Citicoline is a neuroprotective agent
Citicoline is one of the common drugs used in the treatment of central nervous system. It is often used in the treatment of cerebral infarction, cerebral insufficiency, cerebral atrophy and other diseases, especially for patients with cerebral infarction.
The essence of citicoline is an activator of energy metabolism, which plays an important role in promoting the energy metabolism of nerve cells, and can promote the functional recovery of cerebral infarction patients from many aspects. The specific mechanism is as follows.
1. Improves blood flow to the brain
Cerebral infarction patients often have a hypercoagulable state of blood, so there is often a local brain tissue of insufficient blood supply performance.
Studies have shown that citicoline has certain anticoagulant and antiplatelet aggregation effects, which can effectively improve the hypercoagulable state of blood.
Citicoline can dilate blood vessels, reduce vascular resistance and improve blood supply to the brain, which is of great significance for promoting the recovery of central system function in patients with cerebral infarction.
2. Protect brain cells
Complete or incomplete blockage of brain blood vessels will directly cause ischemia and hypoxia to brain cells, and brain cells in an environment of ischemia and hypoxia for a long time will lead to abnormal energy metabolism, which will lead to necrosis and apoptosis of brain cells.
Citicoline is an activator that promotes cell energy metabolism. It can interact with mitochondria in brain cells to improve the state of energy metabolism of brain cells, thereby improving the tolerance of brain cells to ischemic and hypoxic environment and protecting the integrity of brain cells, thus laying the foundation for improving brain function.
3. Repair damaged brain function
Nerve cells are non-regenerative cells, once damaged can not be restored, but in addition to nerve cells, there are many glial cells in the brain, such as astrocytes, oligodendrocytes, etc., these cells can partially replace the function of damaged nerve cells, and these cells can be regenerated.
Pharmacological studies have shown that citicoline can increase the uptake of glutamate by glial cells and promote the differentiation of glial cells, thus partially repairing and making up for the function of damaged brain cells, which is of great significance for promoting the rehabilitation of limb movement, language and other functions of patients after cerebral infarction.
Citicoline can enhance the excitability of the pyramidal system, so as to activate the function of the brain stem reticular structure ascending activation system, which is of great significance for improving the numbness, fatigue and other clinical symptoms of cerebral infarction patients.
What is citicoline?
Citicoline is a single nucleotide composed of ribose, cytosine, pyrophosphate and choline, which is the endogenous nucleotide of the human body.
It is an intermediate and rate-limiting enzyme in cell membrane phospholipid biosynthesis.
Product introduction
【Product name】 Citicoline sodium tablets
【 Specification 】0.1g*12 pieces *2 boards
【 Main ingredient 】 The main ingredient of this product is citicoline sodium.
【Functional indications/indications】 It is used to treat the sequelae of the nervous system caused by craniocerebral injury or cerebrovascular accident.
【 Usage and Dosage 】 Orally, 2 tablets (0.2g) each time, 3 times a day, with warm water.
Pharmacological action of citicoline
1. Protects the lipid structure of cell membranes
Citicoline promotes brain phospholipid synthesis and repairs cell membrane structure;
Citicoline inhibits the activity of phospholipase, reduces the decomposition of phospholipids, and blocks cell apoptosis.
2. Stimulates the neurotransmitter system
Citicoline promotes striatal dopamine synthesis;
Citicoline effectively protects dopaminergic neurons;
3. Promotes energy metabolism in brain tissue
Citicoline restores the activity of NA-K-ATPase
Citicoline promotes energy metabolism in the brain
4. Neuroprotective effect
It affects the levels of neurotransmitters in synapses
Increases levels of dopamine, norepinephrine and acetylcholine in the central nervous system
Promote the repair and regeneration of nerve cell membrane
Choline is an intermediate in the synthesis of phosphatidylcholine, and phosphatidylcholine can stimulate the repair and regeneration of damaged neuron cell membrane, and promote the recovery of nerve function
Promotes brain energy metabolism
Restore the activity of NA-K-ATPase
Abnormal ATP levels in recovered neurons
Alleviates the toxic effects of excitatory amino acids
Reduce extracellular glutamate levels and reduce the toxic effects of excitatory amino acids
Anti-inflammatory and antioxidant effects
Citicoline reduces phospholipase A2(PLA2) activity, reducing inflammation and free radical production
Combination regimen
1. Oxiracetam + citicoline
Treatment of acute cerebral infarction
Clinical treatment results showed that oxiracetam combined with citicoline had a definite effect in the treatment of acute cerebral infarction, and could effectively improve the cytokine level, nerve function and quality of life, and improve the self-care ability of patients, which was significantly better than the control group treated with oxiracetam alone.
Method of medication:
Oxiracetam 4 g plus 0.9% sodium chloride injection 250 ml intravenously, once a day;
Citicoline 0.5g plus 5% glucose injection 100ml intravenously, once a day. Continuous treatment for 1 month.
2. Donepezil + citicoline
Treatment of senile vascular dementia/Type 2 diabetes combined with Alzheimer’s disease
The clinical results showed that compared with citicoline sodium alone, Citicoline sodium combined with Donepezil hydrochloride in the treatment of vascular dementia can significantly improve the mental state and cognitive function of patients, and the adverse reactions are mild.
Methods of administration:
Citicoline sodium tablets were taken orally 0.2g, 3 times/day; Donepezil hydrochloride tablet is taken orally 5mg once before going to bed every night, and increased to 10mg once a day after 1 month. Take it for 8 weeks.
Other clinical studies have shown that Donepezil combined with citicoline sodium has accurate efficacy and good safety in patients with type 2 sugar disease combined with Alzheimer’s disease, and can improve patients’ daily living ability, enhance patients’ memory and language ability.
Methods of administration:
On the basis of routine treatment such as blood sugar control, the patient was given Donepezil hydrochloride orally 5 mg once a day before going to bed; Citicoline sodium capsule 0.2g orally, 3 times/day. The treatment was continued for 16 weeks without taking other drugs that affect memory.
3. Piracetam + citicoline
Treatment of MCI after acute cerebral infarction
Clinical treatment results showed that piracetam combined with citicoline can improve mild cognitive dysfunction (MCI) after acute cerebral infarction, which is suitable for clinical acute cerebral infarction patients and significantly better than the control group.
Methods of administration:
On the basis of conventional treatment (such as anti-platelet aggregation, control of blood pressure, blood sugar, regulation of lipids and plaque stabilization, nerve nutrition, etc.), the control group was given cyticoline 0.5g plus 250 mL 0.9% NaCl solution intravenically, once a day.
A total of 14 days of treatment. Observation group was treated with piracetam tablet 0.8g orally, 3 times/day for 4 weeks on the basis of the treatment regimen of control group.
Is citicoline recommended for long-term use?
The recovery of cerebral infarction is often a long-term process, and the function of the central nervous system has recovered almost after 6 months. It is not recommended for patients with cerebral infarction to take citicoline for a long time, mainly for the acute phase and the recovery period, generally in 3-6 months.
Long-term oral citicoline is easy to cause adverse reactions, because the essence of citicoline is to promote brain excitement, long-term use of citicoline is easy to cause limb tremor, increased muscle tension, but not conducive to the rehabilitation of limb function in patients with cerebral infarction, but also prone to insomnia, limb numbness, extracorporeal reactions, and so on. It is not recommended that patients with cerebral infarction take citicoline for a long time.
