What is CDP-choline?
Cytidine diphosphate-choline (CDP-choline, also known as citicoline (INN) and cytidine 5’diphosphocoline) is an intermediate in the metabolic pathway by which dietary choline is synthesized into phosphatidylcholine.
Originally developed as a stroke treatment in Japan, it is considered to be a nootropic that may also have psychostimulant properties via its effects on neurotransmitter levels. It is sold as a dietary supplement in the U.S. and is classified as a drug in Japan and European countries, where it is often prescribed for cognitive impairment, neurological disorders, and as a post-stroke treatment.
How does it work?
CDP-choline stimulates the production of structural phospholipids that build cell membranes, increase brain metabolism, and seem to increase levels of the neurotransmitters acetylcholine and dopamine. More specifically, CDP-choline increases the amount of raw material available to produce phosphatidylcholine. This particular lipid is used by neurons to replenish cell membrane lipids and maintain cellular integrity.
Scientists have studied the effects of CDP-choline on cellular function in a number of model systems. In vitro cell culture studies have shown that phosphatidylcholine synthesis is necessary for cell viability. Blocking its production causes cells to undergo apoptosis (cellular suicide). This important phospholipid is a critical component of the cell membrane that has been shown to decrease with age. Therefore, supplementing CDP-choline may provide cells the necessary building blocks to replenish phosphatidylcholine in membranes.
CDP-choline was administered to acute ischemic stroke patients during a controlled, double-blind trial that took place at 21 different centers across the U.S. They found that those who received CDP-choline (500 and 2000 mg) had significantly greater functional recovery than patients who received placebo.
This compound has also been shown to prevent, reduce, or reverse damage due to ischemia and hypoxia (lack of blood flow and oxygen) in several model systems. It also decreases cellular membrane damage and edema following head trauma.
The body of research in healthy individuals is not as robust, although there have been a handful of studies that suggest CDP-choline supplementation protects against memory deficits in aging rats.
A small-scale study in 95 healthy elderly people (50-85 years old) reported that 1,000-2,000 mg of CDP-choline taken for 3 months improved delayed recall, verbal memory, and logical memory, three commonly used neuropsychological tests. A Harvard research group used brain imaging to demonstrate that CDP-choline supplementation increased brain energy in healthy 40-60-year-old volunteers, and they observed concomitant improvements on cognitive tests that assess spatial memory and attention.
Anecdotally, the benefits of taking CDP-choline are improved memory acquisition and retention, increased mental clarity, better concentration and mood, and greater focus. It is safe for stroke, Alzheimer’s, and Parkinson’s patients.
CDP-choline side effects?
CDP-choline is extremely safe based on extensive toxicological tests. It is well tolerated and does not seem to induce any serious side effects. However, some people have reported restless sleep, headache, diarrhea, high blood pressure, and nausea. Taking CDP-choline in the morning rather than the afternoon is recommended if you experience insomnia. It has not been clinically tested for periods longer than 90 days.
Unlike many supplements, CDP-choline is exceptionally well absorbed. Nearly 100% of an oral dose accesses systemic circulation. Furthermore, it is able to cross the blood-brain barrier and reach the nervous system, where it exerts its most important effects. The clinical trial of ischemic stroke patients described above determined that 500 mg of CDP-choline per day was the optimal dose, at least for their particular patient population.
Most CDP-choline supplement bottles suggest daily dosages of 250-500 mg (capsules are usually 250 mg) taken before breakfast or lunch. However, if you don’t notice any effects it is safe to take a higher dose (up to 2,000 mg is well tolerated and does not seem to produce any side effects).
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