Citicoline (CDP-Choline) for ADHD and Focus: Evidence and Guidelines

Summary: Citicoline is a brain nutrient (CDP-choline) that provides choline and cytidine to the brain. In healthy adults and teens, studies show modest improvements in attention and processing speed with citicoline supplements. For example, 28-day supplementation (250–500 mg/day) improved attention task performance in middle-aged women and adolescent males . However, clinical data in ADHD are limited: a recent randomized trial in children (7–12 y) found no significant benefit of citicoline over placebo . Citicoline is commonly sold as 250–500 mg capsules or powder; its oral bioavailability is high, and it can even be given intravenously in medical settings . Typical doses range from 500 mg/day (dietary supplement level) up to 2000 mg/day in clinical trials . Side effects are rare and mild (e.g. GI upset, headache) . It has no well-documented interactions with ADHD stimulants , but caution is advised when combining with other dopaminergic agents.

Evidence: Attention and ADHD

• Healthy adults/teens: Several studies report cognitive benefits of citicoline in non-ADHD subjects. For example, a 28-day trial in healthy women (40–60 y) found that daily citicoline (250 mg or 500 mg) significantly reduced errors on a sustained-attention task (CPT-II) versus placebo . Likewise, a placebo-controlled trial in 75 healthy adolescent males (250–500 mg/day for 28 d) showed improved selective attention, faster motor speed, and reduced impulsivity in the citicoline group . These results suggest citicoline can modestly enhance focus and response speed in healthy individuals.
• ADHD studies: Evidence in ADHD patients is scarce. A 2024 pediatric RCT (ages 7–12) found no significant difference between citicoline and placebo on ADHD symptoms; citicoline was well tolerated but did not improve attention or impulsivity measures . (This was a double-blind, crossover trial.) A few small open-label or pilot reports (not cited here) have hinted at minor improvements, but overall the quality of evidence is low. Major reviews note that citicoline is not an established ADHD treatment . In summary, citicoline has plausible neurochemical actions (choline → acetylcholine; boosting dopamine) but “further studies are required” to confirm any ADHD benefit .

Practical takeaway: Citicoline appears to support attention in healthy people (including teens) at ~250–500 mg/day, but ADHD-specific gains are unproven. It may be tried as a supplement, but should not replace standard ADHD therapies.

Formulations and Delivery

• Forms: Citicoline (CDP-choline) is available as capsules, tablets, powders (bulk CDP-choline), liquids, and even intravenous solution (in medical contexts) . The active molecule is the same in all forms (citicoline free-base or sodium salt) . A popular branded form is Cognizin® (Kyowa Hakko’s citicoline sodium), used in many studies.
• Administration: For supplements, oral capsules/tablets (e.g. 250–500 mg each) are most common. Powder can be mixed into water or smoothies. Oral citicoline is “very well absorbed” and crosses the blood–brain barrier. (By contrast, intravenous citicoline is used only in clinical settings like stroke/neurorehabilitation.) Bioavailability is high for oral use , so capsules and powders are equivalent if dosed correctly.
• Comparison: No form has a proven advantage for focus. Capsules are convenient and pre-dosed. Powders allow flexible dosing but may taste bitter. Liquid or liposomal citicoline products exist, but there’s no clear evidence they outperform standard forms. Both free-base and sodium salt forms work similarly .

Dosage Guidelines

• Typical doses: Studies and supplements commonly use 500 mg per day as a maintenance dose . This often means one 500 mg capsule daily. Healthline and Drugs.com note ~500 mg/day as a standard supplement dose .
• Clinical range: In research, doses have varied widely. Clinical trials have tested 250–2000 mg/day , often given in divided doses if high (e.g. 500 mg twice daily for a 1000 mg/day total). The proven therapeutic range in humans is 7–28 mg/kg (roughly 500–2000 mg for a 70 kg adult) .
• ADHD-focused dosing: No standard ADHD dose exists. In the cited studies: healthy women used 250 or 500 mg/day ; healthy teens used 250 or 500 mg/day ; the pediatric ADHD trial does not specify dose in abstract (but similar ranges are implied). One nootropic guide notes 250–500 mg/day for cognitive enhancement as common practice.
• Duration: Trials typically last 4–6 weeks. For ADHD or focus, expect that any effects would emerge after at least 2–4 weeks of daily use. Some protocols titrate up (e.g. starting 250 mg and increasing) though this is not well-studied.
• Key point: Start low and go slow. If combining with other stimulants (e.g. ADHD medication, caffeine), begin at the lower end (250–500 mg) to assess tolerance.

Practical takeaway: A daily dose of ~500 mg citicoline (often once with breakfast) is a reasonable starting point for focus enhancement . Higher doses (up to 1000–2000 mg) have been used safely in studies, but more is not always better.

Side Effects and Interactions

• Tolerance: Citicoline is generally very well tolerated. It is a natural intermediate in cell metabolism and shows “minimal toxicity” . Clinical overviews report no serious adverse effects in trials .
• Common side effects: When they occur, they tend to be mild and transient. Reported effects include gastrointestinal symptoms (nausea, diarrhea or constipation, stomach pain), headache, insomnia or restlessness, and (rarely) dizziness . For example, drugs.com lists “GI disturbances, transient headaches, restlessness” as possible , while a health article adds nausea/vomiting . One review notes that no cholinergic (parasympathetic) side effects are seen (no increased saliva, tears, urination, etc.) – unlike older cholinesterase drugs, citicoline does not cause drooling or sweating.