CDP-choline is a nootropic compound that is essentially a prodrug for both choline and uridine, conferring both of those molecules to the body following oral ingestion of CDP-Choline. Specifically, the CDP-choline dissociates into choline and cytidine, with the cytidine then converting into uridine. CDP-choline is one of the three choline-containing phospholipids that can be orally supplemented (the other two being Alpha-GPC and phosphatidylcholine).
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This supplement is catered towards preventing or treating memory impairments associated with aging due to the fact that both of the molecules it confers are neuroprotective and potentially enhance learning. While it appears to be more effective than phosphatidylcholine (PC) at this role, in part due to also increasing PC synthesis in the brain, its potency is somewhat comparable to that of Alpha-GPC.
CDP-choline has some other potential uses in relation to cognition. It is commonly used as a memory enhancer in youth, but despite some rodent studies suggesting that this is possible with oral CDP-choline, there are no human studies in youth at this point in time. One study has noted an increase in attention with low dose CDP-choline (which needs to be replicated), and CDP-choline may have roles as an anti-addictive compound against both cocaine and (preliminary evidence suggests) food as well.
Short-term treatment with citicoline has shown benefits in individuals with lower cognition at the beginning of studies, but due to discrepancies across studies, there is insufficient evidence that it is beneficial in healthy people with otherwise good cognition.
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Citicoline supplementation improved speed in cognitive tasks in teenage boys [1], and reaction time in young adults in their 20s [2; 3]. However, another small study in young men found that while performance on measures of processing speed, memory, and executive function improved following supplementation in low performers, it declined slightly in those with high performance at baseline [4]. Similarly, improvements in memory in healthy elderly adults have primarily been observed in those with memory problems [5]. One study in healthy middle-aged women reported that citicoline improved attention [6], while another study in healthy middle age to older adults found a small effect on memory but no effects on attention [7]. Reduction in markers of oxidative stress have also been observed with citicoline supplementation [3].
No studies have examined whether citicoline can prevent dementia, but studies to date have shown little to no benefit regarding protection against stroke or brain injury-related cognitive impairment. Citicoline has not shown benefits in ischemic stroke relative to the current standard of care [8; 9; 10]. In traumatic brain injury, modest neuroprotection has been observed with intravenous citicoline, while no clear benefits have been observed with other forms of administration [11].
The impact of APOE4 on the effects of citicoline is unclear. One small pilot study in people with the APOE4 variant reported that citicoline treatment for three months improved cognition compared to patients on a placebo [12], another study reported that APOE4 carriers showed less benefit [13], while a third study indicated that cognitive benefits were independent of APOE4 status [14]. For more information on what the APOE4 gene allele means for your health, read our APOE4 information page.
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