Nutracon and SupplyExpo convention-goers voted Kyowa Hakko?s citicoline supplement Cognizin ?best new ingredient? for 2003, but the compound touted for its memory-enhancing abilities is only really new to the North American market. It has been sold as a pharmaceutical for more than 20 years in such countries as Spain, Italy, Belgium, Korea and Japan, and a review of literature on the ingredient turns up more than 550 published papers.
Citicoline is a nucleic acid that is also known as CDP-choline. It is a form of choline that serves as the raw material for the production of phospholipids in the brain. Brain cells have the ability to convert citicoline into phosphatidylcholine, the primary phospholipid component found in cell membranes.
Citicoline is believed to stabilise the membranes and, when absorbed by the body, breaks down into cytidine and choline. However, once citicoline reforms in the body, it is converted to acetylcholine, a neurotransmitter, which is involved in memory, thought, sexual function and other vital functions. Numerous studies have indicated that when taken as a supplement, citicoline can lessen the symptoms of Alzheimer?s and Parkinson?s disease, as well as alleviate mild cognitive impairment associated with ageing and strokes.
Accessing North America
Kyowa Hakko introduced its version of citicoline, which they produce through a fermentation process, to the North American market in the 1990s; this year the company launched its Cognizin brand, which it sells in a bulk powder form to supplement manufacturers, such as Jarrow Formulas and Advanced Ortho-molecular Research.
The company is focusing its efforts on expansion in the North American market, which it hopes to achieve by boosting consumer awareness, particularly among ageing baby boomers. ?Public education is key to our efforts, which is why we exhibited at SupplyExpo,? said Neil Sullivan, director of sales for the Japanese company. ?Right now it is only being sold in capsules, but there is good beverage potential as its solubility is high.?
Kyowa Hakko isn?t the only company in this fast-growing cerebro-neuropsychiatry segment. Recently, Spanish firm Ferrer SA entered into a licensing agreement with Elder Pharmaceuticals to market and produce its citicoline compound.
Research has found benefits to citicoline in a host of medical conditions.
- In a 1990 German study published in Clinical Therapeutics, 85 patients with Parkinson?s disease received 1,200mg/day of oral citicoline. Half the group took 381mg of L-dopa, and the other half took 196mg of L-dopa. After four weeks, both groups showed the same symptom improvements, suggesting citicoline treatment reduced the amounts of L-dopa needed in therapy and may reduce L-dopa?s long-term side effects.
- NeuroRehabilitation in 2000 reported on two studies testing the effect of citicoline on persistent memory deficits following traumatic brain injury. Supplementation proved to help normalise blood flow at lesional sites, making neuropsychological training of the patients more effective.
- Four double-blind, placebo-controlled studies enrolling 1,372 people tested the effectiveness of citicoline in the treatment of strokes. Overall, the evidence suggests its use in the immediate period following a stroke slightly improves the chances of full recovery (Stroke 2002; 33:2850-7).
- Finally, a study published in 1996 in Archives of Neurology reported on a double-blind trial using 95 healthy volunteers aged 50-85. A subgroup identified to have poor memories showed gains in delayed recall and logical memory when supplementing 2,000mg/day.
Kyowa Hakko defines optimal dosing of citicoline as 500mg-1g per day, depending on body weight and the level of impairment. But some studies have used therapeutic doses of up to 2-3g per day for more severe conditions, such as moderate Alzheimer?s, Sullivan said.