Research Article
Expert Perspectives on the Prescription Practice of Citicoline and Piracetam, Both as Monotherapy and in Combination for Stroke Management in Indian Settings
Manjula S* and Krishna Kumar M
Department of Medical Services, Micro Labs Limited, Bangalore, Karnataka, India
*Corresponding author:Manjula S, Department of Medical Services,Micro Labs Limited,Race Course Road, Bangalore, Karnataka, India. Email Id:drmanjulas@gmail.com
Article Information:Submission: 12/11/2024; Accepted: 06/12/2024; Published: 09/12/2024
Copyright: © 2024 Manjula S, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background:Although there are several studies available regarding the efficacy and safety of citicoline and piracetam for stroke management, studies among clinicians in actual practice are scarce. This study aims to gather expert perspectives on the clinical use and prescribing practice of citicoline and piracetam, both as monotherapy and combination therapy, for stroke management in Indian clinical settings.
Methodology:This cross-sectional study was conducted with a 24-item questionnaire among clinicians specializing in stroke management. The survey assessed prescription practices, clinical observations, and preferences regarding citicoline and piracetam, both as monotherapy and combination therapy, as well as overall stroke management. Data analysis employed descriptive statistics, with results reported as frequencies and percentages.
Results: The survey included 439 experts and nearly 55% of participants identified elderly patients as the most affected by acute ischemic stroke (AIS). Around 43% noted that the increased use of intravenous thrombolysis (IVT) has revolutionized AIS treatment. Nearly 63% of the clinicians observed the occurrence of cognitive decline in stroke patients. Most clinicians (71.75%) preferred a combination of piracetam and citicoline as neuroprotective agents, with 51% emphasizing the benefits of citicoline in restoring mitochondrial ATPase and Na+/K+ ATPase activity. About 37% of clinicians highlighted better tolerability with fixed combinations. Most (94.99%) recommended 800 mg piracetam and 500 mg citicoline, with tablets being the preferred dosage form for 91.8% of the participants.
Conclusion: The survey reveals clinicians’ preference for combining piracetam and citicoline as neuroprotective agents in stroke management, particularly for role of citicoline in restoring mitochondrial ATPase activity. However, challenges with patient adherence and education hinder treatment optimization. Further research is needed to evaluate the efficacy, tolerability, and long-term benefits of this therapy
Methodology:This cross-sectional study was conducted with a 24-item questionnaire among clinicians specializing in stroke management. The survey assessed prescription practices, clinical observations, and preferences regarding citicoline and piracetam, both as monotherapy and combination therapy, as well as overall stroke management. Data analysis employed descriptive statistics, with results reported as frequencies and percentages.
Results: The survey included 439 experts and nearly 55% of participants identified elderly patients as the most affected by acute ischemic stroke (AIS). Around 43% noted that the increased use of intravenous thrombolysis (IVT) has revolutionized AIS treatment. Nearly 63% of the clinicians observed the occurrence of cognitive decline in stroke patients. Most clinicians (71.75%) preferred a combination of piracetam and citicoline as neuroprotective agents, with 51% emphasizing the benefits of citicoline in restoring mitochondrial ATPase and Na+/K+ ATPase activity. About 37% of clinicians highlighted better tolerability with fixed combinations. Most (94.99%) recommended 800 mg piracetam and 500 mg citicoline, with tablets being the preferred dosage form for 91.8% of the participants.
Conclusion: The survey reveals clinicians’ preference for combining piracetam and citicoline as neuroprotective agents in stroke management, particularly for role of citicoline in restoring mitochondrial ATPase activity. However, challenges with patient adherence and education hinder treatment optimization. Further research is needed to evaluate the efficacy, tolerability, and long-term benefits of this therapy
Keywords:Stroke; Piracetam; Citicoline; Neuroprotective; Hypertension