Long COVID: Addiction drug may help with some symptoms



Lauren Nichols, a 34-year-old logistics skilled for the U.S. Department of Transportation in Boston, has been affected by impaired pondering and focus, fatigue, seizures, headache and ache since her COVID-19 an infection within the spring of 2020.

Last June, her physician advised low doses of naltrexone, a generic drug usually used to deal with alcohol and opioid dependancy.

After greater than two years of dwelling in “a thick, foggy cloud,” she mentioned, “I can really suppose clearly.”

Researchers chasing lengthy COVID cures are desperate to be taught whether or not the drug can provide related advantages to hundreds of thousands affected by ache, fatigue and mind fog months after a coronavirus an infection.

The drug has been used with some success to deal with an analogous complicated, post-infectious syndrome marked by cognitive deficits and overwhelming fatigue known as myalgic encephalomyelitis/continual fatigue syndrome (ME/CFS).

Drawing on its use in ME/CFS and a handful of lengthy COVID pilot research, there at the moment are a minimum of 4 scientific trials deliberate to check naltrexone in lots of of sufferers with lengthy COVID, in keeping with a Reuters evaluation of Clinicaltrials.gov and interviews with 12 ME/CFS and lengthy COVID researchers.

It can also be on the quick listing of remedies to be examined within the U.S. National Institutes of Health’s $1 billion RECOVER Initiative, which goals to uncover underlying causes and discover remedies for lengthy COVID, advisers to the trial informed Reuters.

Unlike remedies aimed toward addressing particular symptoms attributable to COVID harm to organs, such because the lungs, low-dose naltrexone (LDN) may reverse some of the underlying pathology driving symptoms, they mentioned.

Naltrexone has anti-inflammatory properties and has been used at low doses for years to deal with circumstances resembling fibromyalgia, Crohn’s illness and a number of sclerosis, mentioned Dr. Jarred Younger, director of the Neuro-inflammation, Pain and Fatigue Laboratory on the University of Alabama at Birmingham.

At 50 milligrams – 10 occasions the low dose – naltrexone is permitted to deal with opioid and alcohol dependancy. Several generic producers promote 50mg drugs, however low-dose naltrexone have to be bought by means of a compounding pharmacy.

Younger, writer of a scientific evaluation of the drug as a novel anti-inflammatory, in September submitted a grant software to review LDN for lengthy COVID. “It needs to be on the high of everybody’s listing for scientific trials,” he mentioned.

Still, the drug is unlikely to help all sufferers with lengthy COVID, a set of some 200 symptoms starting from ache and coronary heart palpitations to insomnia and cognitive impairment. One 218-patient ME/CFS examine discovered 74% had enhancements in sleep, diminished ache and neurological disturbances.

“It’s not a panacea,” mentioned Jaime Seltzer, a Stanford researcher and head of scientific outreach for the advocacy group MEAction. “These individuals weren’t cured, however they had been helped.”

Dr. Jack Lambert, an infectious illness skilled at University College Dublin School of Medicine, had used LDN to deal with ache and fatigue related with continual Lyme illness.

During the pandemic, Lambert beneficial LDN to colleagues treating sufferers with lingering symptoms after bouts of COVID.

It labored so nicely that he ran a pilot examine amongst 38 lengthy COVID sufferers. They reported enhancements in vitality, ache, focus, insomnia and total restoration from COVID-19 after two months, in keeping with findings printed in July.

Lambert, who’s planning a bigger trial to substantiate these outcomes, mentioned he believes LDN may restore harm of the illness somewhat than masks its symptoms.

Other deliberate LDN trials embody one by the University of British Columbia in Vancouver and a pilot examine by Ann Arbor, Michigan-based startup AgelessRx. That examine of 36 volunteers ought to have outcomes by year-end, mentioned firm co-founder Sajad Zalzala.

Scientists are nonetheless engaged on explaining the mechanism for the way LDN would possibly work.

Experiments by Dr. Sonya Marshall-Gradisnik of the National Centre for Neuroimmunology and Emerging Diseases in Australia recommend ME/CFS and lengthy COVID symptoms come up from a major discount in perform of pure killer cells within the immune system. In laboratory experiments, LDN may have helped restore their regular perform, a principle that should nonetheless be confirmed.

Others imagine infections set off immune cells within the central nervous system known as microglia to supply cytokines, inflammatory molecules that trigger fatigue and different symptoms related with ME/CFS and lengthy COVID. Younger believes naltrexone calms these hypersensitized immune cells.

Dr. Zach Porterfield, a virologist on the University of Kentucky who co-chairs a RECOVER process drive commonalities with different post-infectious syndromes, mentioned it has beneficial LDN be included in RECOVER’s remedy trials.

Other therapies into consideration, sources mentioned, had been antivirals, resembling Pfizer Inc’s PFE.N Paxlovid, anti-clotting brokers, steroids and dietary dietary supplements. RECOVER officers mentioned they’ve acquired dozens of proposals and couldn’t touch upon which medication shall be examined till trials are finalized.

Dr. Hector Bonilla, co-director of the Stanford Post-Acute COVID-19 Clinic and a RECOVER adviser, has used LDN in 500 ME/CFS sufferers, with about half reporting advantages.

He studied LDN in 18 lengthy COVID sufferers, with 11 displaying enhancements, and mentioned he believes bigger, formal trials might decide whether or not LDN affords a real profit.

Nichols, a affected person adviser to RECOVER, was “ecstatic” when she discovered LDN was being thought of for the government-funded trials.

While LDN has not mounted all her COVID-related issues, Nichols can now work all day with out breaks and have a social life at house.

“It has made me really feel like a human once more.”

(Reporting by Julie Steenhuysen in Chicago; Editing by Caroline Humer and Bill Berkrot)


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