Citicoline, also known as cytidine-5’-diphosphocholine or CDP-choline, is a fat molecule that is an important part of the cell membrane.
Researchers have studied citicoline in the setting of neurological (brain and nerve) diseases, such as dementia. It is commonly used to enhance cognitive function.
This article discusses citicoline's potential benefits and safety.
What Is Citicoline?
Citicoline has been studied to treat the following conditions:
Citicoline has improved cognition in people with neurological conditions. And it has also improved memory and cognitive function in healthy people.
Citicoline works to protect the brain by:
norepinephrine
, and serotonin levelsacetylcholine
, a type of chemical messenger that helps brain and body functionsglutamate
, a brain chemical that causes damage to the brain under low oxygen conditionsphospholipase
A2, a type of enzyme that then reduces inflammationUses
Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian (RD) or registered dietitian nutritionist (RDN), pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.
Age-Related Cognitive Decline
Citicoline supplementation improved memory in older adults with age-associated memory impairment compared to a placebo (no treatment) group. However, the study is not generalizable to young adults or people with cognitive diseases like dementia and Alzheimer’s disease (AD).
A review of a collection of studies showed a positive effect of citicoline on cognitive function in people with mild vascular cognitive impairment, vascular dementia, or AD. Because citicoline was used with the standard treatment (acetylcholinesterase inhibitor) for AD, the effect of citicoline alone on AD is unclear.
Cognitive Enhancement
In a study, a citicoline-caffeine-based drink improved attention, mental alertness, and memory. Since citicoline was combined with caffeine, it is unclear what the effect of citicoline alone is on attention and memory.
Based on a study in young, healthy males, citicoline improved motor function and attention after four weeks of supplementation. However, study results might not apply to populations other than young, healthy males.
Eye Surgery Recovery
Using citicoline eye drops three times a day for one month after eye surgery aided the recovery of corneal sensitivity after LASIK (laser-assisted in situ keratomileusis).
Stroke Treatment
A systematic review of studies found citicoline alone benefited acute ischemic stroke (blood clots in the brain). However, citicoline offers limited benefits on top of standard stroke treatment with rtPA or recombinant tissue plasminogen activator (clot-busting drug).
Furthermore, one study in people with a first ischemic stroke showed that after the stroke, people who received citicoline over two years had reduced cognitive impairment.
Neuroprotection
Citicoline has been studied for the following neuroprotective (protecting the nerves and brain) effects:
While citicoline may benefit various cognitive conditions, further research is needed to confirm these results.
Food Sources
Besides supplementation, another way to increase citicoline levels is by consuming cytidine- and choline-rich foods. Citicoline is composed of cytidine and choline. Cytidine is found in meat, especially organ meats.
Foods rich in choline include the following:
Dosage
The usual therapeutic dose for humans used in clinical trials is 500 to 2,000 mg daily.
Listed below are the citicoline dosing for various conditions used in clinical trials.
Safety
Citicoline is naturally present in the human body and is a nontoxic substance. Citicoline taken by mouth at amounts of up to 1 g per day has been shown to be safe and well-tolerated.
Overall, citicoline is well-tolerated and has no adverse systemic cholinergic side effects (e.g., increased saliva and tear production, urination and defecation, and decreased heart rate).
Avoid citicoline if you're allergic to it or its components (parts). Seek immediate medical attention if you have a severe allergic reaction (itching, hives, shortness of breath).
Side Effects
Although no serious side effects were noted in some studies, mild side effects include the following:
Common side effects include the following:
Interactions
While there are few studies on drug interactions with citicoline, citicoline theoretically can increase the effect of levodopa by increasing dopamine levels.
Moreover, citicoline with levodopa allowed for a lower dose of levodopa in studies.
Precautions
Many clinical trials exclude people who are pregnant or breastfeeding. Therefore, the safety of citicoline in people who are pregnant or breastfeeding is unknown.
Although citicoline is well-tolerated, it is essential not to take more than instructed.
Please consult with your healthcare provider before starting citicoline.
Dietary supplements are not regulated like prescription medications in the United States. Therefore, some may be safer than others. When choosing a supplement, consider factors such as third-party testing, potential drug interactions, and other safety concerns. Talk to a healthcare provider or a registered dietitian nutritionist (RD or RDN) about supplement quality and safety.
Similar Supplements
Other supplements that have cognitive-enhancing properties include the following:
Similar to citicoline, the supplements above are believed to improve cognitive function. However, whereas citicoline is naturally found in the human body as CDP-choline, the above supplements are not produced by the human body.
Summary
Not only does citicoline protect the brain, but it also has an excellent safety profile.
Several clinical studies indicate citicoline's therapeutic potential in various neurological conditions, including age-related cognitive decline and stroke treatment and recovery.
How does citicoline work to improve cognitive function?
Citicoline works to improve cognitive function by increasing brain choline and promoting the production of acetylcholine, a neurotransmitter essential for memory. Additionally, citicoline increases levels of dopamine, norepinephrine, and serotonin.
How is citicoline administered?
Citicoline is administered via the following routes: oral (by mouth), intravenous (within a vein), or intramuscular (within a muscle).
What is the difference between citicoline and choline?
Once citicoline is ingested, it is broken down into two molecules: cytidine and choline.
After these two molecules cross the blood-brain barrier separately and reach the brain cells, they combine to form CDP-choline (citicoline) again.
Citicoline serves as a source for making phosphatidylcholine, one of the parts of cell membranes.
Choline, one of the breakdown products of citicoline, serves as one of the building blocks for the production of acetylcholine, a neurotransmitter (chemical messenger) involved in memory and muscle movement.
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