The Impact of Citicoline/Phosphatidylserine Supplementation on Cognitive Performance and Executive Functions in Mental Disorders: A Systematic Review of Controlled Trials

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Human Psychopharmacology: Clinical and Experimental Pub Date : 2026-08-01 DOI:10.1002/hup.70058

Nazan Gundogan Kucuksahin, Tugce Turan Kaya, Eren Halac, Ekin Sut, Remzi Ogulcan Ciray

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引用次数: 0

Abstract

Introduction

Citicoline and phosphatidylserine (PS) have been proposed as potential neuroprotective and cognitive-enhancing agents; however, evidence of their therapeutic impact across populations with mental disorders remains limited. This systematic review aimed to evaluate the effects of citicoline and PS, administered as monotherapy or adjunctive treatment, on cognitive performance in children, adolescents, and adults with mental disorders.

Methods

A systematic review of 11 included studies was conducted following PRISMA guidelines. Databases searched were PubMed/MEDLINE, Scopus, Web of Science, and Cochrane CENTRAL through October 2025. Ten studies were randomized controlled trials (RCTs), and one was a non-randomized controlled trial (non-RCT). Methodological quality and risk of bias were evaluated using the RoB 2 and ROBINS-I tools.

Results

Five studies focused on children with ADHD, and the remaining studies included adults with mood disorders, alcohol and substance use disorders, and schizophrenia. Regarding ADHD, PS-containing supplementation produced significant improvements in attention and impulsivity in three studies, whereas two studies found no significant differences. A single study in schizophrenia reported significant improvements in verbal free recall but no global cognitive gains. Results for alcohol and substance use disorders, as well as mood disorders were mixed. Two studies revealed selective benefits in cognitive performance, while the others showed none. Overall, findings were heterogeneous and inconsistent across diagnostic groups.

Conclusion

Given methodological limitations and high risk of bias, current evidence does not support citicoline or PS-containing compounds as effective cognitive enhancers in mental disorders. Consequently, these agents should be positioned as adjunctive or investigational rather than as evidence-based treatments.

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胞胆碱/磷脂酰丝氨酸补充对精神障碍患者认知表现和执行功能的影响：一项对照试验的系统综述

胞胆碱和磷脂酰丝氨酸（PS）被认为是潜在的神经保护和认知增强剂；然而，它们对精神障碍人群的治疗效果的证据仍然有限。本系统综述旨在评价胞胆碱和磷酸腺苷单药或辅助治疗对患有精神障碍的儿童、青少年和成人的认知能力的影响。方法按照PRISMA指南对11项纳入的研究进行系统评价。检索的数据库包括PubMed/MEDLINE、Scopus、Web of Science和Cochrane CENTRAL，截止到2025年10月。10项研究为随机对照试验（rct）， 1项为非随机对照试验（non-RCT）。使用rob2和ROBINS-I工具评估方法学质量和偏倚风险。结果5项研究集中在患有多动症的儿童身上，其余的研究包括患有情绪障碍、酒精和物质使用障碍以及精神分裂症的成年人。关于多动症，三个研究中含有ps的补充剂对注意力和冲动性有显著改善，而两个研究没有发现显著差异。一项针对精神分裂症的研究报告称，在语言自由回忆方面有显著改善，但在整体认知能力方面没有提高。酒精和物质使用障碍以及情绪障碍的结果好坏参半。两项研究揭示了认知表现的选择性益处，而其他研究则没有。总的来说，诊断组的结果是不同的和不一致的。结论：由于方法学的局限性和高偏倚风险，目前的证据不支持胞胆碱或含有ps的化合物作为有效的认知增强剂治疗精神障碍。因此，这些药物应该被定位为辅助或研究性治疗，而不是基于证据的治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Human Psychopharmacology: Clinical and Experimental 医学-精神病学

CiteScore

4.10

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Human Psychopharmacology: Clinical and Experimental provides a forum for the evaluation of clinical and experimental research on both new and established psychotropic medicines. Experimental studies of other centrally active drugs, including herbal products, in clinical, social and psychological contexts, as well as clinical/scientific papers on drugs of abuse and drug dependency will also be considered. While the primary purpose of the Journal is to publish the results of clinical research, the results of animal studies relevant to human psychopharmacology are welcome. The following topics are of special interest to the editors and readers of the Journal: -All aspects of clinical psychopharmacology- Efficacy and safety studies of novel and standard psychotropic drugs- Studies of the adverse effects of psychotropic drugs- Effects of psychotropic drugs on normal physiological processes- Geriatric and paediatric psychopharmacology- Ethical and psychosocial aspects of drug use and misuse- Psychopharmacological aspects of sleep and chronobiology- Neuroimaging and psychoactive drugs- Phytopharmacology and psychoactive substances- Drug treatment of neurological disorders- Mechanisms of action of psychotropic drugs- Ethnopsychopharmacology- Pharmacogenetic aspects of mental illness and drug response- Psychometrics: psychopharmacological methods and experimental design