Addiction drug shows promise to clear long COVID brain fog and fatigue

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Lauren Nichols, who has long COVID, takes a break and rests in a lounge bed in the office in her home in Andover, Mass., Aug. 3. An addiction drug could help those with COVID brain fog.

Lauren Nichols, who has long suffered from COVID, takes a break and rests on a lounge bed in the office of her Andover, Massachusetts home on August 3. An addictive drug could help people with COVID brain fog. (Lauren Owens Lambert, Reuters)

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CHICAGO — Lauren Nichols, a 34-year-old logistics specialist with the U.S. Department of Transportation in Boston, has been suffering from impaired thinking and concentration, fatigue, seizures, headaches and pain since contracting COVID-19 in spring 2020.

Last June, her doctor suggested low doses of naltrexone, a generic drug typically used to treat alcohol and opioid addiction. After living in “a thick, foggy cloud” for more than two years, she said, “I can actually think straight.”

Researchers pursuing long-running COVID cures are excited to see if the drug can offer similar benefits to millions of people suffering pain, fatigue and brain fog months after contracting coronavirus.

The drug has been used with some success to treat a similar complex post-infectious syndrome characterized by cognitive deficits and overwhelming fatigue called myalgic encephalomyelitis/chronic fatigue syndrome. Based on its use in ME/CFS and a handful of long COVID pilot studies, at least four clinical trials are now planned to test naltrexone in hundreds of patients with long COVID ME/CFS, according to a Reuters review of Clinicaltrials.gov and interviews with 12 and long COVID researchers.

It’s also on the short list of treatments to be tested in the US National Institutes of Health’s $1 billion RECOVER initiative, which aims to uncover the underlying causes and find treatments for long-lasting COVID , consultants on the study told Reuters.

Unlike treatments aimed at treating specific symptoms caused by COVID damage to organs like the lungs, low-dose naltrexone can reverse some of the underlying pathological symptoms, they said.

Naltrexone has anti-inflammatory properties and has been used at low doses to treat conditions like fibromyalgia, Crohn’s disease and multiple sclerosis for years, said Dr. Jarred Younger, director of the Neuroinflammation, Pain and Fatigue Laboratory at the University of Alabama at Birmingham.

At 50 milligrams – ten times the low dose – naltrexone is approved for the treatment of opioid and alcohol addiction. Several generic manufacturers sell 50 mg pills, but low-dose naltrexone must be purchased through a compound pharmacy.

Younger, author of a scientific review of the drug as a novel anti-inflammatory, submitted a grant application in September to study LDN for long COVID. “It should be at the top of every clinical trial list,” he said.

Still, the drug is unlikely to help all patients with long-term COVID, a collection of around 200 symptoms ranging from pain and palpitations to insomnia and cognitive impairment. A ME/CFS study of 218 patients found that 74% of patients experienced improvements in sleep, reduced pain and neurological disorders.

“It’s not a panacea,” said Jaime Seltzer, a Stanford researcher and director of scientific outreach for advocacy group MEAction. “These people were not healed, but they were helped.”


It’s not a panacea. These people were not healed, but they were helped.

–Jaime Seltzer, MEAction


“human again”

dr Jack Lambert, an infectious disease expert at University College Dublin School of Medicine, had used LDN to treat pain and fatigue associated with chronic Lyme disease.

During the pandemic, Lambert recommended LDN to colleagues treating patients with ongoing symptoms after COVID attacks.

It worked so well that he did a pilot study in 38 long COVID patients. They reported improvements in energy, pain, focus, insomnia and overall recovery from COVID-19 after two months, according to results released in July.

Lambert, who is planning a larger study to confirm these findings, said he believes LDN may repair damage from the disease rather than masking its symptoms.

Lauren Nichols, who has been ill with COVID for a long time, takes her second pill of the day with the low-dose naltrexone on August 3 at her home in Andover, Mass.
Lauren Nichols, who has been ill with COVID for a long time, takes her second pill of the day with the low-dose naltrexone on August 3 at her home in Andover, Mass. (Photo: Lauren Owens Lambert, Reuters)

Other planned LDN studies include one by the University of British Columbia at Vancouver and a pilot study by Ann Arbor, Michigan-based startup AgelessRx. This study, involving 36 volunteers, should have results by the end of the year, company co-founder Sajad Zalzala said.

Scientists are still working to explain the mechanism of how LDN might work. experiments by dr. Sonya Marshall-Gradisnik from the National Center for Neuroimmunology and Emerging Diseases in Australia suggests that ME/CFS and long COVID symptoms are due to a significant reduction in natural killer cell function in the immune system.

In laboratory experiments, LDN may have helped restore their normal function, a theory that has yet to be confirmed. Others believe that infections trigger immune cells in the central nervous system called microglia to produce cytokines, inflammatory molecules that cause fatigue and other symptoms associated with ME/CFS and long-term COVID. Younger believes that naltrexone calms down these hypersensitized immune cells.

dr Zach Porterfield, a virologist at the University of Kentucky who chairs a RECOVER task force examining commonalities with other post-infectious syndromes, said he recommended including LDN in RECOVER’s treatment studies. Other therapies under consideration included antivirals such as Pfizer Inc.’s Paxlovid, anticoagulants, steroids and dietary supplements, sources said.

RECOVER officials said they had received dozens of suggestions and could not comment on which drugs will be tested until the trials are complete. dr Hector Bonilla, Stanford Post-Acute COVID-19 Clinic co-director and RECOVER consultant, has used LDN in 500 ME/CFS patients, with about half reporting benefits.

