Citicoline (Cognizin) in the treatment of cognitive impairment

Abstract

Pharmacological treatment of cerebrovascular disorders was introduced at the beginning of the 20th Century. Since then, a multitude of studies have focused on the development of a consensus for a well defined taxonomy of these disorders and on the identification of specific patterns of cognitive deficits associated with them, but with no clear consensus. Nevertheless, citicoline has proved to be a valid treatment in patients with a cerebrovascular pathogenesis for memory disorders. A metanalysis performed on the entire database available from the clinical studies performed with this compound confirms the experimental evidence from the animal studies which have repeatedly described the multiple biological actions of citicoline in restoring both the cell lipid structures and some neurotransmitter functions.

An acute dose, randomized trial of the effects of CDP-Choline on Mismatch Negativity (MMN) in healthy volunteers stratified by deviance detection level

“…In studies with CDP-choline administered up to 12 months, it showed excellent tolerability and safety, with a few transient (never severe) adverse effects (e.g. stomach pain, diarrhea) (Conant et al 2004;Fioravanti et al 2006;Saver 2008). A "double dummy" procedure was used with participants being administered 4 capsules in each session so that the dose remained blind (e.g.…”

“…5'-citidine diphosphocholine or CDP-choline (citicoline) is a dietary supplement which acts as a key intermediate in the biosynthesis of phosphatidylcholine from choline (Secades et al 1995). CDP-choline has been shown to improve impaired cognition associated with chronic ischaemia, head trauma, dementia and normal aging (Alvarez-Sabin and Roman 2011; Conant and Schauss 2004;Davalos et al 2012;Fioravanti and Buckley 2006;Garcia-Cobos et al 2010;Secades 2012). In a 16-week trial combining CDP-choline with the positive allosteric modulator (PAM) of the α7 and α4/β2 nAChRs, galantamine, clinical symptoms of SZ patients were unaffected but overall functional level of patients was increased, as was performance on a test of free verbal recall (Deutsch et al 2013).…”

Citicoline in Vascular Cognitive Impairment and Vascular Dementia After Stroke

“…The effect size was large (OR, 8.89; 95% CI, 5.19 -15.22; PϽ0.001), indicating a strong drug effect for improvement with active treatment. 35,36 These authors concluded that the cognitive effects of citicoline are clearly evident at the behavioral level and can be easily appreciated with a clinical observation of patients irrespective of the functional paradigm used to measure them. Citicoline is remarkably welltolerated and more side effects were seen with the placebo than with the active treatment groups.…”

“…Citicoline is remarkably welltolerated and more side effects were seen with the placebo than with the active treatment groups. 35,36 Experimental and clinical studies have shown that citicoline effects may result from its contribution to several mechanisms of neuroplasticity and neurorepair. Regarding plasticity, Hurtado et al 28 showed that chronic treatment with citicoline improved functional recovery after experimental stroke and, more importantly, demonstrated that a potential neuronal substrate for the improvement of function could be the enhancement of dendritic complexity and spine density compared with the saline control group.…”

Citidine-5-diphosphocholine Ameliorates the Impairment of Spatial Memory Induced by Scopolamine

“…4,5) CDP-choline is a raw material for the synthesis of phospholipids, which are cell-membrane components required to maintain the structure of nerve cells. 6) However, the memory enhancing effect of CDP-choline may be due to increasing the supply of acetylcholine, because CDP-choline increases extracellular acetylcholine in the dorsal hippocampus and neocortex in normal rats.…”