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Review
. 2021 Apr 26;14(5):410.
doi: 10.3390/ph14050410.

Role of Citicoline in the Management of Traumatic Brain Injury

Julio J Secades  1
Affiliations
Review

Role of Citicoline in the Management of Traumatic Brain Injury

Julio J Secades. Pharmaceuticals (Basel). .

Abstract

Head injury is among the most devastating types of injury, specifically called Traumatic Brain Injury (TBI). There is a need to diminish the morbidity related with TBI and to improve the outcome of patients suffering TBI. Among the improvements in the treatment of TBI, neuroprotection is one of the upcoming improvements. Citicoline has been used in the management of brain ischemia related disorders, such as TBI. Citicoline has biochemical, pharmacological, and pharmacokinetic characteristics that make it a potentially useful neuroprotective drug for the management of TBI. A short review of these characteristics is included in this paper. Moreover, a narrative review of almost all the published or communicated studies performed with this drug in the management of patients with head injury is included. Based on the results obtained in these clinical studies, it is possible to conclude that citicoline is able to accelerate the recovery of consciousness and to improve the outcome of this kind of patient, with an excellent safety profile. Thus, citicoline could have a potential role in the management of TBI.

Keywords: CDP-choline; brain ischemia; citicoline; head injury; pharmacological neuroprotection; traumatic brain injury.

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Conflict of interest statement

JJ Secades is a full-time employee on a company marketing citicoline.

Figures

Figure 1
Figure 1
Relationship between citicoline and choline metabolism, cerebral phospholipids and acetylcholine. ACh: Acetylcholine; CTP: Cytidin triphosphate (Adapted with permission from Secades, J.J.; Lozano, R. Traumatismos craneoencefálicos: revisión fisiopatológica y terapéutica. Aportaciones de la citicolina. Excerpta Medica. Amsterdam, The Netherlands, 1991. Copyright 1985 Ferrer Internacional S.A.).
Figure 2
Figure 2
Effect of citicoline treatment on the rates of mortality and unfavorable outcome. ICU = Intensive Care Unit.
Figure 3
Figure 3
Forest plot of the meta-analysis of the effects of citicoline on independence after traumatic brain injury. OR = 1.815 (95% CI:1.302–2.530) based on the random-effects model. (From Secades, J.J. Citicoline for the Treatment of Head Injury: A Systematic Review and Meta-analysis of Controlled Clinical Trials. J. Trauma. Treat. 2014, 4, 227).
See this image and copyright information in PMC

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