Quick Comparison
| Citicoline (CDP-Choline) | Sunifiram | |
|---|---|---|
| Half-Life | 56-71 hours (sustained release characteristics) | Estimated 1-2 hours (limited data) |
| Typical Dosage | Standard: 250-500 mg daily. Clinical studies use 500-2000 mg daily. Take in the morning — mildly stimulating. Cognizin is the most studied form. Can be split into 2 doses. Often combined with racetams to provide the choline needed for enhanced acetylcholine turnover. | Standard: 4-8 mg sublingually. Active doses are very small — do NOT dose by weight equivalence with piracetam. Start at 4 mg. Do not use daily due to lack of long-term data. Sublingual preferred for consistent absorption. |
| Administration | Oral (capsules, powder). Cognizin branded form is most studied. Take in the morning. | Sublingual (preferred) or oral. Very small doses — requires a milligram scale for accurate dosing. |
| Research Papers | 10 papers | 10 papers |
| Categories |
Mechanism of Action
Citicoline (CDP-Choline)
Citicoline (CDP-choline) is hydrolyzed in the gut by alkaline phosphatase to choline and cytidine-5'-monophosphate, which are absorbed separately and reassembled in the brain via the Kennedy pathway. Choline feeds two critical pathways: (1) Acetylcholine synthesis via choline acetyltransferase (ChAT) — the primary memory and learning neurotransmitter acting at muscarinic and nicotinic receptors. (2) Phosphatidylcholine synthesis via CTP:phosphocholine cytidylyltransferase — the structural component of neuronal membranes and synaptic vesicles. Cytidine is dephosphorylated to uridine, converted to UTP, and supports RNA synthesis and CDP-choline formation for synapse formation. Citicoline also activates SIRT1 (possibly via NAD+ modulation) and increases brain norepinephrine and dopamine (mechanism unclear — may enhance synthesis or release). It is the only choline source providing both cholinergic and membrane-building support in one molecule.
Sunifiram
Sunifiram (DM-235) is a positive allosteric modulator of AMPA receptors (GluA1-4 subunits) — an ampakine that slows receptor desensitization and deactivation, enhancing glutamatergic excitatory neurotransmission and calcium influx through the receptor. This calcium influx activates CaMKII (calcium/calmodulin-dependent protein kinase II), which phosphorylates GluA1 at Ser831 and is a key enzyme in long-term potentiation (LTP) and memory consolidation. Sunifiram also activates protein kinase C (PKC) isoforms, which phosphorylate GluA2 and regulate receptor trafficking. It increases acetylcholine release in the prefrontal cortex and hippocampus, likely via presynaptic nicotinic receptor activation or enhanced glutamatergic drive onto cholinergic neurons. Downstream, these mechanisms enhance CREB phosphorylation, Arc expression, and synaptic AMPA receptor insertion — the molecular basis of memory formation.
Risks & Safety
Citicoline (CDP-Choline)
Common
Headache (especially with racetams — indicates too much cholinergic stimulation), nausea, diarrhea.
Serious
None documented at standard doses.
Rare
Insomnia, blurred vision.
Sunifiram
Common
Overstimulation, headache, jaw clenching at higher doses.
Serious
No long-term human safety data. Animal studies show a wide therapeutic index.
Rare
Insomnia, anxiety, irritability.
Full Profiles
Citicoline (CDP-Choline) →
A naturally occurring intermediate in the synthesis of phosphatidylcholine, the primary phospholipid in neuronal cell membranes. Citicoline provides both choline (for acetylcholine and phospholipid synthesis) and cytidine (converted to uridine, supporting RNA and synapse formation). It is prescribed in Europe and Japan for stroke recovery and cognitive decline. Cognizin is the most studied branded form.
Sunifiram →
An experimental ampakine compound structurally related to piracetam but estimated to be 1,000x more potent. Sunifiram enhances AMPA receptor function, increases long-term potentiation in the hippocampus, and activates CaMKII and PKC signaling — molecular processes directly involved in memory formation. It has a noticeable acute effect on focus and memory, but very limited human safety data.