AOR guarantees that no ingredients not listed on the label have been added to the product. Contains no wheat, gluten, corn, nuts, dairy, soy, eggs, fish or shellfish.

Suggested Use
Take two to four capsules daily, or as directed by a qualified health consultant.

Main Applications
As reported by literature:
• Cognitive support.
• Age-associated memory impairment (AAMI).
• Support for nerves of the eye.

Source
Biofermentation.

Pregnancy / Nursing
No studies have been conducted; best avoid.

Cautions
None known.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Copyright © 2005, Advanced Orthomolecular Research

By contrast, Citicoline works by enhancing the brain's ability to synthesize its own phospholipids. Citicoline's real "business end" is its cytidine group. Taking Citicoline delivers cytidine to the brain, where it is transformed into cytidine diphosphate (CDP). CDP plays a key role in the body's production of the brain's phospholipids. Studies show that cytidine itself, or cytidine delivered as Citicoline, boosts brain and neural PS by 37.2%, PC by 22-30%, PI by 16%, and PE by 11-13%. By supporting the brain's ability to make its own phospholipids, Citicoline increases levels of all phospholipids in neural membranes - yet the healthy, youthful proportions of the various phospholipids are not altered.

At the same time, new research suggests that Citicoline allows the body to make better use of phospholipids derived directly from the diet or supplements. When you take phospholipid supplements, the fatty acid "tails" have to be modified as they are taken from the blood, then brought into the cell's outer membrane, so that they meet the specific needs of the local tissue. Studies in isolated neuron precursor cells show that Citicoline selectively enhances the ability of phospholipids to incorporate a variety of fatty acids into their "tails," facilitating this "customization" process. As well, Citicoline increases the manufacture or release of key neurotransmitters, including acetylcholine, norepinephrine, dopamine, and serotonin.

Controlled human studies prove that Citicoline provides effective nutritional support in a wide range of cognitive disorders - a broader range than other phospholipids-based nutritional supplements such as PS. Trials have documented the powerful support provided by Citicoline supplementation in Alzheimer's disease, stroke, dementia associated with Parkinson's disease, and head trauma, and that it improves the odds of a good outcome after high-risk brain surgery.

Most importantly for most healthy people looking to maintain, protect, boost, or restore healthy brain function, double-blind, placebo-controlled trials have also shown that Citicoline significantly improves memory function in persons with "normal" age-associated memory impairment (AAMI).

In one such trial, older subjects who were experiencing problems with their memory, but who were not suffering dementia, were tested on a battery of memory tests, and found to perform more poorly than young controls. Then the subjects were given each of four treatments, for four weeks each, at different times. All volunteers underwent three periods with different Citicoline regimens (a high (1000 mg) or moderate (500 mg) dose of Citicoline, or a lower (300 mg) dose combined with nimodipine (a blood pressure drug also used to treat some neurological deficits)). Subjects also underwent a dummy-pill phase. The results showed that Citicoline significantly improves performance on several memory tasks, including the free recall of word lists and the ability to remember a set of objects (either immediately after seeing them or later on). All Citicoline groups showed some improvement over the course of the trial. The only side effects were a decrease in blood pressure, and immunomodulatory effects shown as minor changes in the populations of white blood cells.

Citicoline was also tested in AAMI in a randomized, double-blind, placebo-controlled trial run by MIT in conjunction with US Army Research Institute of Environmental Medicine. In the first phase, ninety-five older volunteers with no active psychiatric or neurological disorders, and who were within the normal range on tests of mental status, were randomly assigned to take either a dummy pill or Citicoline for three months. The subjects with poorer memory at baseline showed improvements in recall (remembering details of a story heard one half hour previously). Subjects who began the study with poorer memories were then used in an additional study, in which they received one of two high doses of Citicoline for two months each. The higher dosage of Citicoline was "clearly associated with improved immediate and delayed logical memory." And while some side effects were reported, the incidence of side effects was actually higher in the placebo group than in people taking Citicoline!

