Evidence supporting the use of: Citicoline
For the health condition: Concussions

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Citicoline (CDP-choline) is a compound involved in brain metabolism and the synthesis of phospholipids in neuronal membranes. Its use for concussion (mild traumatic brain injury, mTBI) is based on its neuroprotective properties, seen mostly in preclinical studies and some clinical trials. Citicoline is believed to support membrane repair, stabilize cell membranes, reduce free fatty acid buildup (which can be toxic post-injury), and promote the synthesis of neurotransmitters. Early animal studies indicated potential benefits in reducing neuronal damage following traumatic brain injury.

However, the scientific evidence in humans for concussion is limited and mixed. The largest, most rigorous trial to date – the COBRIT trial (Zafonte et al., JAMA 2012) – found no significant benefit of citicoline over placebo for functional or cognitive outcomes in patients with traumatic brain injury, including mild cases. While some small studies and open-label trials have suggested improvements in cognition or symptoms after TBI with citicoline, these are generally of lower methodological quality.

Overall, while there is a plausible scientific rationale and some preliminary data, the current clinical evidence does not robustly support the use of citicoline for concussion. The evidence rating is therefore moderate to low (2 out of 5), with further high-quality studies needed to establish efficacy for this indication.

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