Citicoline in addictive disorders: a review of the literature

Abstract

Background Citicoline is a dietary supplement that has been used as a neuroprotective agent for neurological disorders such as stroke and dementia. Citicoline influences acetylcholine, dopamine, and glutamate neurotransmitter systems; serves as an intermediate in phospholipid metabolism; and enhances the integrity of neuronal membranes. Interest has grown in citicoline as a treatment for addiction since it may have beneficial effects on craving, withdrawal symptoms, and cognitive functioning, as well as the ability to attenuate the neurotoxic effects of drugs of abuse. Objectives To review the literature on citicoline’s use in addictive disorders. Methods Using PubMed we conducted a narrative review of the clinical literature on citicoline related to addictive disorders from the years 1900 to 2013 using the following keywords: citicoline, CDP-choline, addiction, cocaine, alcohol, substance abuse, and substance dependence. Out of approximately 900 first hits, nine clinical studies have been included in this review. Results Most addiction research investigated citicoline for cocaine use. The findings suggest that it is safe and well tolerated. Furthermore, citicoline appears to decrease craving and is associated with a reduction in cocaine use, at least at high doses in patients with both bipolar disorder and cocaine dependence. Limited data suggest citicoline may also hold promise for alcohol and cannabis dependence and in reducing food consumption. Conclusions Currently, there is limited research on the efficacy of citicoline for addictive disorders, but the available literature suggests promising results. Future research should employ larger sample sizes, increased dosing, and more complex study designs.

A Randomized, Double-Blind, Placebo-Controlled Trial of Citicoline for Cocaine Dependence in Bipolar I Disorder

“…Previous research has not been conducted to determine whether citicoline could have an effect on cocaine urine drug screen sensitivity. Although this possibility cannot be entirely ruled out, citicoline is not structurally similar to cocaine or other substances of abuse and has no known drug-drug or other interactions (22). The use of CBT as a psychosocial platform potentially had advantages and disadvantages.…”

“…Citicoline is sold as a prescription drug in Japan and Europe and over the counter as a dietary supplement in the United States (22). Citicoline has a mild side effect profile, and a Cochrane review observed that citicoline "tended to be associated with fewer adverse effects than placebo" in elderly patients with cognitive disorders (23).…”

“…Citicoline has a mild side effect profile, and a Cochrane review observed that citicoline "tended to be associated with fewer adverse effects than placebo" in elderly patients with cognitive disorders (23). It is also relatively inexpensive and has no known drug-drug interactions (22). In animal models, citicoline has been found to increase incorporation of phospholipids into membranes, enhance the synthesis of structural phospholipids, and increase cerebral metabolism (24).…”

Citicoline retards myopia progression following form deprivation in guinea pigs

“…It has been widely demonstrated that citicoline can activate the biosynthesis of phospholipids in neuronal membranes and can stimulate cerebral metabolism and some brain neurotransmitter systems, including the dopaminergic system. 22 When used as a long-term medication, it is a safe and well-tolerated drug that has no significant systemic side effects, and it has been used in the pharmacotherapy of senile cognitive impairment, 23 addictive disorders, 24 stroke, head trauma and Parkinson's disease 25 as well as in amblyopia 26 and glaucoma. 27,28 At present, citicoline is available in the United States as a dietary supplement for neurological disorders such as stroke and dementia.…”

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

“…Cytidine‐50‐diphosphocholine or CDP‐choline with the generic name of citicoline is a widely consumed dietary supplement (Wignall & Brown, ) which is hydrolyzed into choline and cytidine (a component of RNA) in the intestine (Wurtman, Regan, Ulus, & Yu, ). It is a middle product and precursor in the synthesis of cell membrane phospholipids and the neurotransmitter acetylcholine (Grieb, ; Tayebati & Amenta, ).…”