Related Terms

• CDP, Cebrolux®, Cebroton, Cognizin®, cytidine diphosphate choline, cytidine-5'-diphosphocholine, cytidinediphosphocholine, diphosphocholine, Neuroton®, somazina.

• Note: The terms citicoline, citicholine, and CDP-choline are used interchangeably throughout the literature. "Citicoline" will be used throughout this monograph.

Background

• Citicoline was first used to treat stroke. Citicoline may help treat diseases of the nerves and brain. Citicoline may help prevent the release of harmful chemicals in the body after decreased blood flow to the brain.

• Citicoline has been studied as a treatment for disorders associated with aging, including memory loss, glaucoma (increased eye pressure), and problems with nerve function.

• Citicoline is used in Europe and Japan for stroke, head injury, and other nerve diseases.

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

• Alcoholism, cardiac arrhythmia (irregular heartbeat), encephalitis (brain inflammation), head injury, high cholesterol, Huntington's disease, immunomodulation (affects the immune system), lung disease, neuroprotection (nerve protection), pain, poisoning (carbon monoxide).

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

• For aging, 1,000 milligrams has been taken by mouth daily for 21 days.

• For Alzheimer's disease, 1,000 milligrams has been used by mouth daily for 12 weeks.

• For bipolar disorder, added to regular treatment, 500 milligrams of citicoline daily, with a gradual increase to 2,000 milligrams daily has been used by mouth for 12 weeks.

• For bleeding in the brain, 1,000 milligrams has been injected into a vein every 12 hours for two weeks. Also, 1,000 milligrams has been taken by mouth every 12 hours for two weeks.

• For brain damage, 1,000 milligrams has been injected into a vein daily for four weeks.

• For cocaine dependence, 1,000 milligrams has been used by mouth daily for four days. Also, 500 milligrams has been used by mouth twice daily for an unknown length of time.

• For delirium, 1,200 milligrams has been used by mouth daily 24 hours prior to hip surgery and during the four days after surgery.

• For decreased blood flow to the brain, 1,000 milligrams has been injected into the muscle daily for 28 days. Also, 1,000 milligrams of citicoline has been used by mouth daily for 28 days.

• For dementia, 200 milligrams has been injected into the muscle every eight hours for the first 10 days, followed by an additional 200 milligrams every 12 hours for the next 10 days, and 200 milligrams every 24 hours for the last 10 days. Also, 500 milligrams has been used by mouth twice daily for an unknown length of time.

• For depression, 500 milligrams has been used by mouth daily. The dose was separated into 300 milligrams at 8 a.m. and 200 milligrams at 5 p.m. for at least 21 days.

• For eye disorders, 1,000 milligrams has been injected into the muscle daily for 15 days.

• For glaucoma (increased eye pressure), 1,600 milligrams of Cebrolux® has been taken by mouth daily for 60 days. Also, 500 milligrams of citicoline has been taken by mouth twice daily for 14 days. In addition, 1,000 milligrams of Neuroton® or Cebroton has been injected into the muscle daily for 60-120 days.

• For memory loss, 1,000 milligrams has been used by mouth daily for an unknown length of time. Also, 500-2,000 milligrams has been used daily for 4-8 weeks. In addition, 250-500 milligrams has been injected into the muscle daily for 14-20 days.

• For muscle strength after stroke, 250 milligrams of citicoline has been injected into a vein twice daily for 14 days.

• For nerve disease of the eye, 1,600 milligrams of Cebrolux® has been used by mouth daily for 60 days.

• For Parkinson's disease, 500-1,200 milligrams has been used by mouth daily for one month in addition to levodopa treatment. Also, 1,000 milligrams has been injected into the muscle daily for 15 days added to levodopa treatment

• For stroke, 500-2,000 milligrams has been used by mouth once or twice daily for six weeks. Also, 500 milligrams of citicoline has been injected into a vein daily for seven days.

• For tardive dyskinesia (movement disorder), 500-1,200 milligrams has been used by mouth daily for four weeks.

Children (under 18 years old)

• There is no proven safe or effective dose for citicoline in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

• Avoid in people with a known allergy or sensitivity to citicoline.

Side Effects and Warnings

• Use cautiously in people taking growth hormone or agents that affect dopamine (a chemical in the brain). Use cautiously in people with disease of the heart or blood vessels, or frequent headaches.

• Citicoline may cause back pain, changes in heart rate, constipation, diarrhea, difficulty sleeping, headache, low blood pressure, nausea, skin rash, stomach pain, swelling in the limbs, and vomiting.

Pregnancy and Breastfeeding

• There is a lack of scientific evidence on the use of citicoline during pregnancy or breastfeeding.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

• Citicoline may cause low blood pressure. Caution is advised in people taking agents that lower blood pressure.

• Citicoline may interact with agents that affect dopamine, agents that affect heart rate, agents used to treat acute stroke, agents used to treat asthma, agents used to treat Parkinson's disease, Alzheimer's agents, anti-aging agents, cholesterol-lowering agents, growth hormone, and pain relief agents.

Interactions with Herbs and Dietary Supplements

• Citicoline may cause low blood pressure. Caution is advised in people taking herbs and supplements that lower blood pressure.

• Citicoline may interact with herbs and supplements that affect dopamine, herbs and supplements that affect heart rate, herbs and supplements that lower cholesterol, herbs and supplements that treat Alzheimer's disease, herbs and supplements that treat asthma, herbs and supplements that treat Parkinson's disease, herbs and supplements used for pain relief, herbs and supplements used to treat acute stroke, and antiaging herbs and supplements.

Author Information

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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