Citicoline, also known as cytidine diphosphate-choline (CDP Choline) and cytidine 5'-
diphosphocholine, is a naturally occurring intermediate involved in the synthesis of
phosphatidylcholine, a major constituent of the grey matter of brain tissue (30%). CDP
choline consumption promotes brain metabolism by enhancing the synthesis of acetyl-
choline, restoring phospholipid content in the brain and affecting neuronal membrane
excitability and concentration. CDP Choline is mainly used in the treatment of disorders of a
cerebrovascular nature. The many years of use have caused an evolution in dosage, method
of administration, and selection criteria.
EFFICACY: NEUROPROTECTION
Brown et al. state that CDP choline has been used to treat stroke, dementia, and brain
injury in Europe and Japan,^1 is well absorbed, crosses the blood- brain barrier, and
breaks down into components useful for brain health. Choline is incorporated into the
membrane phospholipid structure, improves mitochondrial metabolism and synthesis of
phospholipids and elevates norepinephrine, dopamine, and serotonin. Thus, it has long
been thought of as a sort of “brain tonic.”^2
A 2005 meta-analysis of controlled trials of CDP choline by the Cochrane Stroke Review
Group concluded that “there is some evidence that the CDP choline has positive
effects on memory and behavior in the short to medium term in cerebral disorders in
the elderly. The evidence of benefit from global impression was stronger, but is still
limited by the duration of the studies.^3
Fourteen studies were included in this review. Participants varied over the years and by
type of disorders and severity, and ranged from aged individuals with subjective
memory disorders to patients with Vascular Cognitive Impairment (mild to moderate),
