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Addiction drug shows promise of long COVID brain fog, fatigue removal

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by Julie Steenhuysen

CHICAGO (Reuters) – Lauren Nichols, a 34-year-old logistics expert for the US Department of Transportation in Boston, has suffered from impaired thinking and focus, fatigue, seizures, headaches and pain since her spring COVID-19 infection. the year 2020.

Last June, her doctor recommended low doses of naltrexone, a generic drug typically used to treat alcohol and opioid addiction. “I can actually think clearly,” he said after more than two years of living in “a thick, foggy cloud.” Researchers pursuing long-term COVID treatments are eager to find out if the drug can provide similar benefits to the millions who suffer from pain, fatigue and brain fog months after a coronavirus infection. The drug has been used with some success to treat a similar complex, post-infection syndrome marked 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, there are currently at least four clinical trials planned to test naltrexone in hundreds of patients with long-term COVID, according to a Reuters review of and interviews with 12 people. ME/CFS and long-term COVID researchers. It is also on the shortlist of treatments to be tested in the US National Institutes of Health’s $1 billion RECOVER Initiative, which aims to uncover underlying causes and find treatments for long-term COVID, trial consultants told Reuters.

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

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

At 50 milligrams – 10 times the low dose – naltrexone is approved to treat opioid and alcohol addiction. A few generic manufacturers sell 50mg pills, but low-dose naltrexone must be purchased from a compounding pharmacy.

Younger, who is the author of a scientific review of the drug as a new anti-inflammatory, applied for a grant in September to study LDN for long-term 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 long-term COVID, a collection of nearly 200 symptoms ranging from pain and heart palpitations to insomnia and cognitive impairment. A ME/CFS study of 218 patients found that 74% had improved sleep, reduction in pain, and neurological disturbances.

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

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

During the pandemic, Lambert recommended LDN to colleagues who treated patients whose symptoms persisted after their COVID episode.

It worked so well that it conducted a pilot study among 38 tall COVID patients. They reported improvements in energy, pain, concentration, insomnia, and overall recovery from COVID-19 after two months, according to findings published in July.

Lambert, who plans to conduct a larger trial to confirm these results, said he believes LDN can repair the damage done by the disease rather than mask the symptoms.

Other planned LDN trials include a trial by the University of British Columbia in Vancouver and a pilot by Michigan-based AgelessRx startup Ann Arbor. The founding partner of the company, Sajad Zalzala, said that this work of 36 volunteers should have results by the end of the year. Scientists are still trying to explain the mechanism for how LDN might work. From the National Center for Neuroimmunology and Emerging Diseases in Australia, Dr. Experiments by Sonya Marshall-Gradisnik show that ME/CFS and the long-term symptoms of COVID are caused by a significant reduction in the function of natural killer cells in the immune system. In lab experiments, LDN may have helped them regain their normal function, a theory that still needs to be confirmed. Others believe infections trigger immune cells in the central nervous system called microglia to produce cytokines, fatigue-inducing inflammatory molecules, and other symptoms associated with ME/CFS and the long COVID. Younger believes that naltrexone calms these hypersensitive immune cells.

A virologist at the University of Kentucky and co-chairing a RECOVER task force examining commonalities with other post-infectious syndromes. Zach Porterfield says LDN recommends that RECOVER be included in treatment trials. Other treatments under investigation include antivirals, anti-clotting agents, steroids, and nutritional supplements like Pfizer Inc’s Paxlovid, sources said. RECOVER officials said they have received dozens of offers and cannot comment on which drugs will be tested until the trials are concluded. Co-director of the Stanford Post-Acute COVID-19 Clinic and a RECOVER consultant, Dr. Hector Bonilla has used LDN in 500 ME/CFS patients, with nearly half reporting benefits.

He studied LDN in 18 long-term COVID patients, 11 of whom had recovered, and said he believes larger, formal trials can determine whether LDN provides a real benefit. Nichols, RECOVER’s patient advisor, was “ecstatic” when he learned that LDN was being considered for government-funded trials. While LDN hasn’t fixed all of his COVID-related issues, Nichols can now work all day and have a social life at home. “It made me feel human again.”

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