology 53, 441-448.
  5. Alvarez XA, Mouzo R, Pichel V et al. (1999) Double-blind placebo-controlled study with citicoline in APOE genotyped Alzheimer's disease patients. Effects on cognitive performance, brain bioelectrical activity and cerebral perfusion. Methods Find Exp Clin Pharmacol 21, 633-644.
  6. Cacabelos R, Alvarez XA, Franco-Maside A et al. (1993) Effect of Citicoline on cognition and immune function in Alzheimer's disease and multi-infarct dementia. Annals of the New York Academy of Sciences 695, 321-323.
  7. Caamano J, Gomez MJ, Franco A et al. (1994) Effects of Citicoline on cognition and cerebral hemodynamics in patients with Alzheimer's disease. Methods Find Exp Clin Pharmacol 16, 211-218.
  8. Cacabelos R, Caamano J, Gomez MJ et al. (1996) Therapeutic effects of Citicoline in Alzheimer's disease. Cognition, brain mapping, cerebrovascular hemodynamics, and immune factors. Annals of the New York Academy of Sciences 777, 399-403.
  9. Gareri P, Castagna A, Cotroneo AM et al. (2017) The Citicholinage Study: Citicoline Plus Cholinesterase Inhibitors in Aged Patients Affected with Alzheimer's Disease Study. Journal of Alzheimer's disease : JAD 56, 557-565.
  10. Castagna A, Cotroneo AM, Ruotolo G et al. (2016) The CITIRIVAD Study: CITIcoline plus RIVAstigmine in Elderly Patients Affected with Dementia Study. Clin Drug Investig 36, 1059-1065.
  11. Fioravanti M, Yanagi M (2004) Cytidinediphosphocholine (CDP choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly. The Cochrane database of systematic reviews, CD000269.
  12. Cotroneo AM, Castagna A, Putignano S et al. (2013) Effectiveness and safety of citicoline in mild vascular cognitive impairment: the IDEALE study. Clinical interventions in aging 8, 131-137.
  13. Grieb P (2014) Neuroprotective properties of citicoline: facts, doubts and unresolved issues. CNS drugs 28, 185-193.