A team of researchers at McLean Hospital in Belmont recently tested the effects of a six week supplementation of Citicoline. Volunteers were given an MRI at the beginning and end of the six week period to observe any changes. They found that supplies of brain energy were increased in critical regions of the brain.

Does "PS" Even Work?
All of the original trials documenting the benefits of "PS" supplements used a phosphatidylserine concentrate derived from cow brains. This product nearly vanished from the marketplace a decade ago when BSE ("mad cow disease" swept through Britain and threatened to create an epidemic across Europe. It was replaced by a form of "PS" derived from soy - a supplement fundamentally different in its biochemical structure from the original, mammalian brain-derived material. Until recently, there were only two small, nonrandomized, low-power, uncontrolled studies available to tell us about what this vegetal PS might do for a person.

Now, the first proper, double-blind, placebo-controlled trial using soy-derived PS has been performed. The results clearly show that unlike the original brain-derived PS supplements, the soy-based "PS" you can buy in capsules or softgels at health food stores today actually doesn't work any better than dummy pills at supporting memory or other aspects of brain function.

Neurons Beyond the Brain
Of course, the proper functioning of neurons is required for a lot more than just the workings of the brain. The final word isn't in, but preliminary evidence suggests that Citicoline is helpful with many non-brain conditions grounded in neurological dysfunction. Glaucoma, for instance, is most commonly the result of a buildup of pressure from the fluid in the eye (intraocular pressure), which literally squeezes the nerves that leave the eyeball, causing them to lose their supply of nutrients and slowly starve. In an open trial, 36 patients with glaucoma were given one gram of Citicoline daily for ten days. While the study was too short to assess any improvement in symptoms, the researchers did find that Citicoline "acts positively on the glaucomatous optic nerve damage" and led to "favorable neurotrophic [nerve-nourishing] effects."

Likewise, amblyopia, or "lazy eye," is ultimately a neurological disorder, although always associated with some other problem with visual function (such as a misalignment of the focus of the two eyes). Amblyopia develops when the nerve cells, which connect one eye to the brain are literally turned off, because the sensory messages the poorer eye is sending don't match up with those being sent by the dominant eye. After years of being deactivated, the nerves leading to the amblyopic eye can ultimately cause that eye to go fully blind.

Again, Citicoline may offer hope. Italian researchers have performed several trials in patients with amblyopia, which have confirmed that Citicoline significantly improves both symptoms and neurological function, and can be used to increase the effectiveness of occlusion (the standard therapy for "lazy eye").

With ongoing research, we may expect the fulfillment of some present promises, and the discovery of new applications for this remarkable nutrient.

Bring the Balance Back
Our minds are what make us who we are. Memories are our connection to our history, and the foundation of who we are today. The workings of the mind reflect the structure of the brain, and phospholipids play a vital part in that structure. Citicoline restores more youthful levels and balance of brain phospholipids, carrying us from our past into a clear future.

References

Secades JJ, Frontera G. CDP-choline: pharmacological and clinical review. Methods Find Exp Clin Pharmacol. 1995 Oct; 17 Suppl B: 1-54.

Spiers PA, Myers D, Hochanadel GS, Lieberman HR, Wurtman RJ. Citicoline improves verbal memory in aging. Arch Neurol. 1996 May; 53(5): 441-8.

Alvarez XA, Laredo M, Corzo D, Fernandez-Novoa L, Mouzo R, Perea JE, Daniele D, Cacabelos R. Citicoline improves memory performance in elderly subjects. Methods Find Exp Clin Pharmacol. 1997 Apr; 19(3): 201-10.

Eberhardt R, Birbamer G, Gerstenbrand F, Rainer E, Traegner H. Citicoline in the treatment of Parkinson's disease. Clin Ther. 1990 Nov-Dec; 12(6): 489-95.

Clark WM, Warach SJ, Pettigrew LC, Gammans RE, Sabounjian LA. A randomized dose-response trial of citicoline in acute ischemic stroke patients. Neurology. 1997 Sep; 49(3): 671-8.

