Positives

• A patient taking 600mg/day citicoline for 8 months reported a noticeably faster rate of cognitive improvement after Long COVID brain fog, word-finding difficulties, and attention deficits Reddit.
  
  

Negatives

• A PMC case series documented probable nootropic-induced psychiatric adverse effects including anxiety, mania, and insomnia in patients taking choline-based nootropics, with effects resolving on discontinuation. PMC.
• Healthline lists insomnia, headache, GI distress, restlessness, fatigue, and tremors as the dose-dependent side effects of citicoline; patients with autonomic dysregulation in Long COVID may be especially sensitive to the cholinergic load. Healthline.

Hurdles & Side Effects

• Examine.com notes typical citicoline doses of 500-2,000 mg/day split into 250-1,000 mg twice daily, which adds up to a significant monthly cost compared with simpler choline sources like phosphatidylcholine or eggs. Examine.com.
• WebMD describes citicoline as well-studied via the trademarked Cognizin form, but notes patients should expect short-term mood, sleep, or GI changes, especially during the first two weeks of titration. WebMD.