Individuals with long COVID sometimes referred to as “long-haulers,” experience symptoms that may persist for weeks, months, or even years after their acute viral infection.
While symptoms vary widely, a common complaint among patients is “brain fog”—a colloquial term for significant, persistent cognitive deficits, with consistent impairment of executive functioning and working memory.
In a study from Yale University, scientists found a new treatment for ‘brain fog’ in long COVID.
Drug guanfacine was approved by the Food and Drug Administration (FDA) for the treatment of ADHD in 2009. But clinicians have also used it extensively for other prefrontal cortical disorders such as traumatic brain injury (TBI) and PTSD.
In the study, the team treated long COVID patients with a combination of guanfacine and N-acetylcysteine (NAC), an anti-oxidant also used for the treatment of TBI.
The combined therapy was successful in relieving brain fog for their small cohort of patients.
And while larger clinical trials will be needed to test these drugs as a bona fide treatment for post-COVID-19 neurocognitive deficits, the researchers say patients can obtain them now if their doctors wish to prescribe them.
Because they are FDA-approved and have been used for years, their safety for patients is established.
Guanfacine, one of the two drugs tested in this trial, is designed to strengthen prefrontal cortex connections and protect against inflammation and stress.
While originally developed to treat ADHD, it is being used to treat other conditions associated with prefrontal cortex dysfunction, and studies show that the drug is effective in restoring executive functioning and memory.
NAC, the second medication, is a robust antioxidant and anti-inflammatory agent that can also be used to treat this neural region.
In the study, the team treated 12 patients experiencing post-COVID brain fog with this regimen.
They instructed patients to take 1 mg of guanfacine at bedtime, and if well-tolerated, to increase the dosage to 2 mg after one month. Patients also took 600 mg of NAC once a day.
Eight patients reported substantial benefits, including improved memory, organizational skills, and the ability to multitask. For some, the brain fog completely resolved, and they were able to resume their normal activities.
Two patients were unavailable for follow-up, and the other two discontinued the medication due to side effects including low blood pressure and dry mouth.
Since then, the researchers have modified the regimen from an immediate-release form of guanfacine to an extended-release form, which reduces the risk of side effects.
One patient in the cohort was a nurse who had become so debilitated that she had to significantly reduce her hours at work.
Although she found relief with the treatment, she had to briefly stop due to dizzy episodes, and her cognitive deficits returned. When she resumed treatment, her brain fog once again lifted. She has not experienced any dizziness since.
For more information about health, please see recent studies about the cause of blood clots in people with severe COVID-19, and results showing how vitamin B helps fight vision loss and COVID-19.
The study was conducted by Amy Arnsten et al and published in Neuroimmunology Reports.
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