Citicoline (CDP-choline)
Endogenous nucleotide with RCT signal for vascular cognitive decline and post-stroke recovery; used clinically across Europe.
Why
Citicoline (cytidine-5'-diphosphocholine, CDP-choline) is an endogenous intermediate in phosphatidylcholine synthesis. Prescribed across Italy, Spain, France and Japan for cognitive complaints and stroke recovery. The IDEALE study reported preserved cognitive function in vascular MCI over 9 months; the CITICHOLINAGE study supported the same signal at 1,000 mg/day for two years. The ICTUS trial in acute stroke was null overall but showed benefit in lacunar stroke subgroup analysis.
How it works
Provides choline and cytidine for phosphatidylcholine synthesis, the structural lipid of neuronal membranes. Increases brain acetylcholine, dopamine, and noradrenaline. Reduces phospholipid breakdown after ischaemic injury.
Expected onset · Cognitive endpoints emerge over 3–9 months
How to take
Dosage
Cognition: 500–1,000 mg/day divided. Acute stroke (clinical context): 2,000 mg/day for 6 weeks. Maintenance: 250–500 mg/day.
Timing
With meals; divided morning and evening
On the label
'Citicoline' or 'CDP-choline' with stated milligrams. Cognizin® is the brand used in many RCTs. Distinct from generic choline (which is just one of the two components).
Ideal for
Older adults with vascular cognitive impairment or post-stroke cognitive complaints under clinical supervision; people exploring cognition-supporting nutrients.
Safety
Evidence
Cotroneo 2013 IDEALE study (n=349 vascular MCI): citicoline 1,000 mg/day preserved MMSE score over 9 months while controls declined. Gareri 2017 pooled analysis confirmed benefit in vascular cognitive impairment. Acute stroke trials are mixed: null overall in ICTUS but with a subgroup signal in lacunar stroke. Used clinically across Southern Europe and Japan.
Where to get it
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