Citicoline research update

Published on: July 19, 2019

Researchers study citicoline’s impact on adolescent brain health, traumatic brain injury, schizophrenia, and alcohol addiction.

A vast array of substances and processes are required for a well-functioning brain. One such substance is citicoline. Citicoline can be synthesized by the body or obtained in pure dietary supplement form. Once the supplement is ingested, it undergoes a series of chemical transformations before being used in the synthesis and maintenance of brain cell membranes.¹

While the mechanisms by which citicoline works are not well understood, and despite negative press received on two large-scale trials on citicoline for ischemic stroke and traumatic brain injury,^2–3 scientists continue to investigate citicoline and the potential it may have to do some serious good when ingested as a dietary supplement.

Citicoline is actively sold in nootropics, formulas marketed for brain health, and as a standalone product. Many of these products feature Cognizin, a branded citicoline supplied by Kyowa Hakko USA (New York City) and for which there exists a sizable amount of ingredient-specific research.

Companies involved in the sale of citicoline products should stay afloat of the latest citicoline research. There’s a good amount of it, and we’ve broken down some of the latest findings.

References

P Grieb. “Neuroprotective properties of citicoline: Facts, doubts, and unresolved issues.” CNS Drugs, vol. 28, no. 3 (2014): 185–193

A DÃ¡valos et al. “Citicoline in the treatment of acute ischaemic stroke: an international, randomized, multicenter, placebo-controlled study (ICTUS trial).” The Lancet, vol. 380, no. 9839 (July 28, 2012): 349–357

RD Zafonte et al. “Effect of citicoline on functional and cognitive status among patients with traumatic brain injury: Citicoline Brain Injury Treatment Trial (COBRIT).” JAMA, vol. 308, no. 19 (November 21, 2012): 1993–2000

Photo © iStockphoto.com/kirstypargeter

Adolescent Brain Health

While some citicoline studies focus on subjects with deficits and disorders, a respectable amount has instead focused on generally healthy populations. Recently, one such study involved adolescent males and the aforementioned Cognizin citicoline.⁴

In Utah, a team of researchers assigned 75 young male subjects to a 28-day regimen of citicoline (250 mg or 500 mg) or placebo daily. At baseline and 28 days, each subject completed a variety of cognitive tests intended to evaluate their attention, psychomotor function, and impulsivity. Citicoline was associated with improvements in attention and psychomotor speed, and a higher dose was deemed most beneficial.

The results complement a previous study, created by the same lead researcher, on 28 days of citicoline use in an adult female population.

Reference

4. E McGlade et al. “The effect of citicoline supplementation on motor speed and attention in adolescent males.” Journal of Attention Disorders, vol. 23, no. 2 (January 2019): 121–134

Photo © iStockphoto.com/arieliona

Traumatic Brain Injury

Some research suggests that citicoline can provide benefit when administered within hours of traumatic brain injury, in part by helping to restore the blood-brain barrier post-injury. New data sets freshly collected from Austria appear to support the notion.⁵

In reviewing 778 cases of traumatic brain injury, scientists compared the mortality rates of 67 subjects who’d received citicoline following hospital admittance with 67 who didn’t receive citicoline. Their findings indicated significantly reduced rates of intensive care unit mortality, hospital mortality, and six-month mortality with citicoline. The team was so pleased with their findings that they now want to create a multicenter, randomized clinical trial with traumatic brain injury patients and citicoline.

While these findings are promising, it’s important to consider history. In the fall of 2012, citicoline took a big hit in the press when JAMA published the large-scale COBRIT trial. It found no benefit of daily citicoline (2000 mg) over placebo in 1000 people with mild to severe traumatic brain injury.³ Some researchers questioned the methodology used in that study or at least the extent to which the data can be applied,⁶ and so research on citicoline and traumatic brain injury continues.

References

3. RD Zafonte et al. “Effect of citicoline on functional and cognitive status among patients with traumatic brain injury: Citicoline Brain Injury Treatment Trial (COBRIT).” JAMA, vol. 308, no. 19 (November 21, 2012): 1993–2000
5. H Trimmel et al. “Citicoline in severe traumatic brain injury: indications for improved outcome: a retrospective matched pair analysis from 14 Austrian trauma centers.” Wiener Klinische Wochenschrift, vol. 130, no. 1–2 (January 2018): 37–44
6. A Meshkini et al. “Citicoline for traumatic brain injury: a systematic review & meta-analysis.” Journal of Injury and Violence Research, vol. 9, no. 1 (January 2017): 41–50

Photo © Shutterstock.com/adike

Schizophrenia

Sometimes, scientists administer dietary ingredients in combination with pharmaceutical drugs, with the hope of seeing combined benefits greater than those from drug use alone. Iranian researchers recently employed this tactic with citicoline in a schizophrenia population.

In Tehran, a total of 73 subjects were assigned to consume citicoline (2500 mg) or placebo daily for eight weeks while taking risperidone,⁷ an anti-psychotic drug popularly used to treat schizophrenia. Subjects participated in a series of tests to assess psychiatric symptoms, at baseline and at eight weeks, and results were compared. Scores relating to “negative symptoms” of schizophrenia, such as withdrawal and reduced displays of emotion, were significantly improved in the citicoline group. Other scores were reportedly not impacted by combined treatment.

Only 66 subjects completed the trial, but the preliminary findings may encourage further research on citicoline for schizophrenia and addictive disorders.

Reference

7. Ghajar A et al. “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.” Human Psychopharmacology, vol. 33, no. 4 (July 2018): e2662

Alcohol and Other Addictions

Can citicoline help with substance abuse and addiction? A handful of scientists across the world are considering this possibility.

In the past, studies have linked citicoline use to reduced dependency or other beneficial outcomes in alcohol, cocaine, and methamphetamine addiction.⁸ But those studies are limited in number. To add to what’s already available, researchers at the University of Texas Southwestern Medical Center in Dallas pursued a trial on citicoline and people with alcohol use disorder.⁹

For 12 weeks, 62 adults consumed citicoline (500 mg to 2000 mg in a scaling-up fashion) or placebo daily while completing periodic self-assessment questionnaires covering daily drink habits such daily drinks consumed, heavy drinking days, cravings, depression, and other measures. Fifty-five subjects completed the study.

If proven efficacious, citicoline would be a welcome alternative to pharmaceutical drugs used for alcoholism and other addictions. These drugs can sometimes carry side effects. Unfortunately, researchers were unable to muster up a significant association between citicoline and reduced alcohol dependency this time around-perhaps due to a small sample size.

Citicoline was at least well tolerated, consistent with previous studies on this population and the general adult population.

References

8. ND Wignall et al. “Citicoline in addictive disorders: a review of the literature.” The American Journal of Drug and Alcohol Abuse, vol. 40, no. 4 (July 2014): 262–268
9. ES Brown et al. “A randomized, double-blind, placebo-controlled trial of citicoline in patients with alcohol use disorder.” Alcoholism: Clinical and Experimental Research. Published online November 20, 2018.