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Citicoline and attention: grade C

Limited evidence. Direction: Benefit.

C LimitedIndustry-fundedShort-term only

Educational guidance, not medical advice

Why this grade

Rubric condition met: C: one small RCT in healthy adolescents (n=75, 24 on placebo) plus a low-quality single-blind study; the larger older-adult RCT found no effect on its sustained attention task

The only randomized placebo-controlled trial of citicoline alone on attention in healthy people enrolled 75 adolescent males for 28 days and found improved attention; three of its authors are affiliated with the ingredient supplier. A 2-week study in 40 young adults reported gains but was single-blind with no described randomization. In older adults with memory complaints, the industry-funded 12-week trial found no effect on a sustained attention task, and a Cochrane review in clinical older populations found no evidence of benefit on attention. Evidence is mixed and thin.

How we grade evidence

Studies this grade rests on

EffectMixedNo effectSize shows participants (n)20052010201520202025Systematic reviewRCTPlacebo-controlle…Nakazaki 2021, 2021: RCT, n = 100, result not recordedMcGlade 2019, 2019: RCT, n = 75, result not recordedAl-Kuraishy 2020, 2020: placebo-controlled study, 2 weeks, two groups of 20; randomization not described; described as double-blind in one place and single-blind in another, n = 40, result not recordedFioravanti 2005, 2005: systematic review, n not recorded, result not recorded
each study this grade rests on, by publication year and design. Solid: effect versus the comparator; half-filled: mixed; hollow: no effect; dashed: result not recorded yet. Larger marks had more participants.
Show the numbers
StudyYearDesignParticipantsResult
Fioravanti 20052005systematic reviewnot recordedresult not recorded
McGlade 20192019RCT75result not recorded
Al-Kuraishy 20202020placebo-controlled study, 2 weeks, two groups of 20; randomization not described; described as double-blind in one place and single-blind in another40result not recorded
Nakazaki 20212021RCT100result not recorded

Citicoline Improves Human Vigilance and Visual Working Memory: The Role of Neuronal Activation and Oxidative Stress.

Al-Kuraishy HM, Al-Gareeb AI. Citicoline Improves Human Vigilance and Visual Working Memory: The Role of Neuronal Activation and Oxidative Stress Basic Clin Neurosci, 2020. PMID 33613880

Result not recorded
Design
Placebo-controlled study, 2 weeks, two groups of 20; randomization not described; described as double-blind in one place and single-blind in another
Sample
n = 40
Population
Healthy volunteers aged 21-22
Funding
No grant funding (full text)

The Effect of Citicoline Supplementation on Motor Speed and Attention in Adolescent Males.

McGlade E, Agoston AM, DiMuzio J. The Effect of Citicoline Supplementation on Motor Speed and Attention in Adolescent Males J Atten Disord, 2019. PMID 26179181

Result not recorded
Design
Randomized, placebo-controlled trial, 28 days
Sample
n = 75
Population
Healthy adolescent males
Funding
not stated in PubMed record

Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Nakazaki E, Mah E, Sanoshy K. Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial J Nutr, 2021. PMID 33978188

Result not recorded
Design
Randomized, double-blind, placebo-controlled trial, 12 weeks
Sample
n = 100
Population
Healthy adults aged 50-85 with age-associated memory impairment
Funding
Kyowa Hakko Bio Co., Ltd (sponsor; full text)

Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly.

Fioravanti M, Yanagi M. Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly Cochrane Database Syst Rev, 2005. PMID 15846601

Result not recorded
Design
Cochrane systematic review of 14 double-blind, placebo-controlled RCTs
Population
Older people with cognitive or behavioural problems from chronic cerebral disorders (clinical population), from subjective memory complaints to vascular cognitive impairment and dementia
Funding
not stated

Search and history

Search (): TITLE:(citicoline OR "CDP-choline") AND (ABSTRACT:attention) AND (ABSTRACT:healthy) AND PUB_TYPE:"Randomized Controlled Trial"

  • Graded C (proposed): Proposed in the monograph draft
  • C to C (approved): Editor sign-off November 13, 2026: grade matches the editor-approved final page