While citicoline has been shown to be beneficial in ameliorating the adverse effects of acute ischemic stroke , it may not be the best agent for supporting cognition while using cannabis to combat cancer, especially glioblastomas and other tumors treated with bevacizumab (Avastin).
Following a stroke, citicoline helps promote new blood vessel formation (angiogenesis) via induction and upregulation of vascular endothelial growth factor (VEGF). Research shows induction of VEGF helps promote new blood vessels to the area of the brain undergoing healing and regeneration. This is a good thing.
Avastin is a monoclonal antibody that blocks angiogenesis by inhibiting VEGF. New blood vessels support the growth of primary tumors and their metastases. Avastin has been used to treat glioblastoma, metastatic colon cancer, certain lung cancers, renal cancers, ovarian cancers, and several eye diseases that are characterized by excessive vascularization (e.g. diabetic retinopathy).
Avastin and citicoline appear to have opposite effects on new blood vessel formation. While new blood vessels may be an important aspect of recovery from an acute ischemic stroke, shutting down blood flow to primary and metastatic tumors is a way of destroying these cancers.
Citicoline is also beneficial in acute ischemic stroke and retinal neurodegeneration by helping injured brain and retina cells stay alive. It has an anti-apoptotic action. With cannabis, Tetrahydrocannabinol (THC) is thought to help kill cancer cells by inducing apoptosis (programmed cell death).
As you can see, citicoline appears to promote (at least in acute ischemic stroke) VEGA and anti-apoptosis. For these reasons it seems prudent to not use citicoline as a cognition booster and psycho activity inhibitor in conjunction with THC treatments for cancer.
Two nootropic nutraceuticals that may serve as replacements for citicoline are: Alpha-GPC, which appears to provide a safe source of choline. And, Bacopa monnieri, which appears to have pro-apoptotic actions.