CDP-Choline (Citicoline) for Stroke Recovery
High-quality randomized trials and a Cochrane review show that CDP-choline (citicoline) does not improve survival, disability, or functional recovery after an ischemic stroke. The current evidence places it in the counter-evidence category, not as a useful recovery aid.
Why this grade7-layer evidence engine
The grade rests on the strongest available trials returning null results. The large, double-blind ICTUS trial (PMID 22691567; n=2,298) found global recovery at 90 days no better than placebo (OR 1.03, 95% CI 0.86-1.25; p=0.364). A 2020 Cochrane review (PMID 32860632; 10 RCTs, n=4,281) likewise found little to no effect on mortality (RR 0.94) or disability (RR 1.11), rated low-certainty, and a separate 2022 RCT (PMID 35639720) showed no benefit on any outcome.
An earlier 2016 meta-analysis (PMID 27234918) had suggested benefit (OR 1.56, 95% CI 1.12-2.16), but it was dominated by smaller, older studies and has since been superseded by the much larger ICTUS trial and the Cochrane review. Cochrane also noted that 6 of the 10 pooled trials were industry-sponsored with inadequate adverse-event reporting, which further weakens that early positive signal.
Regulators and major clinical bodies offer no support for this use. The US FDA has not approved any stroke claim for citicoline and has cited CDP-choline products marketed for stroke as misbranded, while EFSA rejected related health claims for insufficient evidence. Leading clinics (NIH ODS, Mayo, Cleveland Clinic, Harvard Health) do not endorse it for stroke recovery, where multidisciplinary rehabilitation remains the established standard of care.
Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditable▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.34
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高品質 SR/MA 顯示 positive (1 篇 > 0 negative)
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status