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Potential New Treatment for “Brain Fog” in Long COVID Patients
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. Long-haulers may experience a lack of mental clarity, poor focus and concentration, memory problems, difficulty with multi-tasking, and more. Brain fog can be debilitating, but there currently are no treatment options that are approved for the condition.
While the number of patients they studied is too small for their results to be definitive, Yale researchers—using their extensive experience with two existing medications—have published initial evidence that those drugs, given together, can mitigate or even eliminate brain fog.
Guanfacine, developed in the lab of Amy Arnsten, PhD, Albert E. Kent Professor of Neuroscience and professor of psychology, was approved by the Food and Drug Administration (FDA) for the treatment of ADHD in 2009, but clinicians have also used it extensively off-label for other prefrontal cortical disorders such as traumatic brain injury (TBI) and PTSD. Now, Arnsten has joined forces with Arman Fesharaki-Zadeh, MD, PhD, assistant professor of psychiatry and of neurology, who has been treating 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, they found, was successful in relieving brain fog for their small cohort of patients. And while larger, placebo-controlled clinical trials will be needed to establish these drugs as a bona fide treatment for post-COVID-19 neurocognitive deficits, they say patients can obtain them now if their doctors wish to prescribe them.
“There’s a paucity of treatment out there for long COVID brain fog, so when I kept seeing the benefits of this treatment in patients, I felt a sense of urgency to disseminate this information,” says Fesharaki-Zadeh. “You don’t need to wait to be part of a research trial. You can ask your physician—these drugs are affordable and widely available.” Because they are FDA-approved and have been used for years, their safety for patients is established.
The researchers published their case study in Neuroimmunology Reports on November 25.
https://medicine.yale.edu/news-article/potent...-patients/
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