Citicoline (CDP Choline) Review: Discover The Side Effects, Benefits, Dosage, Stacks, and Where To Buy

What is Citicoline?

Citicoline, also known as CDP-choline, is a chemical produced naturally in our brains. Studies have found that it protects the brain from damage, boosts the levels of numerous neurotransmitters, and improves memory and learning.

For decades this compound has been used both as a drug to help with certain health conditions and as a nootropic to improve cognitive function.

What is Citicoline Used For?

Originally developed for stroke treatment, citicoline has since been used to help those suffering from Alzheimer’s disease, Parkinson’s disease, brain injuries, age-related memory decline, drug addiction, glaucoma, and ADHD.

It’s commonly sold as a supplement in the US where it’s used as a source of choline and as a nootropic.

As a nootropic people use CDP-choline on its own to help with memory, learning, focus and more. Citicoline is often used by neurohackers in a nootropic stack where it’s combined with other nootropics as a source of choline.

Citicoline vs CDP-Choline: Is There a Difference?

CDP-choline is simply another name for citicoline. Click here for a list of all alternative names.

How Does it Work?

When you take citicoline orally it gets broken down into choline and cytidine, the latter of which converts into uridine. Many of the benefits of this supplement are thanks to its providing the body with a good source of choline.

Once absorbed, these nutrients are delivered throughout the body, with some crossing the blood-brain barrier. In the brain they are resynthesized into citicoline. (1)

Citicoline is known to:
Boost neurotransmitter synthesis
Promote healthy cell membranes
Protect neurons (brain cells)
Increase cerebral blood flow

Increases Neurotransmitters

Choline is a precursor to the neurotransmitter acetylcholine (ACh). As deficient choline is typically the limiting step in ACh production, more choline leads to increased levels of ACh in the brain.

ACh is partly responsible for memory, learning, and overall brain health and function. ACh levels tend to decrease as we age, and low levels of ACh are associated with many age-related cognitive diseases.

ACh is not the only neurotransmitter increased by supplementing with this nootropic. Multiple animal studies have found an increase in dopamine, a neurotransmitter critical for focus and motivation, when taking citicoline. (6,7,8)

Promotes Healthy Cell Membranes

Citicoline is known to promote healthy cell membranes through boosting phospholipid metabolism. Phospholipids form the outer membrane around cells, keeping brain cells safe.

It boosts all three major phospholipids found in brain cell membranes: phosphatidylcholine, phosphatidylethanolamine, and phosphatidylserine. (2) Citicoline does this both through the synthesis of phospholipids and by reducing their breakdown.

Protects Neurons in the Brain

Neurons are the basic working cells found in the brain. They communicate to one another through impulses that essentially allow us to properly respond to our environment.

Through the improved creation and reduced breakdown of phospholipids covered above, citicoline may help to prevent the death of neurons, particularly those found in the hippocampus (1,3,4,5).

Additional ways that this nootropic protects brain cells is through repair to damaged cholinergic neurons and the reduction of free fatty acids in stroke patients.

Top 8 CDP-Choline Benefits

Studies provide evidence for numerous benefits thanks to this compound’s neuroprotective and cognitive-enhancing properties.

1. Enhances Memory and Learning

Memory and learning tend to decrease as we age.

These brain processes are dependent upon healthy cell membranes for proper nerve impulse transmission, as well as a good supply of dopamine. As we get older we experience a decrease in brain cell membrane phospholipids, which leads to hindered membrane function and a loss of cholinergic neurons. We also tend to create less dopamine as we age.

One human study found an improvement in both memory acquisition and global memory efficiency in elderly patients suffering from memory loss following six weeks of supplementation with CDP-choline. (1)

2. Improves Attention

Studies have found citicoline to be effective at improving attention in those with a deficit in cognitive performance, including the elderly and those who have suffered a stroke. More recently, studies have found this to apply to the general population as well. (10)

Citicoline was found to improve attentional performance over 28 days of supplementation in healthy adult women. This trend was found at both 250 and 500 mg daily doses. Another study found similar results for young, adolescent males. (11)

These results, combined with user reports, suggest that this nootropic may be helpful for those with ADHD.

3. May Help You Lose Weight

While much more research is needed on the use of this drug for modulating appetite, the limited evidence and user reports are promising. (14)

In a study on appetite and food cravings in humans, functional brain responses post treatment led researchers to conclude that citicoline may be helpful in reducing appetite. The treatment was 2,000 mg/day citicoline for 6 weeks. However, no significant weight loss during this period was found.

4. Protects from Brain Injury and Stroke

Multiple studies have found protective benefits from CDP-choline for those suffering from brain injuries and strokes.

