Addiction drug shows promise in lifting long-Covid brain fog, fatigue

CHICAGO, Oct 18 (Reuters) – Lauren Nichols, a 34-year-old logistics specialist with the U.S. Department of Transportation in Boston, has suffered from impaired thinking and attention, fatigue, seizures, headaches and pain since her Covid-19 infection. In the spring of 2020.

Last June, her doctor prescribed a low dose of naltrexone, a generic drug commonly used to treat alcohol and opioid addiction.

After more than two years in “a thick, foggy cloud,” he said, “I can actually think clearly.”

Researchers behind the long-running COVID cure are eager to see if the drug can offer similar benefits to the millions of people who suffer from pain, fatigue and brain fog months after contracting the 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).

At least four clinical trials are now planned to test naltrexone in hundreds of patients with prolonged Covid, drawing on its use in ME/CFS and a handful of longer Covid pilot studies, according to a Reuters review of clinicaltrials.gov and interviews with 12 people. has been ME/CFS and long-term covid researchers.

It is on the short list of treatments to be tested in the US National Institutes of Health’s $1 billion recovery initiative, which aims to uncover the underlying causes and find treatments for prolonged Covid, advisers to the trial told Reuters.

Unlike treatments aimed at addressing specific symptoms caused by Covid-19 damage to organs such as the lungs, low-dose naltrexone (LDN) may reverse some of the symptoms driving the underlying pathology, they said.

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

At 50 mg — 10 times the lower 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 compounding pharmacy.

Young, author of a scientific review of the drug as a novel anti-inflammatory, submitted a grant application in September to study LDN for chronic COVID. “It should be at the top of everyone’s list for clinical trials,” he said.

Still, the drug is unlikely to help all patients with chronic Covid, a collection of nearly 200 symptoms ranging from pain and heart palpitations to insomnia and cognitive impairment. A 218-patient ME/CFS study found that 74% reported improved sleep, reduced pain and neurological disturbances.

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

‘Human Again’ Dr Jack Lambert, an infectious disease specialist at University College Dublin School of Medicine, used LDN to treat pain and fatigue associated with chronic Lyme disease.

During the pandemic, Lambert recommended LDN to colleagues treating patients with chronic symptoms after a bout of Covid.

It worked so well that he ran a pilot study in 38 chronic Covid patients. They reported improvements in energy, pain, concentration, insomnia and overall recovery from Covid-19 after two months, according to results published in July.

Lambert, who is planning a larger trial to confirm these findings, said he believes LDN can repair disease damage rather than mask disease symptoms.

Other planned LDN trials include one at the University of British Columbia in Vancouver and a pilot study by Ann Arbor, Michigan-based startup AgelesRx. Company co-founder Sajad Zaljala said the results of the 36-volunteer study should be available by the end of the year.

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

Experiments by Dr Sonia Marshall-Gradisnick of Australia’s National Center for Neuroimmunology and Emerging Diseases suggest that ME/CFS and prolonged Covid symptoms stem from a significant reduction in the function of natural killer cells in the immune system. In laboratory tests, LDN helped them restore normal function, a theory that still needs to be confirmed.

Others believe that infections trigger immune cells in the central nervous system called microglia to release cytokines, inflammatory molecules that cause fatigue and other symptoms associated with ME/CFS and prolonged covid. Young believes that naltrexone calms these hypersensitized immune cells.

Dr. Jack Porterfield, a virologist at the University of Kentucky who co-chairs a Recover task force that studies similarities to other post-infectious syndromes, said it recommends including LDN in Recover treatment trials.

Other therapies under consideration, sources said, were antivirals, such as Pfizer Inc (PFE.N) Paxlovide, anti-clotting agents, steroids and nutritional supplements. Recover officials said they received dozens of proposals and could not comment on which drugs will be tested until the trial is finalized.

Dr. Hector Bonilla, co-director of the Stanford Post-Acute COVID-19 Clinic and a recovery counselor, has used LDN in 500 ME/CFS patients, with about half reporting benefit.

He studied LDN in 18 chronic Covid patients, showing improvement in 11, and he believes that larger, formal trials can determine whether LDN provides a true benefit.

Nichols, a patient counselor in recovery, was “thrilled” when she learned that LDN was being considered for a government-funded trial.

While LDN hasn’t solved all of her COVID-related problems, Nichols can now work all day without a break and have a social life at home.

“It made me feel human again.”

Reporting by Julie Steenhuysen in Chicago; Editing by Carolyn Hummer and Bill Berkrot

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