title: Citicoline in addictive disorders: a review of the literature.
abstract: BACKGROUND
  Citicoline is a dietary supplement that has been used as a neuroprotective agent for neurological disorders such as stroke and dementia. Citicoline influences acetylcholine, dopamine, and glutamate neurotransmitter systems; serves as an intermediate in phospholipid metabolism; and enhances the integrity of neuronal membranes. Interest has grown in citicoline as a treatment for addiction since it may have beneficial effects on craving, withdrawal symptoms, and cognitive functioning, as well as the ability to attenuate the neurotoxic effects of drugs of abuse.
  
  
  OBJECTIVE
  To review the literature on citicoline's use in addictive disorders.
  
  
  METHODS
  Using PubMed we conducted a narrative review of the clinical literature on citicoline related to addictive disorders from the years 1900-2013 using the following keywords: citicoline, CDP-choline, addiction, cocaine, alcohol, substance abuse, and substance dependence. Out of approximately 900 first hits, nine clinical studies have been included in this review.
  
  
  RESULTS
  Most addiction research investigated citicoline for cocaine use. The findings suggest that it is safe and well tolerated. Furthermore, citicoline appears to decrease craving and is associated with a reduction in cocaine use, at least at high doses in patients with both bipolar disorder and cocaine dependence. Limited data suggest citicoline may also hold promise for alcohol and cannabis dependence and in reducing food consumption.
  
  
  CONCLUSIONS
  Currently, there is limited research on the efficacy of citicoline for addictive disorders, but the available literature suggests promising results. Future research should employ larger sample sizes, increased dosing, and more complex study designs.
authors.affiliation: Department of Psychiatry, The University of Texas Southwestern Medical Center , Dallas, TX , USA.
authors.forename: Nicholas D
authors.initials: ND
authors.lastname: Wignall
authors.forename: E Sherwood
authors.initials: ES
authors.lastname: Brown
mesh_terms: D016739:Behavior, Addictive / Q000188:drug therapy*; D003566:Cytidine Diphosphate Choline / Q000627:therapeutic use*; D006801:Humans; D019966:Substance-Related Disorders / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D003566:Cytidine Diphosphate Choline
keywords: Addiction; alcohol; bipolar disorder; citicoline; cocaine; methamphetamine; substance abuse; substance dependence; substance use