Alcohol dependence is a major public health concern with a high prevalence, and adverse consequences that include unemployment, legal problems, and shortened life expectancy. Thus, new and effective treatments are needed. Our group evaluates medications for substance dependence. A particularly promising medication that we have investigated is citicoline, an agent that modulates cholinergic systems and membrane phospholipid metabolism. These are new and novel mechanisms for treating alcohol dependence. Citicoline has neuroprotective properties and improves cognition in a variety of neurological disorders including vascular dementia. Thus, citicoline may represent a new approach to substance use disorders targeting deficits in cognitive processes (e.g. executive functioning, decision making, memory) that facilitate and perpetuate substance use. Our group conducted a randomized, placebo-controlled pilot study in bipolar disorder and cocaine dependence that suggested that citicoline was well tolerated, and was associated with a reduction in both cocaine and alcohol use we well as improvement in executive functioning and memory. The improvement in cognition was particularly robust in the subset with alcohol use disorders. The findings are consistent with two other small studies of citicoline that suggest that it may reduce alcohol use. In the current application, we propose a pilot study of citicoline in alcohol dependence. Citicoline is a naturally occurring compound in the brain that has a very favorable side effect and safety profile and is relatively inexpensive. Thus, if effective in reducing alcohol use, citicoline might be a practical treatment that would be well accepted by patients. This application proposes a 12-week randomized, double-blind, placebo-controlled trial of citicoline in 62 outpatients with alcohol dependence. Participants will be evaluated weekly for assessment of self-reported alcohol use and craving. Executive functioning, attention, impulsivity, and working and declarative memory will be assessed every 4 weeks. We hypothesize that citicoline therapy will be associated with decreased alcohol use and improved cognition. The data from this pilot study, if promising, will be used to inform the design of a larger trial.

Public Health Relevance

Alcohol dependence remains a major public health concern with a high prevalence and adverse consequences that include unemployment, legal problems, and shortened life expectancy. New and effective treatments are badly needed. Citicoline is a very well tolerated dietary supplement that in our pilot study was associated with a reduction in cocaine and alcohol use and improvement in measures of executive functioning and memory. The proposed study will examine citicoline in a sample of people with alcohol dependence.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21AA021777-01A1
Application #
8633907
Study Section
Health Services Research Review Subcommittee (AA)
Program Officer
Litten, Raye Z
Project Start
2014-03-05
Project End
2016-02-29
Budget Start
2014-03-05
Budget End
2015-02-28
Support Year
1
Fiscal Year
2014
Total Cost
$188,813
Indirect Cost
$70,063
Name
University of Texas Sw Medical Center Dallas
Department
Psychiatry
Type
Schools of Medicine
DUNS #
800771545
City
Dallas
State
TX
Country
United States
Zip Code
75390