Wednesday, October 19, 2022
A cure for long COVID? Drug used to treat alcohol and opioid addiction is found to relieve persistent brain fog and fatigue
A drug used to treat addiction could be what millions of long Covid sufferers around the world need to finally address their symptoms.
Naltrexone is a generic drug approved by the Food and Drug Administration to treat both alcohol and opioid addicts.
But in small trials it has been able to relieve long Covid patients of lingering ailments like brain fog and fatigue that last months after the initial infection.
The drug - sold under the brand name Revia - is now being touted as a crucial piece of the puzzle of long Covid that has stumped experts for over two years.
Larger trials are underway and scientists are still searching for the mechanism as to why naltrexone seems to be so effective against chronic Covid.
Current treatments for long Covid include therapy targeted at the symptoms a person is feeling to manage the condition, though there are no universal treatments.
Treatments include physical therapy, and drug to manage symptoms like chronic pain, respiratory issues and others.
Lauren Nichols, a 34-year-old logistics expert for the US Department of Transportation in Boston, was a patient suffering from the condition.
She reported symptoms of impaired thinking and focus, fatigue, seizures, headache and pain since her COVID-19 infection in the spring of 2020.
In June, she was suggested the anti-addiction medication by the doctor. Within months, she could think clearly again and was pain-free.
The drug has previously shown promise against post-infection syndromes like chronic fatigue syndrome, suffered by people after a severe illness.
It works by blocking the euphoric and sedative effects of opioid drugs by blocking the brains receptors, and stopping cravings for the drug as a result. It is to be taken orally.
Common side-effects include nausea, headaches, dizziness, vomiting and other symptoms.
It also has anti-inflammatory properties and has been used in the past to treat conditions such as fibromyalgia, Crohn's disease and multiple sclerosis.
'It should be at the top of everyone's list for clinical trials,' said Dr Jarred Younger, from the University of Alabama at Birmingham.
Testing of naltrexone was included in a $1billion initiative by the National Institutes of Health (NIH) to discover the causes and treatments for long Covid.
At least four clinical trials testing a low-dose naltrexone's (LDN) effectiveness against long Covid are now underway.
The condition is made up of a collection of some 200 symptoms ranging from pain and heart palpitations to insomnia and cognitive impairment.
At 50 milligrams (mg) naltrexone is approved to treat opioid and alcohol addiction. But in long Covid studies it is being used in tiny doses up to 10 times lower than that.
Dr Jack Lambert, an infectious disease expert at University College Dublin School of Medicine, had used the drug to treat pain and fatigue associated with Lyme disease.
During the pandemic, Lambert recommended naltrexone to colleagues treating patients with lingering symptoms after bouts of Covid.
It worked so well that he ran a pilot study among 38 long 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 is planning a larger trial to confirm those results, said he believes it may repair damage of the disease rather than mask its symptoms.
Other planned trials include one by the University of British Columbia in Vancouver and a pilot study by Ann Arbor, Michigan-based startup AgelessRx. That study of 36 volunteers should have results by year-end, said company co-founder Sajad Zalzala.
Scientists are still working on explaining the mechanism for how the addiction drug might work.
Experiments by Dr Sonya Marshall-Gradisnik of the National Centre for Neuroimmunology and Emerging Diseases in Australia suggest long Covid symptoms arise from a significant reduction in function of natural killer cells in the immune system. In laboratory experiments, naltrexone has been shown to help restore their normal function.
Dr Hector Bonilla, co-director of the Stanford Post-Acute COVID-19 Clinic and a RECOVER adviser, has used naltrexone in 500 patients with chronic fatigue syndrome, with half reporting feeling better.
He studied it in 18 long Covid patients, with 11 showing improvements, and said he believes larger, formal trials could determine whether it offers a true benefit.
There are also theories that long Covid is the product of the 'nocebo' affect, where a person's symptoms may be a result of a psychological effect, not physical illness.