Alvarez XA, Mouzo R, Pichel V, et al. Double-blind placebo-controlled study with citicoline in APOE genotyped Alzheimer's disease patients. Effects on cognitive performance, brain bioelectrical activity and cerebral perfusion. Methods Find Exp Clin Pharmacol. 1999 Nov; 21(9): 633-44.

Rejdak R, Toczolowski J, Kurkowski J, Kaminski ML, Rejdak K, Stelmasiak Z, Grieb P. Oral citicoline treatment improves visual pathway function in glaucoma. Med Sci Monit. 2003 Mar; 9(3): PI24-8.

CDP-choline reduces dopaminergic cell loss induced by MPP(+) and glutamate in primary mesencephalic cell culture.
Int J Neurosci. 2007 Jul;117(7):985-98.
Radad K, Gille G, Xiaojing J, Durany N, Rausch WD.

Cytidine-5'-diphosphocholine (citicoline or CDP-choline) is an essential endogenous intermediate in the biosynthesis of phosphatidylcholine. In the present study, primary dopaminergic cultures from mouse mesencephala were treated with citicoline to investigate its neuroprotective potential on the survival of dopaminergic neurons exposed to MPP(+) and glutamate. Treatment with citicoline alone significantly increased the survival of dopaminergic neurons compared to controls. MPP(+) or glutamate decreased the total number of dopaminergic neurons whereas citicoline afforded significant protection against either toxicity. Moreover, citicoline significantly decreased propidium iodide uptake by cultured cells. The study concludes that citicoline exerts stimulant and neuroprotective actions on cultured dopaminergic neurons.


A chronic treatment with CDP-choline improves functional recovery and increases neuronal plasticity after experimental stroke.
Neurobiol Dis. 2007 Apr;26(1):105-11. Epub 2007 Jan 16.
Hurtado O, Cardenas A, Pradillo JM, Morales JR, Ortego F, Sobrino T, Castillo J, Moro MA, Lizasoain I.

Chronic impairment of forelimb and digit movement is a common problem after stroke that is resistant to therapy. Although in the last years some studies have been performed to increase the efficacy of rehabilitative experience and training, the pharmacological approaches in this context remain poorly developed. We decided to study the effect of a chronic treatment with CDP-choline, a safe and well-tolerated drug that is known to stabilize membranes, on functional outcome and neuromorphological changes after stroke. To assess the functional recovery we have performed the staircase reaching test and the elevated body swing test (EBST), for studying sensorimotor integration and asymmetrical motor function respectively. The treatment with CDP-choline, initiated 24 h after the middle cerebral artery occlusion (MCAO) and maintained during 28 days, improved the functional outcome in both the staircase test (MCAO+CDP=87.0+/-6.6% pellets eaten vs. MCAO+SAL=40.0+/-4.5%; p<0.05) and the EBST (MCAO+CDP=70.0+/-6.8% vs. MCAO+SAL=88.0+/-5.4%; contralateral swing p<0.05). In addition, to study potential neuronal substrates of the improved function, we examined the dendritic morphology of layer V pyramidal cells in the undamaged motor cortex using a Golgi-Cox procedure. The animals treated with CDP-choline showed enhanced dendritic complexity and spine density compared with saline group. Our results suggest that a chronic treatment with CDP-choline initiated 24 h after the insult is able to increase the neuronal plasticity within noninjured and functionally connected brain regions as well as to promote functional recovery.


Citicoline: Pharmacological and clinical review, 2006 update.
Methods Find Exp Clin Pharmacol. 2006 Sep;28 Suppl B:1-56.
Secades JJ, Lorenzo JL.

