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On the limits of Citicoline and the need for comprehensive brain injury rehabilitation

Posted Nov 21 2012 1:38pm

Citicoline does not improve functional, cognitive status in patients with traumatic brain injury (Outcome Magazine):

“Although approved for use for treating traumatic brain injury (TBI) in nearly 60 countries, use of citicoline in a randomized trial that included more than 1,200 participants with TBI did not result in improvement in functional and cognitive status, according to a study appearing in the November 21 issue of JAMA.

“Despite considerable advances in emergency and critical care management of TBI as well as decades of research on potential agents for neuroprotection or enhanced recovery, no effective pharmacotherapy has yet been identified ”…Citicoline is widely available in the United States as a nutraceutical (product that reportedly provides health and medical benefits) and is used by patients with a range of neurologic disorders, yet it has not been evaluated in a large randomized clinical trial for TBI.

In an accompanying editorial…write that the primary importance reported by this trial “is that it conclusively demonstrated the lack of efficacy of citicoline monotherapy for TBI…The broader implication may be that no single therapeutic agent is likely to be sufficient to improve functional outcomes for patients with TBI. The diverse and complex nature of the pathological mechanisms activated by TBI suggests that multimodal treatment interventions may be needed to improve recovery. Future studies of TBI treatment should be designed to incorporate multiple treatment interventions and comprehensive TBI rehabilitation strategies, either as components of the intervention or standardized across study treatment groups.”

Study: Effect of Citicoline on Functional and Cognitive Status Among Patients With Traumatic Brain Injury Citicoline Brain Injury Treatment Trial (JAMA). From the Abstract:

  • Context: Traumatic brain injury (TBI) is a serious public health problem in the United States, yet no treatment is currently available to improve outcome after TBI. Approved for use in TBI in 59 countries, citicoline is an endogenous substance offering potential neuroprotective properties as well as facilitated neurorepair post injury.
  • Conclusion: Among patients with traumatic brain injury, the use of citicoline compared with placebo for 90 days did not result in improvement in functional and cognitive status.

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