The current state of citicholine (CDP-choline)
in cerebral ischemia
Abad-Santos F, Gallego-Sandin S, Novalbos J, Galvez-Mugica MA.
Servicio de Farmacologia Clinica,
Hospital Universitario de la Princesa,
Rev Neurol 2000 Apr 1-15;30(7):663-70
INTRODUCTION: CDP-choline has a neuroprotector effect since it reduces the lesions of nerve membranes, by increase in the synthesis of phospholipids, and reduces the levels of free fatty acids. In this study we review the existing data on the efficacy of CDP-choline in the treatment of acute ischemic cerebrovascular disease and its sequelae, both in animals and in clinical trials involving patients.
DEVELOPMENT: In various animal models CDP-choline reduces the volume of cerebral infarction and neurological sequelae and also potentiates the effects of other neuroprotector drugs. On analysis of the literature, we found six randomised clinical trials, double-blind and placebo-controlled in which the effect of CDP-choline was evaluated in patients who had acute ischemic cerebrovascular accidents. In all of these it was found that CDP-choline reduced the neurological sequelae. The finding of a broad therapeutic window (24-48 hours) gives this an advantage over the fibrinolytic agents, which have to be given within the first three to six hours. In further controlled trials carried out in patients with sequelae of cerebrovascular disease different degrees of neurological improvement were found, although studies of greater duration are required to see improvement in a longer term.
CONCLUSIONS: With the data available, we may affirm that CDP-choline is a safe, effective drug, although clinical trials are still underway in larger populations of patients. In these trials not only the neurological state but also the area of infarction are assessed to confirm their efficacy.