Cytidine 5'-diphosphocholine, CDP-choline, or citicoline is an essential intermediate in the biosynthetic pathway of structural phospholipids in cell membranes, particularly phosphatidylcholine. Following administration by both the oral and parenteral routes, citicoline releases its two main components, cytidine and choline. Absorption by the oral route is virtually complete, and bioavailability by the oral route is therefore approximately the same as by the intravenous route. Once absorbed, citicoline is widely distributed throughout the body, crosses the blood-brain barrier and reaches the central nervous system (CNS), where it is incorporated into the membrane and microsomal phospholipid fraction. Citicoline activates biosynthesis of structural phospholipids of neuronal membranes, increases brain metabolism, and acts upon the levels of different neurotransmitters. Thus, citicoline has been experimentally shown to increase norepinephrine and dopamine levels in the CNS. Owing to these pharmacological mechanisms, citicoline has a neuroprotective effect in hypoxic and ischemic conditions, decreasing the volume of ischemic lesion, and also improves learning and memory performance in animal models of brain aging. In addition, citicoline has been shown to restore the activity of mitochondrial ATPase and membrane Na+/K+ATPase, to inhibit activation of certain phospholipases, and to accelerate reabsorption of cerebral edema in various experimental models. Citicoline has also been shown to be able to inhibit mechanisms of apoptosis associated to cerebral ischemia and in certain neurodegeneration models, and to potentiate neuroplasticity mechanisms. Citicoline is a safe drug, as shown by the toxicological tests conducted, that has no significant systemic cholinergic effects and is a well tolerated product. These pharmacological characteristics and the action mechanisms of citicoline suggest that this product may be indicated for treatment of cerebral vascular disease, head trauma (HT) of varying severity, and cognitive disorders of different causes. In studies conducted in the treatment of patients with HT, citicoline was able to accelerate recovery from post-traumatic coma and neurological deficits, achieving an improved final functional outcome, and to shorten hospital stay in these patients. Citicoline also improved the mnesic and cognitive disorders seen after HT of minor severity that constitute the so-called post-concussional syndrome. In the treatment of patients with acute ischemic cerebral vascular disease, citicoline accelerates recovery of consciousness and motor deficit, achieves a better final outcome, and facilitates rehabilitation of these patients. The other major indication of citicoline is for treatment of senile cognitive impairment, either secondary to degenerative diseases (e.g. Alzheimer disease) or to chronic cerebral vascular disease. In patients with chronic cerebral ischemia, citicoline improves scores in cognitive rating scales, while in patients with senile dementia of the Alzheimer type it stops the course of disease, and neuroendocrine, neuroimmunomodulatory, and neurophysiological benefits have been reported. Citicoline has also been shown to be effective in Parkinson disease, drug addictions, and alcoholism, as well as in amblyopia and glaucoma. No serious side effects have occurred in any series of patients treated with citicoline, which attests to the safety of treatment with citicoline. (c) 2006 Prous Science. All rights reserved.


CDP-choline: pharmacological and clinical review.
Methods Find Exp Clin Pharmacol 1995 Oct; 17 Suppl B: 1-54.
Secades JJ, Frontera G.

Cytidine 5'-diphosphocholine, CDP-choline or citicoline, is an essential intermediate in the biosynthetic pathway of the structural phospholipids of cell membranes, especially in that of phosphatidylcholine. Upon oral or parenteral administration, CDP-choline releases its two principle components, cytidine and choline. When administered orally, it is absorbed almost completely, and its bioavailability is approximately the same as when administered intravenously. Once absorbed, the cytidine and choline disperse widely throughout the organism, cross the blood-brain barrier and reach the central nervous system (CNS), where they are incorporated into the phospholipid fraction of the membrane and microsomes. CDP-choline activates the biosynthesis of structural phospholipids in the neuronal membranes, increases cerebral metabolism and acts on the levels of various neurotransmitters. Thus, it has been experimentally proven that CDP-choline increases noradrenaline and dopamine levels in the CNS. Due to these pharmacological activities, CDP-choline has a neuroprotective effect in situations of hypoxia and ischemia, as well as improved learning and memory performance in animal models of brain aging. Furthermore, it has been demonstrated that CDP-choline restores the activity of mitochondrial ATPase and of membranal Na+/K+ ATPase, inhibits the activation of phospholipase A2 and accelerates the reabsorption of cerebral edema in various experimental models. CDP-choline is a safe drug, as toxicological tests have shown; it has no serious effects on the cholinergic system and it is perfectly tolerated. These pharmacological characteristics, combined with CDP-choline's mechanisms of action, suggest that this drug may be suitable for the treatment of cerebral vascular disease, head trauma of varying severity and cognitive disorders of diverse etiology. In studies carried out on the treatment of patients with head trauma, CDP-choline accelerated the recovery from post-traumatic coma and the recuperation of walking ability, achieved a better final functional result and reduced the hospital stay of these patients, in addition to improving the cognitive and memory disturbances which are observed after a head trauma of lesser severity and which constitute the disorder known as postconcussion syndrome. In the treatment of patients with acute cerebral vascular disease of the ischemic type, CDP-choline accelerated the recovery of consciousness and motor deficit, attaining a better final result and facilitating the rehabilitation of these patients. The other important use for CDP-choline is in the treatment of senile cognitive impairment, which is secondary to degenerative diseases (e.g., Alzheimer's disease) and to chronic cerebral vascular disease. In patients with chronic cerebral ischemia, CDP-choline improves scores on cognitive evaluation scales, while in patients with senile dementia of the Alzheimer's type, it slows the disease's evolution. Beneficial neuroendocrine, neuroimmunomodulatory and neurophysiological effects have been described. CDP-choline has also been shown to be effective as co-therapy for Parkinson's disease. No serious side effects have been found in any of the groups of patients treated with CDP-choline, which demonstrates the safety of the treatment.


