Citicoline

At 500 mg a day for 12 weeks, a randomised placebo-controlled trial in 100 healthy older adults with age-associated memory impairment found greater gains in episodic and composite memory (PMID 33978188). A 4-week controlled trial in 24 older adults with memory deficits gave 500 or 1,000 mg a day and found similar free-recall gains in both groups, so the curve is flat from 500 to 1,000 mg (PMID 9203170). At 1 g a day for 12 months, an open-label randomised trial in 347 people after a first ischaemic stroke found better attention-executive function and temporal orientation than usual care (PMID 23406981). The 2,000 mg ceiling is a 12-week placebo-controlled trial in 62 adults with alcohol use disorder, where citicoline titrated to 2,000 mg a day was well tolerated but did not change cognitive measures (PMID 30457668). The dementia meta-analysis (PMID 36678257) found improved cognitive status in studies of poor quality and gives no doses. No trial found a better dose than 500 mg, so no optimal dose is set.