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.

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.

Dosages shown are for research reference only. Always consult a qualified healthcare provider.

Half-Life

56-71 hours (sustained release characteristics)

Administration

Oral (capsules, powder). Cognizin branded form is most studied. Take in the morning.

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Mechanism of Action

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.

Regulatory Status

Prescription drug in Europe and Japan (stroke, cognitive decline). Dietary supplement in the US. Available OTC in most countries.

Risks & Safety

Common

Headache (especially with racetams — indicates too much cholinergic stimulation), nausea, diarrhea.

Serious

None documented at standard doses.

Rare

Insomnia, blurred vision.

Compare Citicoline (CDP-Choline) With

Research Papers

10
Citicoline (CDP-choline): mechanisms of action and effects in ischemic brain injury.

Published: July 31, 1995

AI Summary

Membrane repair and regeneration is necessary for recovery from stroke. Data from many pre-clinical and clinical trials support the hypothesis that citicoline may be a safe and effective treatment for stroke.

Citicoline (CDP-choline): What role in the treatment of complications of infectious diseases.

Published: July 22, 2009

AI Summary

Citicoline is a natural compound that is registered for use in ischemic stroke, head trauma and neurological disorders. This short review highlights the potential role of citicoline as part of adjunct therapy in the treatment of infectious diseases.

SCARLET (Supplemental Citicoline Administration to Reduce Lung injury Efficacy Trial): study protocol for a single-site, double-blinded, placebo-controlled, and randomized Phase 1/2 trial of i.v. citicoline (CDP-choline) in hospitalized SARS CoV-2-infected patients with hypoxemic acute respiratory failure.

Published: May 17, 2024

AI Summary

Prior studies showed that post-infection treatment of influenza A virus-infected mice with the liponucleotide CDP-choline, which is an essential precursor for de novo phosphatidylcholine synthesis, improved gas exchange and reduced pulmonary inflammation without altering viral replication.

Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Published: August 6, 2021

AI Summary

Supplementation of citicoline (CDP-choline), a naturally occurring mononucleotide, has shown beneficial effects on memory function and behavior in populations with a wide range of impairments. However, few studies have investigated its effect in healthy older populations.

Citicoline (CDP-choline) protects myocardium from ischemia/reperfusion injury via inhibiting mitochondrial permeability transition.

Published: February 5, 2014

AI Summary

Oxidative stress emerges after reperfusion of an organ following an ischemic period and results in tissue damage. This occurs in consequence of increased non-specific permeability.

Citicoline (CDP-choline) add-on therapy to risperidone for treatment of negative symptoms in patients with stable schizophrenia: A double-blind, randomized placebo-controlled trial.

Published: July 13, 2018

AI Summary

We aimed to evaluate the efficacy and tolerability of citicoline add-on therapy in treatment of negative symptoms in patients with stable schizophrenia.

Citicoline (CDP-choline) increases Sirtuin1 expression concomitant to neuroprotection in experimental stroke.

Published: September 12, 2013

AI Summary

Our findings suggest that therapeutic strategies to activate SIRT1 may be useful in the treatment of stroke. Our findings suggest that therapeutic strategies acting on SIRT1 may be useful in the treatment of stroke.

Cytidine 5'-diphosphocholine (CDP-choline) adversely effects on pilocarpine seizure-induced hippocampal neuronal death.

Published: January 20, 2015

AI Summary

We found that citicoline did not modulate kainate seizure-induced neuronal death, BBB disruption or microglial activation. These results suggest that citicoline may not have neuroprotective effects after seizure and that clinical application of citicoline after seizure needs careful consideration.

Short-term treatment with citicoline (CDP-choline) attenuates some measures of craving in cocaine-dependent subjects: a preliminary report.

Published: February 1, 1999

AI Summary

Subjects did not experience any side effects and citicoline treatment was associated with decreases in self-reported mood states associated with cocaine craving. These preliminary data are encouraging and suggest that citicoline warrants further study as a promising potential treatment for cocaine abuse and dependence that is devoid of side effe...

Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly.

Published: April 17, 2005

AI Summary

Animal studies suggest that CDP-choline may protect cell membranes by accelerating resynthesis of phospholipids. Modalities of the clinical studies, including length of observation, severity of disturbance, and methodology of evaluation of the results were also heterogeneous.

Frequently Asked Questions

What is Citicoline (CDP-Choline) used for?

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.

What are the side effects of 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.

How is Citicoline (CDP-Choline) administered?

Citicoline (CDP-Choline) is administered via oral (capsules, powder). cognizin branded form is most studied. take in the morning..

What is the half-life of Citicoline (CDP-Choline)?

The half-life of Citicoline (CDP-Choline) is 56-71 hours (sustained release characteristics).

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