Citicoline improves verbal memory in aging.
Arch Neurol 1996 May; 53(5): 441-8.
Spiers PA, Myers D, Hochanadel GS, Lieberman HR, Wurtman RJ.

OBJECTIVE: To test the verbal memory of older volunteers given citicoline.
DESIGN: A randomized, double-blind, placebo-controlled, parallel group design was employed in the initial study. After data analysis, a subgroup was identified whose members had relatively inefficient memories. These subjects were recruited for a second study that used a crossover design. The subjects took either placebo or citicoline, 1000 mg/d, for 3 months in the initial study. In the crossover study, subjects took both, placebo and citicoline, 2000 mg/d, each for 2 months.
SUBJECTS: The subjects were 47 female and 48 male volunteers 50 to 85 years old. They were screened for dementia, memory disorders, and other neurological problems. Of the subjects with relatively inefficient memories, 32 participated in the crossover study.
MAIN OUTCOME MEASURE: Verbal memory was tested at each study visit using a logical memory passage. Plasma choline concentrations were measured at baseline; at days 30, 60, and 90 in the initial study; and at day 60 of each treatment condition in the crossover study. Plasma choline concentrations and memory scores were analyzed using repeated-measures analysis of variance and covariance, followed by planned comparisons whenappropriate.
RESULTS: In the initial study, citicoline therapy improved delayedrecall on logical memory only for the subjects with relatively inefficient memories. In the crossover study, the higher dosage of citicoline was clearly associated with improved immediate and delayed logical memory.
CONCLUSIONS: Citicoline therapy improved verbal memory functioning in older individuals with relatively inefficient memories. Citicoline may prove effective in treating age-related cognitive decline that may be the precursor of dementia.


Citicoline improves memory performance in elderly subjects.
Methods Find Exp Clin Pharmacol. 1997 Apr; 19(3): 201-10.
Alvarez XA, Laredo M, Corzo D, Fernandez-Novoa L, Mouzo R, Perea JE, Daniele D, Cacabelos R.

