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Cit8.5
Citicoline Research
Probably helpsHigh safety
27 peer-reviewed studies
What the evidence says
Probably helps
Citicoline helped in about half (4/6) of the studies that measured an effect — promising, but not unanimous.
Most evidence is from high-quality meta-analyses and randomised trials published 1997–2026 with a typical study size of 73 participants.
Based on 27 studies · 4 meta-analyses · 15 RCTs · 6,794 total participants
Confidence
High
What the studies found
4helped1unclear1didn't help· 21 more without graded effect data
By outcome
Stroke & cerebrovascular
Probably helps25 studies
Cognitive functionBetter memory formation and recall · 4-8 weeks
Focus & attentionEnhanced attention and concentration · 1-4 weeks
Too few graded studies1 study
Depression & moodDopamine synthesis support may enhance motivation and mood · 4-8 weeks
Too few graded studies1 study
Safety profile
Too few graded studies1 study
By the numbers
Pulled from 22 studies with measurable effects
Likely real effects
60%
across studies
People studied
6,794
typical study: 73 people
Strongest designs
19
4 pooled, 15 randomised
Showed benefit
67%
4/6 studies
How long studies ran
1–4 weeks
1
1–3 months
1
3+ months
3
Populations Studied
Glaucoma patients2
Patients with schizophrenia1
Bipolar disorder patients1
Adults with dementia1
Active research area
14 studies in the last 5 years · Latest meta-analysis: 2025
199720112026
1Total symptomatologyMeta-AnalysisCited 10×n=50 · small study2025
Fornaro M et al. · Molecular psychiatry (2025)
Large benefit
← WorseNo effectBetter →
Change (Standardized Mean Difference = SMD) in total symptomatology and acceptability (Risk Ratio = RR) were co-primary outcomes.
High heterogeneity (tau2 = 0.10, I2 = 55.9%) and global inconsistency (Q = 40.79, df = 18, p = 0.002) emerged without publication bias (Egger's test, p = 0.42).
2Neurocognitive effects in bipolar disordersSystematic Review2025
Specific nutraceuticals may offer pro-cognitive effects for BD.
Balanzá-Martínez V et al. · Psychiatry research (2025)
Specific nutraceuticals may offer pro-cognitive effects for BD.
However, the evidence is limited by the small number of included studies and substantial heterogeneity in populations, interventions, and cognitive assessments.
Future studies should examine whole-diet, physical activity/exercise and multimodal LBIs.
Overall, citicoline improved cognitive status, with pooled standardized mean differences ranging from 0.56 (95% CI: 0.37-0.75) to 1.57 (95% CI: 0.77-2.37) in different sensitivity analyses.
This review does not support the current prescription of cholinergic agents to treat PUD.
Salloum N et al. · Psychopharmacology (2024)
Only two studies on galantamine (AChEI) and citicoline, reported a significant reduction of cocaine consumption. «Proof-of-concept» laboratory trials showed no evidence of efficacy on the selected outcomes, notably on craving.
This review does not support the current prescription of cholinergic agents to treat PUD.
Replication clinical trials notably on galantamine or other AChEI, and proof-of-concept trials on comedown symptoms will be necessary to identify a potential therapeutic indication for cholinergic agents in PUD.
9Cognition, mood, and behavioral symptoms in Alzheimer's diseaseSystematic ReviewCited 20×2020
Limited evidence from pooled data of two observational studies suggests that CC used in adjunct with AChEIs in the treatment of AD was well-tolerated and showed improvement in cognition, mood, and behavioral symptoms compared to treating with AChEIs alone.
Piamonte BLC et al. · Journal of Alzheimer's disease : JAD (2020)
Limited evidence from pooled data of two observational studies suggests that CC used in adjunct with AChEIs in the treatment of AD was well-tolerated and showed improvement in cognition, mood, and behavioral symptoms compared to treating with AChEIs alone.
Functional outcomes were significantly improved by citicoline, but the positive role of this drug in neurological recovery, domestic adaptation, and cognitive outcomes is still a topic of discussion for future.
Agarwal S et al. · Indian journal of pharmacology (2017)
Noticeable harm
← WorseNo effectBetter →
Likely real
In neurological evaluation, domestic adaptation evaluation, and cognitive outcomes, there was no significant difference in both the citicoline and placebo groups (odds ratio [OR] = 1.04 [0.9-1.2, P = 0.583]; OR = 1.1 [0.94-1.27, P = 0.209]; OR = 0.953 [0.75-1.2, P = 0.691]).
In evaluation of functional outcomes, there was significant difference in both groups and OR was 1.18 (1.04-1.34, P = 0.01).
Functional outcomes were significantly improved by citicoline, but the positive role of this drug in neurological recovery, domestic adaptation, and cognitive outcomes is still a topic of discussion for future.