These benefits include boosted phospholipid levels, reduced free fatty acid release following ischemia, and increased glutathione levels. These findings suggest that this supplement may help to reduce oxidative stress while enhancing overall brain health and ability to recover from brain injuries. (1).

In fact, one study concluded that taking CDP-choline within the first 24 hours following a stroke increased the probability of complete recovery at the three month mark. (13)

Another human study found that 1,000 mg/day helped to boost both cognitive and motor abilities, while another demonstrated that it helped to restore blood flow to the site of brain trauma, helping to restore memory. (15,16)

5. Fights Age-Related Cognitive Decline

Administration of citicoline for six weeks in the elderly was found to increase the brain levels of the byproducts of phospholipid metabolism. This finding suggests that supplementation with this drug may increase the synthesis and turnover of phospholipids, which can help to reverse age-related cognitive decline (1).

6. May Help Alzheimer’s Disease Patients

Human studies have demonstrated that choline helps to improve symptoms associated with Alzheimer’s disease (AD).

This drug may boost neuronal regeneration and restore membrane phospholipids in AD patients. It has also been demonstrated in human studies of AD patients to increase cerebral blood flow and improve immune strength. (9,17,18)

7. Improves Parkinson’s Disease Symptoms

In a study on Parkinson’s disease patients it was found that injection with 500 mg citicoline daily led to improvement in symptoms. This may be thanks to the impact of CDP-choline on dopamine levels. (6,7)

8. May Help to Repair Glaucoma Damage

This drug has been shown to repair optic nerve damage found in glaucoma patients through phosphatidylcholine synthesis and a boost in dopamine production (19).

Additional Benefits

Thanks to its impact on brain health and choline levels in the body, it’s speculated that this supplement may help with autism, bipolar disorder, and schizophrenia, but research is needed. One study also found that it may boost serum growth hormone. (19)

Citicoline Dosage Administration

CDP-choline is typically taken orally. What dosage you choose will depend on why you’re taking the compound, your individual experience with it, and even your diet (heavy meat eaters tend to get more choline from their diet when compared to their vegetarian counterparts).

Standard dosing in human clinical studies was generally between 500 to 2,000 mg/day divided into two doses. It does not appear to impact sleep, so you may take it at anytime during the day. There is no need to take a higher dose as 4,000 mg does not appear to affect the plasma levels any more than 2,000 mg.

Dose as a Nootropic

The improved mental energy and attention appears to be most prevalent at lower, not higher, doses. The typical dose for the nootropic benefits of enhancing attention and general brain function is between 250 and 500 mg.

Dose for Stroke

In a meta-analysis of studies on citicoline in stroke patients, it was found that 2,000 mg/day was the most effective dose at reducing symptoms and achieving recovery.

Dose for Renal Failure

There is no data regarding how safe this drug is or how much you should take if you are experiencing liver or kidney problems. That said, the toxicology data out there suggests an increased risk of hyperphosphatemia when taking citicoline.

If you suffer from kidney failure you’ll want to talk to your doctor before adding in this supplement.

Doses for Other Medical Conditions

The following dosages have been used in human studies (1):

  • Alzheimer’s disease: 1,000 mg/day orally
  • Parkinson’s disease: 500 mg/day intramuscular injection
  • Glaucoma: 1,000 mg/day intramuscular injection
  • Head injury and brain trauma: 1,000 mg/day orally
  • Age-related memory impairment: 1,000-2,000 mg/day orally
  • Appetite suppressant: 2,000 mg/day orally

If you’re simply looking to increase your choline levels, you can always increase the choline-rich food in your diet. While most foods rich in this nutrient are animal-based, there are vegetarian sources of choline too. Here is a list of high-choline foods:

  • Beef liver
  • Chicken
  • Salmon
  • Scallops
  • Broccoli
  • Brussel sprouts
  • Peanuts
  • Eggs

Half-Life

Citicoline is excreted through the body in two ways: through respiratory CO2 and excretion through the urine. Because of these two excretion pathways there are two half-lives: 56 hours through CO2 and 71 hours through urine. (1)

Side Effects and Contraindications

This drug is considered safe with a very low toxicology profile, however side effects of headache, stomach pain, and diarrhea have been reported with oral use. (1,17) Users have reported depression and other mood-related symptoms.

There are concerns that this compound may not be safe with those with liver or kidney conditions, however there is no specific data. Additionally, high choline intake has been linked with an increased risk of prostate cancer.

No studies have been done on the safety profile of this supplement for women who are pregnant, breastfeeding, or plan to become pregnant.

Comparisons

Choline vs Citicoline

Choline belongs to the B-vitamin complex. While it’s produced in the body at low levels, it’s still considered an essential nutrient as our bodies need more than we produce endogenously.

Citicoline is a drug that when broken down during digestion forms choline and cytidine. With most of the benefits of citicoline attributed to choline, you may wonder why not just take a choline supplement?