Citicoline is a choline donor involved in the biosynthesis of brain phospholipids and acetylcholine extensively used in the treatment of neurodegenerative diseases. In this study we investigated the effects of the oral administration of citicoline alone (C1000:1000 mg/day; C500:500 mg/day) or in combination with nimodipine (C +NI:300 + 90 mg/day) during 4 weeks on memory performance in elderly subjects with memory deficits and without dementia (N = 24; age = 66.12 +/- 10.78 years; MMS score = 31.69 +/- 2.76). Results indicated that citicoline in comparison with placebo improves memory in free recall tasks, but not in recognition tests. A significant improvement in word recall (5.17 +/- 1.1 vs. 3.95 +/- 1.2 omissions; p < 0.005), immediate object recall (6.5 +/- 1.6 vs. 5.5 +/- 1.2 omission; p < 0.05) and delayed object recall (8.5 +/- 2.1 vs. 6.7 +/- 2.4 omissions; p < 0.005) was observed after citicoline treatment. Similar results were found in the three subgroups of treatment (8 subjects per group), suggesting that citicoline possesses memory-enhancing activity at doses of 300-1000 mg/day. A decrease in systolic blood pressure and minor changes in lymphocyte cell counting were also observed in old subjects after receiving citicoline. These effects are consistent with the vasoregulatory and neuroimmune actions of citicoline and suggest that this compound may improve memory by acting on mechanisms of brain neurotropism and cerebrovascular regulation. According to the present results, showing that citicoline improves memory performance in elderly subjects, we concluded that this molecule is suitable for the treatment of memory deficits in old people.


Citicoline in the treatment of Parkinson's disease.
Clin Ther. 1990 Nov-Dec; 12(6): 489-95.
Eberhardt R, Birbamer G, Gerstenbrand F, Rainer E, Traegner H.

Eighty-five patients with an established diagnosis of primary Parkinson's disease were randomly assigned to receive their usual dose of levodopa (mean, 381 mg daily) plus 1,200 mg of citicoline daily or half their usual dose of levodopa (mean, 196 mg daily) plus the citicoline. Results of the Webster Rating Scale, a pegboard test, drawing, writing, and walking tests, a test of emotional state, and an overall assessment, administered before and after four weeks of treatment, revealed no significant between-group differences. Improvements on the tests were shown by more patients who received half their levodopa dose plus citicoline than by those who continued to receive their usual levodopa dose plus the citicoline. It is concluded that the levodopa-saving effect of Citicoline could be used to decrease the incidence of side effects and retard the loss of efficacy of levodopa in long-term treatment.

A randomized dose-response trial of citicoline in acute ischemic stroke patients.
Neurology. 1997 Sep; 49(3): 671-8.
Clark WM, Warach SJ, Pettigrew LC, Gammans RE, Sabounjian LA.

Citicoline (CDP-choline) is a key intermediary in the biosynthesis of phosphatidylcholine, an important component of the neural cell membrane. It has been shown to produce beneficial effects in both animal models and non-US clinical stroke trials. This study comprised a randomized (3 doses of Citicoline to 1 placebo), vehicle-controlled, double-blind trial at 21 US centers. Treatment was to be started within 24 hours of stroke onset and was continued orally for 6 weeks. Final outcome assessments were at 12 weeks. Two hundred fifty-nine patients were enrolled, with approximately 65 in each of the four groups. Mean time from stroke onset to treatment was 14.5 hours, and there were no significant differences in baseline characteristics between the four groups except for patient weight. A significant difference between the groups, favoring citicoline treatment, was seen in terms of functional outcome as measured by the Barthel Index and Rankin scale, neurologic evaluation as measured by the National Institutes of Health (NIH) stroke scale, and cognitive function as measured by the Mini Mental Status Examination. When the baseline NIH stroke scale was used as a covariate, both the 500-mg citicoline group and the 2,000-mg citicoline group had a significant improvement in terms of the percent of patients who had a favorable outcome on the Barthel Index at 90 days. There were no drug-related serious adverse events or deaths in this study. This study suggests that oral citicoline can be used safely with minimal side effects in acute stroke treatment. Citicoline appears to improve functional outcome and reduce neurologic deficit with 500 mg of citicoline appearing to be the optimal dose.


Double-blind placebo-controlled study with citicoline in APOE genotyped Alzheimer's disease patients. Effects on cognitive performance, brain bioelectrical activity and cerebral perfusion.
Methods Find Exp Clin Pharmacol. 1999 Nov;21(9):633-44.
Alvarez XA, Mouzo R, Pichel V, Perez P, Laredo M, Fernandez-Novoa L, Corzo L, Zas R, Alcaraz M, Secades JJ, Lozano R, Cacabelos R.