He studied LDN in 18 long COVID patients, 11 of whom showed improvements, and said he believes larger, formal studies could determine whether LDN offers real benefit. Nichols, a RECOVER patient advisor, was “thrilled” to learn that LDN was being considered for the federally funded trials. While LDN hasn’t fixed all of her COVID-related issues, Nichols is now able to work all day without breaks and maintain a social life at home. “I feel like a human again.”

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Addiction drug shows promise to clear long COVID brain fog and fatigue

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Addiction drug shows promise to clear long COVID brain fog and fatigue

CHICAGO, Oct 18 (Reuters) – Lauren Nichols, a 34-year-old logistics specialist with the U.S. Department of Transportation in Boston, has been suffering from impaired thinking and concentration, fatigue, seizures, headaches and aches and pains since contracting COVID-19 in the spring of 2020.

Last June, her doctor suggested low doses of naltrexone, a generic drug typically used to treat alcohol and opioid addiction.

After living in “a thick, foggy cloud” for more than two years, she said, “I can actually think straight.”

Sign up now for FREE unlimited access to Reuters.com

Researchers pursuing long-running COVID cures are excited to see if the drug can offer similar benefits to millions of people suffering pain, fatigue and brain fog months after contracting coronavirus.

The drug has been used with some success to treat a similar complex post-infectious syndrome characterized by cognitive deficits and overwhelming fatigue called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).

Based on its use in ME/CFS and a handful of long COVID pilot studies, at least four clinical trials are now planned to test naltrexone in hundreds of patients with long COVID ME/CFS, according to a Reuters review of Clinicaltrials.gov and interviews with 12 and long COVID researchers.

It’s also on the short list of treatments to be tested in the US National Institutes of Health’s $1 billion RECOVER initiative, which aims to uncover the underlying causes and find treatments for long-lasting COVID , consultants on the study told Reuters.

Unlike treatments aimed at treating specific symptoms caused by COVID damage to organs like the lungs, low-dose naltrexone (LDN) can reverse some of the underlying pathological symptoms, they said.

Naltrexone has anti-inflammatory properties and has been used at low doses to treat conditions like fibromyalgia, Crohn’s disease and multiple sclerosis for years, said Dr. Jarred Younger, director of the Neuroinflammation, Pain and Fatigue Laboratory at the University of Alabama at Birmingham.

At 50 milligrams – ten times the low dose – naltrexone is approved for the treatment of opioid and alcohol addiction. Several generic manufacturers sell 50 mg pills, but low-dose naltrexone must be purchased through a compound pharmacy.

Younger, author of a scientific review of the drug as a novel anti-inflammatory, submitted a grant application in September to study LDN for long COVID. “It should be at the top of every clinical trial list,” he said.

Still, the drug is unlikely to help all patients with long-term COVID, a collection of around 200 symptoms ranging from pain and palpitations to insomnia and cognitive impairment. A ME/CFS study of 218 patients found that 74% of patients experienced improvements in sleep, reduced pain and neurological disorders.

“It’s not a panacea,” said Jaime Seltzer, a Stanford researcher and director of scientific outreach for advocacy group MEAction. “These people were not healed, but they were helped.”

“HUMAN AGAIN” Dr. Jack Lambert, an infectious disease expert at University College Dublin School of Medicine, had used LDN to treat pain and fatigue associated with chronic Lyme disease.

During the pandemic, Lambert recommended LDN to colleagues treating patients with ongoing symptoms after COVID attacks.

It worked so well that he did a pilot study in 38 long COVID patients. They reported improvements in energy, pain, focus, insomnia and overall recovery from COVID-19 after two months, according to results released in July.

Lambert, who is planning a larger study to confirm these findings, said he believes LDN may repair damage from the disease rather than masking its symptoms.

Other planned LDN studies include one by the University of British Columbia at Vancouver and a pilot study by Ann Arbor, Michigan-based startup AgelessRx. This study, involving 36 volunteers, should have results by the end of the year, company co-founder Sajad Zalzala said.

Scientists are still working to explain the mechanism of how LDN might work.

experiments by dr. Sonya Marshall-Gradisnik from the National Center for Neuroimmunology and Emerging Diseases in Australia suggests that ME/CFS and long COVID symptoms are due to a significant reduction in natural killer cell function in the immune system. In laboratory experiments, LDN may have helped restore their normal function, a theory that has yet to be confirmed.

Others believe that infections trigger immune cells in the central nervous system called microglia to produce cytokines, inflammatory molecules that cause fatigue and other symptoms associated with ME/CFS and long-term COVID. Younger believes that naltrexone calms down these hypersensitized immune cells.

dr Zach Porterfield, a virologist at the University of Kentucky who chairs a RECOVER task force examining commonalities with other post-infectious syndromes, said he recommended including LDN in RECOVER’s treatment studies.

Other therapies under consideration, sources said, included antivirals such as Pfizer Inc.’s Paxlovid (PFE.N), anticoagulants, steroids and dietary supplements. RECOVER officials said they had received dozens of suggestions and could not comment on which drugs will be tested until the trials are complete.

dr Hector Bonilla, Stanford Post-Acute COVID-19 Clinic co-director and RECOVER consultant, has used LDN in 500 ME/CFS patients, with about half reporting benefits.

He studied LDN in 18 long COVID patients, 11 of whom showed improvements, and said he believes larger, formal studies could determine whether LDN offers real benefit.

Nichols, a RECOVER patient advisor, was “thrilled” to learn that LDN was being considered for the federally funded trials.

While LDN hasn’t fixed all of her COVID-related issues, Nichols is now able to work all day without breaks and maintain a social life at home.

“I feel like a human again.”

Sign up now for FREE unlimited access to Reuters.com

reporting by Julie Steenhuysen in Chicago; Edited by Caroline Humer and Bill Berkrot

Our standards: The Thomson Reuters Trust Principles.

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