Citicoline as Add-On Treatment in AlzheimerâÂÂs Disease: Tips from theCiticholinage Study

Abstract

The Citicholinage Study was an Italian multicentric, retrospective study showing the effects of combination treatment of a cholinergic precursor, citicoline, with acetylcholinesterase inhibitors (AchEI) (donepezil, rivastigmine and galantamine) in Alzheimer’s disease (AD) patients. This was the first study which assessed the possible role of citicoline associated to a cholinesterase inhibitor, used for at least 9 months, at the maximum tolerated dosage. It involved 448 patients aged 65 years old or older, 251 treated with combination therapy vs. 197 treated with the only AchEI, mostly donepezil and rivastigmine. Patients in combined treatment showed a statistically significant increase in MMSE between T0 and T1 (16.88 ± 3.38 versus 17.62 ± 3.64, respectively, p=0.000) and between T1 and T2 (17.62 ± 3.64 versus 17.83.54 respectively, p=0.000). The association citicoline plus donepezil showed to be still better than citicoline plus rivastigmine. Definitely the present study showed that a cholinergic precursor such as citicoline plus an AchEI is able to slow down disease progression in AD patients.