Citicoline
also CDP-choline · Cytidine 5'-diphosphocholine · Cytidine diphosphate choline · Citicholine
Citicoline (CDP-choline) is an intermediate in the synthesis of phosphatidylcholine, the main phospholipid in cell membranes [1]. It is a prescription drug in some countries and a supplement in others. A meta-analysis found it improved cognitive status in mild cognitive impairment, Alzheimer's disease and post-stroke dementia, though the underlying studies were of poor quality [2].
One of the better-supported choline sources for cognitive decline, with a broad but mostly low-quality evidence base.
- meta-analysis
- RCT
- trial
- observational
- preclinical / case
- review / patent / other
- retracted
- + Supplies both choline and cytidine for membrane repair
- + Positive signal across several dementia studies
- + Well tolerated
- − Trial quality is generally poor
- − Stroke results have been inconsistent
Citicoline is research-backed mostly in older and neurologically impaired populations. A systematic review of 47 articles concluded it is useful for slowing dementia progression and improving prognosis after stroke, and that it enhances cognitive function in healthy people. The authors also judged its effect after brain trauma unclear [3].
In the nootropics community it is the most common choline source paired with racetams such as Piracetam.
Citicoline is the direct precursor in the body's route to phosphatidylcholine. The usual explanation for its effects is that it stimulates phosphatidylcholine synthesis in injured brain tissue, though the experimental evidence for that is limited [1]. Animal work on cerebral ischemia points to a second action as well, slowing membrane breakdown by inhibiting phospholipases and preserving cardiolipin and sphingomyelin [1].
Once it has been metabolized it also supplies choline, the raw material for acetylcholine. That is why the nootropics community treats it as a "choline source".
Choline is also a selective agonist of the α7 nicotinic receptor, and one trial tested citicoline on that basis. In 24 healthy volunteers given single doses of 500 mg and 1000 mg, it strengthened auditory sensory gating, the suppression of the brain's P50 response to the second of two paired sounds, but only in those whose gating was weak to begin with. The same subgroup showed tentative support for better maze-learning performance at 500 mg. The authors call the findings preliminary [4].
- Phosphatidylcholine synthesis (Kennedy pathway)activatessupplies substrate for membrane phospholipid synthesis [1]moderate
- Phospholipase activationblocksmay limit membrane breakdown after ischemia (animal data) [1]weak
- Acetylcholine synthesisactivatesits choline can feed acetylcholine productionunclear
Dosing
as studied or commonly reported; not a recommendationDoses below are what studies used or, where marked, what is commonly reported. None is a recommendation.
Oral
- 500 mg
- 250 or 500 mg
Intramuscular injection
- 1 g
Pharmacokinetics
what the body does with it| Bioavailability | In rats, oral absorption was slow but essentially complete, matching the intravenous route [8] |
|---|---|
| Excretion | Very little left in urine or feces in the same rat study, giving sustained blood levels [8] |
Safety
risks and cautions, not medical adviceCiticoline is well tolerated in the clinical literature, and none of the reviews cited here report serious adverse effects. The main caveat is about evidence rather than harm. The meta-analysis supporting its use in dementia rated the overall study quality as poor [2].
- Sold as a prescription medicine in some countries and a supplement in others, so product quality varies
Interactions
documented pairs only, not exhaustive- Alpha-GPCcompatibleTwo choline sources with no adverse interaction documented; taking both mostly duplicates the same lever
- CaffeinecompatibleStudied together in a beverage that improved sustained attention in healthy adults [9]
References
entry last reviewed 2026-09-18- [1]Citicoline: neuroprotective mechanisms in cerebral ischemia.Adibhatla RM, Hatcher JF, Dempsey RJJ Neurochem 2002reviewPMID 11796739◌ unreviewed
- [2]Is Citicoline Effective in Preventing and Slowing Down Dementia?-A Systematic Review and a Meta-Analysis.Bonvicini M, Travaglini S, Lelli D et al.Nutrients 2023meta-analysis · humanPMID 36678257◌ unreviewed
- [3]Application of Citicoline in Neurological Disorders: A Systematic Review.Jasielski P, Piędel F, Piwek M et al.Nutrients 2020meta-analysis · humanPMID 33053828◌ unreviewed
- [4]CDP-choline: effects of the procholine supplement on sensory gating and executive function in healthy volunteers stratified for low, medium and high P50 suppression.Knott V, Smith D, de la Salle S et al.J Psychopharmacol 2014RCT · humanPMID 25315828◌ unreviewed
- [5]Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.Nakazaki E, Mah E, Sanoshy K et al.J Nutr 2021RCT · humanPMID 33978188◌ unreviewed
- [6]The Effect of Citicoline Supplementation on Motor Speed and Attention in Adolescent Males.McGlade E, Agoston AM, DiMuzio J et al.J Atten Disord 2019RCT · humanPMID 26179181◌ unreviewed
- [7]A multicentre trial to evaluate the efficacy and tolerability of alpha-glycerylphosphorylcholine versus cytosine diphosphocholine in patients with vascular dementia.Di Perri R, Coppola G, Ambrosio LA et al.J Int Med Res 1991clinical trial · humanPMID 1916007◌ unreviewed
- [8]Bioavailability of methyl-14C CDP-choline by oral route.Agut J, Font E, Sacristán A et al.Arzneimittelforschung 1983preclinical · animalPMID 6684463◌ unreviewed
- [9]Improvements in concentration, working memory and sustained attention following consumption of a natural citicoline-caffeine beverage.Bruce SE, Werner KB, Preston BF et al.Int J Food Sci Nutr 2014RCT · humanPMID 25046515◌ unreviewed