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Moderna's CEO admits only the vulnerable need a COVID booster and likens the virus to flu
Not everyone needs to get an annual Covid booster, according to the head of pharma giant Moderna who also likened the virus to seasonal flu. Stéphane Bancel said his company's shots should mainly be targeted at over-50s and people with underlying health conditions.
His comments seem to be at odds with the Centers for Disease Prevention and Control (CDC) which is urging everyone over the age of five to get boosted.
Covid is now predominantly only killing the most vulnerable because the US has built up strong immunity through high infection rates and repeated vaccine rollouts.
There are currently around 300 deaths from the virus across the country every day, compared to more than 1,000 this time last year.
Mr Bancel told a finance conference on Monday: 'I think it's going to be like the flu. If you're a 25-year-old, do you need an annual booster every year if you're healthy?
‘You might want to... but I think it's going to be similar to flu where it's going to be people at high-risk, people above 50 years of age, people with comorbidities, people with cancer and other conditions, people with transplants.’
Mr Bancel's comments come amid a sluggish vaccine booster rollout that has seen just one in 20 eligible Americans taking up their Omicron-specific shot. Despite there being little appetite for the new vaccines, the CDC last week approved Moderna and Pfizer's shot for children as young as five.
Pfizer recently joined forces with Marvel for a PR campaign that appeared to target children.
But Mr Bancel said it was ‘very important to think about’ whether or not to get Covid boosters.
He said there are around ‘1.5billion people’ globally who would fall into the vulnerable category. But he emphasized that younger people ‘are going to have to decide for themselves what they want to do’.
Dr Rochelle Walensky, director of the Centers for Disease Control and Prevention (CDC), said the country was 'ripe' for a resurgence because it has low levels of immunity.
Influenza has been largely sidelined during the pandemic due to lockdowns and social restrictions, leaving Americans with little protection against the seasonal bug.
But there are signs the flu is making a comeback as latest data shows cases have quadrupled in recent weeks — months before the virus normally strikes.
Flu season typically runs from late October to May, picking up in December and peaking in February.
But the southern hemisphere - which is normally a precursor for the US - suffered an early and brutal wave during its winter earlier in the year.
There are also concerns about flu vaccine uptake, with just 12million Americans having received the shot so far.
Dr Walensky told NBC News: ‘We've noted that flu activity is starting to increase across much of the country.
‘Not everybody got flu vaccinated last year, and many people did not get the flu. So that makes us ripe to have potentially a severe flu season.’
Roughly 14.8million Americans have now received the updated bivalent booster, out of 215million eligible people.
Mr Bancel defended the sluggish Covid booster uptake, pointing out that it is stronger than seasonal flu uptake.
He noted that it is the first time people are getting the booster in more of an endemic than pandemic setting, meaning people are less anxious to get a new vaccine.
‘You might do it to protect other people or because you don’t want to get sick and miss work, or miss vacation.’
But he has been getting the annual flu shot since the age of 30, he said. ‘Is it because I was worried of being hospitalized? Of course not. I just didn’t want to be sick, I wanted to be able to work.’
Controversy was sparked over the Covid vaccine drive when the Food and Drug Administration (FDA) extended eligibility to children who are six months old earlier this year.
Many experts cautioned against the move at the time, saying children face a very low risk from the virus and warned it could interfere with other inoculations they need such as against polio or measles.
There is also now a prevailing sense that the Covid pandemic has come to an end, after President Joe Biden declared it was over on television last month.
He has since attempted to walk back from his words, but many are still under the impression that Covid no longer poses a threat.
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Also see my other blogs. Main ones below:
http://edwatch.blogspot.com (EDUCATION WATCH)
http://antigreen.blogspot.com (GREENIE WATCH)
http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH)
http://australian-politics.blogspot.com (AUSTRALIAN POLITICS)
http://snorphty.blogspot.com (TONGUE-TIED)
https://immigwatch.blogspot.com (IMMIGRATION WATCH)
https://awesternheart.blogspot.com (THE PSYCHOLOGIST)
http://jonjayray.com/blogall.html More blogs
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