11Complete recovery probability at 3 monthsMeta-AnalysisCited 28×2009
A citicoline supplement is now available from several sources on the internet.
Clark WM · Expert opinion on pharmacotherapy (2009)
Citicoline has been studied worldwide in both ischemic and hemorrhagic clinical stroke with excellent safety and possibly efficacy found in several trials.
A meta-analysis of four randomized US clinical citicoline trials concluded that treatment with oral citicoline within the first 24 h after a moderate to severe stroke is safe and increases the probability of complete recovery at 3 months.
Citicoline clinical efficacy trials are now continuing outside of the US in both ischemic and hemorrhagic stroke.
12memory performanceRCTCited 25×n=100 · medium study2021
Dietary supplementation of citicoline for 12 wk improved overall memory performance, especially episodic memory, in healthy older males and females with AAMI.
Nakazaki E et al. · The Journal of nutrition (2021)
Noticeable benefit
← WorseNo effectBetter →
Likely real
Composite memory (secondary outcome), calculated using the scores of 4 memory tests, also significantly improved to a greater extent following citicoline supplementation (mean: 3.78) compared with placebo (mean: 0.72, P = 0.0052).
Dietary supplementation of citicoline for 12 wk improved overall memory performance, especially episodic memory, in healthy older males and females with AAMI.
The findings suggest that regular consumption of citicoline may be safe and potentially beneficial against memory loss due to aging.
15Vision-related quality of lifeCrossoverCited 16×n=45 · small study2023
This is the first placebo-controlled clinical study evaluating the effect of a medical treatment aiming at improving vision-related quality of life in glaucomatous patients.
Rossetti L et al. · Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (2023)
This is the first placebo-controlled clinical study evaluating the effect of a medical treatment aiming at improving vision-related quality of life in glaucomatous patients.
16Alcohol use reductionRCTCited 12×n=55 · small study2019
This proof-of-concept study observed that citicoline was well tolerated, but was not associated with a reduction in alcohol use or other outcomes, as compared to placebo.
Brown ES et al. · Alcoholism, clinical and experimental research (2019)
The primary outcome analysis was conducted in the intent-to-treat sample and consisted of 55 participants (78.2% men and 21.8% women, mean age of 46.47 ± 9.15 years).
In the assessment period, the drinking days, on average, represented 77% of the assessed days.
This proof-of-concept study observed that citicoline was well tolerated, but was not associated with a reduction in alcohol use or other outcomes, as compared to placebo.
18Poststroke cognitive decline improvementRCTCited 51×n=347 · medium study2013
Citicoline treatment for 12 months in patients with first-ever ischemic stroke is safe and probably effective in improving poststroke cognitive decline.
Alvarez-Sabín J et al. · Cerebrovascular diseases (Basel, Switzerland) (2013)
Huge benefit
← WorseNo effectBetter →
Could be chance
We recruited 347 subjects (mean age 67.2 years, 186 male (56.6%), mean education 5.7 years); 172 (49.6%) received citicoline for 12 months (no significant differences from controls n = 175).
Moreover, citicoline group showed a better functional outcome (modified Rankin scale ≤2) at 12 months (57.3 vs. 48.7%) without statistically significant differences (p = 0.186).
Citicoline treatment for 12 months in patients with first-ever ischemic stroke is safe and probably effective in improving poststroke cognitive decline.
These baseline-dependent nicotinic effects on early auditory information processing warrant different dosage and repeated administration assessments in patients with low baseline deviance detection levels.
Choueiry J et al. · Journal of psychopharmacology (Oxford, England) (2023)
While no main treatment effect was observed, CDP-choline/galantamine significantly increased MMN amplitudes to frequency, duration, and vowel speech deviants in low group individuals.
These baseline-dependent nicotinic effects on early auditory information processing warrant different dosage and repeated administration assessments in patients with low baseline deviance detection levels.
20Functional outcomes (NIHSS 0-2, mRS 0-2, Barthel index >=95)RCTCited 18×2022
CAISR was the first to evaluate the role of Citicoline, when used immediately after recanalization therapy, when the penumbral tissue is the most susceptible either to be protected from injury or become ischemic.
Agarwal A et al. · PloS one (2022)
No clear effect
← WorseNo effectBetter →
The OR for achieving NIHSS 0-2, mRS 0-2 and Barthel index> = 95 with Citicoline was found to be 0.96(95%CI 0.39-2.40), 0.92(95%CI 0.40-2.05) and 0.87(95%CI 0.22-2.98) respectively.
CAISR was the first to evaluate the role of Citicoline, when used immediately after recanalization therapy, when the penumbral tissue is the most susceptible either to be protected from injury or become ischemic.
We did not find any significant difference between the Citicoline or placebo arms with respect to either our primary or secondary outcomes.