When your body breaks citicoline down into choline and cytidine, some of the cytidine is used for the production of nucleotides in the brain. It’s also been found that when cytidine is administered with choline it increases the production of phosphatidylcholine. What this means is that the cytidine found in this supplement boosts the ability of choline to improve our brain health and function.

This is especially true for brain injury and stroke, where the boost in phosphatidylcholine is critical to the effectiveness of the drug.

Additionally, cytidine greatly lowers the toxicology of choline. (12) Choline on its own is quite safe, however it is even safer when combined with cytidine.

Stacks

Most neurohackers love combining different nootropics to provide the most benefit and fewest side effects. As a source of choline, citicoline is often included in a nootropic stack.

Citicoline and Adderall + Nootropic Adderall-Like Stack

Many users report negative experiences mixing Adderall with this nootropic when it comes to depression and mood. But what if you could recreate the effects of Adderall with a stack of three nootropics?

If you’re looking for an alternative to Adderall without all of the side effects, citicoline, adrafinil, and phenylpiracetam stacked together offer similar cognitive benefits.

Both phenylpiracetam and adrafinil are so effective at boosting energy and performance that they’re banned by the World Anti-Doping Agency for competitive sports.

Phenylpiracetam is a member of the racetam family of nootropics. It’s one of the most powerful nootropics when it comes to increasing energy, boosting stress tolerance, lifting mood, providing motivation, and enhancing memory.

Adrafinil boasts many of the same benefits, and when combined they become exceptionally effective at improving mood, energy, alertness, and motivation.

CDP-choline is crucial here as a source of choline. Racetams work their magic only when there is a sufficient source of choline in the body. If you don’t add a quality choline source to your racetam stack the side effects can be unfortunate, and the nootropics will stop working for you.

Citicoline AND Alpha GPC

Both of these nootropics are great sources of choline and offer memory and learning benefits. If you’re taking other nootropics, adding in a choline source is important in order to not end up with a choline deficiency. This can be pretty nasty and cause headaches, brain fog, fatigue, memory problems, and much more.

Citicoline vs Alpha GPC

Both citicoline and alpha GPC are highly bioavailable sources of choline for the body and brain that boast additional memory and learning benefits. They’re known to help improve brain metabolism, phospholipid biosynthesis, and neurotransmitter levels.

Many of the benefits attributed to each of these nootropics is thanks to their boosting ACh levels in the brain. In order to understand where the differences lie we must first understand choline metabolism and how ACh is formed.

Choline in our bodies is converted into CDP choline, which in turn is broken down to form phosphatidylcholine. This compounds is used in the synthesis of ACh by being converted into glycerophosphocholine (GPC), then choline, and finally ACh.

As you can see, when you supplement with citicoline you enter early on in the ACh synthesis process. When you take alpha GPC, you enter later, at the glycerophosphocholine (GPC) step. Thus, the difference in ACh synthesis is that alpha GPC is a byproduct of phosphatidylcholine, whereas citicoline is a precursor to phosphatidylcholine.

Simply put, when you supplement with alpha GPC you enter the ACh synthesis process much closer to the final synthesis of ACh when compared to citicoline, where you enter closer to the original source of choline.

When you take alpha GPC, it breaks down, delivering choline and producing ACh. When you take CDP choline it is used as an intermediate to create more ACh when needed.

As both of these nootropics provide similar benefits to the user and are involved in the same ACh synthesis process, it’s natural to wonder which one is superior when it comes to nootropic benefits. This question doesn’t have a black-and-white answer.

Because of the differences outlined above, it would make sense that alpha GPC would lead to the greatest increase in ACh levels. Unfortunately, there are very few studies comparing these two drugs head-to-head. Of the two that there are, alpha GPC, when administered through intramuscular injection, appears to both boost cognitive function more and lead to higher levels of plasma choline. As these studies use a different treatment method than the oral nootropic application, more studies need to be conducted to confirm these results.

When it comes to user reviews, these drugs tend to have similar positive reviews. As each supplement has been shown to produce pronounced cognitive and ACh boosting benefits on their own, the best way to decide which of these supplements works best for you is to test them out and see which one provides the best personal results.

When picking dosages to compare, keep in mind that to get equal quantities of choline you need slightly more than twice the dosage of citicoline as you do alpha GPC. (20).

CDP-choline and Piracetam

Piracetam is a powerful nootropic that needs to be paired with an external choline source. This is because Piracetam increases the need for ACh, which uses choline to be produced in the body. By pairing this racetam with a choline source, you boost its effectiveness and ward off many of the unwanted side effects that are caused by too little choline in the body.

CDP-choline is a great choice thanks to providing a highly bioavailable choline source while offering its own nootropic benefits.

