Role of citicoline in the management of mild head injury

Mild head injuries can cause functional disabilities resulting in economic loss. Post concussion syndrome is seen in 15-45% of these patients. Cytidine-5′-diphosphocholine (citicoline) is known to improve cognitive dysfunction. This study was undertaken to evaluate the effect of citicoline on the number of working days lost and on post concussion symptoms following mild head injury in adults, in a randomized, prospective, single blind study. Following informed consent, adults with mild head injury (Glasgow coma score of 13-15, <24 hours) were randomized, using a computer generated randomization table, to receive either citicoline (1 gram/day) or placebo for one month. The parameters evaluated at one month were number of working days lost, Glasgow outcome score, presence of post concussion symptoms and the Rivermead head injury follow up questionnaire (RHFQ) scores. The groups were compared using Pearson chi-square test and fisher's exact test. The groups were well matched with respect to age, gender, GCS and mode of injury. There was no difference in the number of working days lost between the groups (P=0.061), Glasgow outcome score (P=0.281), Rivermead head injury follow up questionnaire scores (P=0.667) and the post concussion symptoms (P=0.3) between the groups. Compared to placebo, one gram/ day of citicoline for one month in patients with mild head injury did not reduce either the number of working days lost, or the post concussion symptoms. There was no difference in the quality of life between patients taking citicoline and placebo.