Citicoline: pharmacological and clinical review, 2022 update

This comprehensive review builds upon the previous publication by Secades JJ, focusing on Citicoline’s pharmacology and clinical implications. This updated edition includes 176 new references and consolidates key information to enhance accessibility. The scope of this review encompasses various indications for Citicoline, focusing on acute stroke and its aftermath, including cognitive deficits and traumatic brain injury.

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Chemical Background and Mechanism of Action

Citicoline, chemically known as cytidine-5'-diphosphocholine (CDP-choline), serves as a crucial precursor for the synthesis of cell membrane phospholipids. It participates in the formation of structural compounds essential for neurons and their functionality. Impaired phospholipid metabolism has been implicated in a range of neurological disorders, establishing the need for therapeutic agents that can enhance membrane stability.

Neuroprotective Properties

Various studies have highlighted Citicoline's ability to support neuronal integrity under pathological conditions. For instance, research indicates that Citicoline administration can mitigate the neuronal damage induced by oxidative stress and enhance recovery following traumatic brain injury. This protective effect underscores the potential of Citicoline in promoting neuronal regeneration and cognitive resilience.

Clinical Applications

Stroke Recovery and Cognitive Enhancement

In clinical settings, Citicoline has been shown to accelerate recovery in patients suffering from ischemic stroke. Notable studies have demonstrated significant improvements in motor skills and cognitive function following Citicoline treatment. The pharmacological profile of Citicoline—highlighting its neuroprotective effects—positions it as a promising candidate in the management of stroke-related disabilities.

Evidence from Clinical Trials

Clinical trials have consistently reported favorable outcomes with Citicoline treatment, particularly amongst patients with acute ischemic stroke. For example, a double-blind study indicated that Citicoline could significantly enhance recovery in motor function and thrombosis-related conditions. Such findings advocate for its inclusion as a standard treatment protocol in stroke rehabilitation.

Safety Profile

The tolerability of Citicoline has been found to be excellent, with few reported adverse effects. Most reactions, when present, tend to be mild and transient, such as mild headaches or gastrointestinal discomfort. This favorable safety profile allows for its extensive clinical application without significant risk, making it suitable for a diverse patient population.

In summary, Citicoline continues to emerge as a pivotal neuroprotective agent, showing promise in various neurological conditions, particularly acute ischemic stroke and resultant cognitive impairments. Its mechanisms of action, coupled with a favorable safety profile, support its ongoing research and application in clinical settings.

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