Citicoline Experience & Reviews

Positive effects touted by those who have used this nootropic as posted on Longecity and Reddit include:
Enhanced libido
Cleared brain fog
Improved mood
Boosted wakefulness
Vision enhancement
Cured erectile dysfunction

The side effects that users report are as follows:
Depression
Brain fog
Fatigue
Headache
Digestive problems

Here are some user reviews by those who have taken this supplement for its nootropic properties:

“Out of all the choline sources I’ve used (bitartrate, alphagpc, centrophenoxine) CDP-choline has much more of an effect. I feel calmer and it just gives me a great feeling of well being, like my brain is really healthy.” Golden1, Longecity, comparing CDP-choline to other choline sources

“It is as if a cloud has been lifted from my head. I still can’t really focus, but now feel a very light body sensation, and feel as if I can finally feel happiness.” Marshall213, Reddit, after taking 1,000 mg CDP-choline 

Where to Buy CDP-Choline Online

Freebase citicoline is sold as a dietary supplement in the United States and a drug in Japan. Another form of citicoline, the sodium salt of citicoline, is sold in the UK as a drug.

It is best to obtain your nootropics from a trusted online source to ensure that you’re getting the highest quality supplements on the market. We recommend Nootropics Depot and Pure Nootropics. Some of the best citicoline supplements are powders made by Jarrow, Life Extension, and Cognizin (100 mg).

References:

  1. Therapeutic applications of Citicoline for stroke and cognitive dysfunction in the elderly: a review of the literature

http://archive.foundationalmedicinereview.com/publications/9/1/17.pdf

  1. Evidence that 5’-cytidinediphosphocholine can affect brain phospholipid composition by increasing choline and cytidine plasma levels.

https://www.ncbi.nlm.nih.gov/pubmed/7616250

  1. Citicoline mechanisms and clinical efficacy in cerebral ischemia

https://www.ncbi.nlm.nih.gov/pubmed/12271462

  1. Citicoline decreases phospholipase A2 stimulation and hydroxyl radical generation in transient cerebral ischemia

https://www.ncbi.nlm.nih.gov/pubmed/12868064

  1. Citicoline: neuroprotective mechanisms in cerebral ischemia

https://www.ncbi.nlm.nih.gov/pubmed/11796739

  1. Effects of cytidine-5’ diphosphocholine on norepinephrine, dopamine and serotonin synthesis in various regions of the rat brain.

https://www.ncbi.nlm.nih.gov/pubmed/485720

  1. New strategies in the management of Parkinson’s disease: a biological approach using a phospholipid precursor (CDP-choline)

https://www.ncbi.nlm.nih.gov/pubmed/7162583

  1. Cytidine(5’)diphosphocholine enhances the ability of haloperidol to increase dopamine metabolites in the striatum of the rat and to diminish stereotyped behavior induced by apomorphine.  

https://www.ncbi.nlm.nih.gov/pubmed/6543245

  1. Citicoline protect hippocampal neurons against apoptosis induced by brain beta-amyloid deposits plus cerebral hypoperfusion in rats.

https://www.ncbi.nlm.nih.gov/pubmed/10599052

  1. Improved attentional performance following citicoline administration in healthy adult women

https://file.scirp.org/pdf/FNS20120600007_87495447.pdf

  1. Cognition-enhancing citicoline found to improve motor speed and attention in adolescents

https://kyowa-usa.com/news/2014/07-29  

  1. Citicoline (CDP-choline): mechanisms of action and effects in ischemic brain injury.

https://www.ncbi.nlm.nih.gov/pubmed/7477743

  1. Oral citicoline in acute ischemic stroke: an individual patient data pooling analysis of clinical trials.

https://www.ncbi.nlm.nih.gov/pubmed/12468781

  1. Citicoline affects appetite and cortico-limbic responses to images of high-calorie foods.

https://www.ncbi.nlm.nih.gov/pubmed/19260039

  1. Pathogenesis of traumatic brain edema

https://www.sciencedirect.com/science/article/pii/S097305080980021X

  1. Effects of CDP-choline on the recovery of patients with head injury

https://www.ncbi.nlm.nih.gov/pubmed/1940960

  1. Neuroprotective properties of citicoline: facts, doubts and unresolved issues

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3933742/

  1. Oral citicoline in acute ischemic stroke: an individual patient data pooling analysis of clinical trials

https://www.ncbi.nlm.nih.gov/pubmed/12468781

  1. CDP-choline increases plasma ACTH and potentiates the stimulated release of GH, TSH and LH: the cholinergic involvement

https://www.ncbi.nlm.nih.gov/pubmed/15482372

  1. Modulation of monoaminergic transporters by choline-containing phospholipids in rat brain

https://www.ncbi.nlm.nih.gov/pubmed/23244432