Cytidine 5'-diphosphocholine (citicoline) is a an endogenous intermediate in the biosynthesis of structural membrane phospholipids and brain acetylcholine. Citicoline has been extensively used for the treatment of neurodegenerative disorders associated with head trauma, stroke, brain aging, cerebrovascular pathology and Alzheimer's disease. In this study we have investigated the efficacy and safety of the treatment with citicoline versus placebo in patients with Alzheimer disease. Thirty patients (age = 73.0 +/- 8.5 years; range = 57-87 years) with mild to moderate senile dementia (GDS: stages 3-6) of the Alzheimer type were included in a double-blind, randomized and placebo-controlled clinical trial. After a 2-week period of drug washout, patients were treated with i) placebo (n = 17; age = 73 +/- 5 years) or ii) 1,000 mg/day of citicoline (n = 13; age = 76 +/- 9 years) for 12 weeks (84 days). Examinations were done at baseline (T0) and after the 12 weeks of treatment (T12). As compared to placebo, citicoline improved cognitive performance in Alzheimer's disease patients with APOE E4 (ADAS: difference between groups = -3.2 +/- 1.8 scores, p < 0.05; ADAS-cog: difference between groups = -2.3 +/- 1.5, ns); and this improvement on cognition was more pronounced (ADAS, p < 0.01; ADAS-cog: difference between groups = -2.8 +/- 1.3, p < 0.06) in patients with mild dementia (GDS < 5). Citicoline also increased cerebral blood flow velocities in comparison with placebo (p < 0.05) when transcranial Doppler recordings from both hemispheres were considered together, as well as diastolic velocity in the left middle cerebral artery (p < 0.05). Patients treated with citicoline showed an increase in the percentage of brain bioelectrical activity of alpha (occipital electrodes) and theta type (left side electrodes), accompanied by a decrease in relative delta activity particularly marked in the left temporal lobe. Significant differences with respect to placebo (p < 0.05) were observed for theta activity in several fronto-parieto-temporal electrodes of the left hemisphere. Treatment with citicoline tended to reduce serum IL-1 beta levels, mainly after 4 weeks of administration, with no modified blood histamine content. In addition, neither adverse side effects nor alterations in biological and hematological parameters were induced by citicoline. The present data indicate that citicoline (1,000 mg/day) is well tolerated and improves cognitive performance, cerebral blood perfusion and the brain bioelectrical activity pattern in AD patients. According to our results, it seems that citicoline might be a useful treatment in Alzheimer's disease, and that the efficacy of this compound is greater in patients with mild mental deterioration and/or bearing the epsilon 4 allele of the APOE.

Oral citicoline treatment improves visual pathway function in glaucoma.
Med Sci Monit. 2003 Mar; 9(3): PI24-8.
Rejdak R, Toczolowski J, Kurkowski J, Kaminski ML, Rejdak K, Stelmasiak Z, Grieb P.

BACKGROUND: Increased latency and reduced amplitude of visual evoked potentials (VEP), frequently encountered in ocular hypertension or open-angle glaucoma, suggest slowed neural conduction in the visual pathways. An improvement in VEP latency and amplitude has been reported following repeated intramuscular injections of citicoline, a neuroprotective drug. Our aim was to find whether citicoline given orally would produce a similar effect.
MATERIAL/METHODS: VEP latency and amplitude were measured in 21 glaucomatous eyes prior to and after two bi-weekly courses of citicoline taken orally in a dose of 1 gram/day. The treatment courses were separated by a two-week break; post-treatment VEP measurement was performed two weeks after the end of the second treatment.
RESULTS: 62% of the eyes showed a response to the treatment, with VEP latency reduced from 123.5 (3.9 SEM) ms to 111.9 (1.9 SEM) ms (P=0.0008), and VEP amplitude increased from 6.56 (1.39 SEM) to 7.88 (1.16 SEM) (P=0.04).
CONCLUSIONS: Citicoline given orally improves visual evoked potentials in some glaucoma patients.

Copyright © 2005, Advanced Orthomolecular Research