Azithromycin for long COVID
AZITHROMYCIN
What is azithromycin (Zithromax)?
Azithromycin is an antibiotic used to treat bacterial infections such as pneumonia, sinusitis, and sexually transmitted diseases. It works by preventing bacteria from making proteins. Without proteins, bacteria cannot survive and die. Azithromycin is commonly prescribed in the outpatient setting under the name “Z-pack.”
Can azithromycin help with long-COVID?
At the beginning of the COVID-19 pandemic, azithromycin had gained some headway as a potential treatment option for COVID-19 due to its antiviral properties and modifying effects on the immune system. Lab research on azithromycin found that it may prevent COVID-19 from entering the cells while decreasing the likelihood of an overresponse of the immune system [1]. Unfortunately, when tested in clinical studies, azithromycin did not produce positive results in active COVID-19 infections. For instance, one study found that azithromycin did not reduce the time to sustained clinical improvement or discharge in hospitalized patients, rendering it insignificant [2].
Although azithromycin may not be helpful in active COVID-19 infections, a minimal amount of data points to its use as a potential agent in long-COVID. In a case study, an older woman who suffered severe lung inflammation post-COVID was given azithromycin three times weekly for an extended period. After treatment, a follow-up chest X-ray showed almost complete resolution of lung disease [3]. The mechanism as to how this worked needs to be clarified. However, more clinical studies and data could shed light on the use of azithromycin as a potential therapy for patients dealing with long COVID.
References:
1https://bmjopenrespres.bmj.com/content/8/1/e000806#
3https://scholars.direct/Articles/microbiology/amr-5-022.pdf
Bupropion for long COVID
BUPROPION
What is bupropion?
Bupropion is a medication that is commonly used to treat depression, seasonal affective disorder (SAD), and smoking cessation. It is an atypical antidepressant in that it is not in the selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake inhibitor (SNRI) class. Bupropion works by inhibiting the reuptake of norepinephrine and dopamine in the brain. These chemicals are used in reward- and emotion-related behavior [1]. In depression, there is an imbalance of these chemicals in the brain. By inhibiting the reuptake of norepinephrine and dopamine, bupropion makes them more available for the brain to use, thus restoring the chemical balance.
How can bupropion help with long-COVID?
In those diagnosed with long-COVID, many suffer from “brain fog” memory problems, difficulty concentrating, and forgetfulness. The proposed reason for “brain fog” is that during a COVID-19 infection, the body’s immune response becomes activated, causing heavy amounts of inflammation, including in the central nervous system (CNS). Additionally, those with long-COVID can often exhibit symptoms of depression, as it may take months or years for long-COVID to resolve, if at all. To combat this, researchers have turned to already existing medication therapies in the hopes they may be able to help decrease “brain fog” and resolve depression in patients. To date, researchers have found some evidence that bupropion may help mitigate symptoms.
A small case series found that dosing patients with bupropion increases mood, energy, and focus [2]. Although the exact mechanism of how bupropion works in “brain fog” is still unclear, it is proposed to block the loss of brain cells and decrease part of the inflammation response in the brain [2]. More research needs to be explicitly conducted for “brain fog” patients. However, bupropion does play a role in decreasing depressive symptoms that some long-COVID patients may exhibit due to the loss of their baseline activity.
References:
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CompendiRx:
Empowering the long COVID Community
Who We Are
Welcome to CompendiRx, an innovative online platform dedicated to transforming the journey of individuals grappling with the often-overlooked condition known as COVID. Born from a genuine commitment to addressing the unique challenges faced by this community, CompendiRx stands as a beacon of hope, understanding, and invaluable support.
Our mission is simple yet profound: to offer an empowering registry of treatment ratings and reviews, complemented by concise summaries of the latest research findings relevant to long COVID.
We envision a world where individuals impacted by this condition feel informed, supported, and optimistic about their path to recovery.
Our Core Values
At the heart of CompendiRx is a set of guiding principles that inform every aspect of our operations and interactions with the long COVID community:
Integrity and Trust: Upholding the highest standards of honesty and transparency, we are committed to providing reliable, evidence-based information. Your safety and privacy are paramount to us.
Empowerment through Knowledge: We believe in the power of informed decisions. Access to the latest, scientifically-backed treatment insights can significantly impact recovery outcomes.
Community-Centric Approach: We listen, we care, and we adapt. Understanding the evolving needs of the long COVID community is central to our mission.
Collaborative Expertise: Our team is our strength. Drawing upon the diverse knowledge of medical doctors, pharmacists, scientific writers, and HealthIT Web developers, we strive to offer a comprehensive resource for all affected by long COVID.
Serving the Long COVID Community: Our Founders Pledge to You
“To the many patients I’ve personally supported during their long COVID journeys, and to every individual currently navigating the complexities of long COVID, CompendiRx pledges to be your trusted ally. In a landscape where research is rapidly unfolding, and new treatments are continually emerging, staying informed can be overwhelming. We are here to simplify this journey by offering a user-friendly platform where you can find not just information but hope” – Founder, CompendiRx.
Join us in shaping a future where the long COVID community is no longer overlooked but empowered with the knowledge and support needed to embark on a path toward recovery. Whether you’re seeking insights into potential treatments, looking to share your experiences, or simply searching for understanding, CompendiRx is here for you. Together, let’s turn the page towards a brighter, healthier tomorrow. Welcome to CompendiRx – where your journey to empowerment begins.”
Connect with us
We’re eager to hear from you. Whether you have questions, wish to share your story, or simply need someone to talk to, our doors are open. Together, we’re stronger.
Welcome to CompendiRx.
Buspirone for long COVID
BUSPIRONE
What is buspirone (Buspar)?
Buspirone is a medication used to treat anxiety. Although its exact mechanism is unknown, it is believed to act on the serotonin and dopamine receptors in the brain. Serotonin is a neurotransmitter that aids in mood, sexual desire, sleep, digestion, wound healing, bone health, and blood clotting [1]. It is often referred to in psychology as the “happy” chemical. Dopamine is a “feel good” hormone. It affects memory, behavior, motivation, and mood [2]. In conditions like anxiety, the brain is dealing with an imbalance of chemicals such as serotonin and dopamine. An anxiolytic, like buspirone, works by keeping serotonin and dopamine in the space where they can readily be available for bodily processes.
What is the connection between buspirone and long-COVID?
In addition to affecting mood, serotonin also plays a role in viral inflammation. It can block certain viruses (like HIV-1) in the cell and decrease cytokine production, promoting the immune response [3]. In long-COVID, it is thought the body has an overresponse to COVID-19, resulting in a cytokine storm or heightened immune response. This immune response manifests as “brain fog,” decreased cognitive acuity, memory deficits, poor focus, anxiety, reduced ability to multitask, and reduced concentration [3]. As buspirone works to keep serotonin available for bodily processes, in theory, it may help decrease symptoms associated with long-COVID with its anti-inflammatory properties.
As of current, research is limited regarding the use of buspirone for long-COVID. With a labeled indication for anxiety, those suffering from long-COVID induced anxiety may see relief with the use of buspirone. However, if looking for treatment relief from long-COVID, it is unknown if it can affect the high levels of inflammation in the body from COVID-19.
References:
1https://my.clevelandclinic.org/health/articles/22572-serotonin
2https://my.clevelandclinic.org/health/articles/22581-dopamine
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Citalopram for long COVID
CITALOPRAM
What is citalopram (Celexa)?
Used for depression, citalopram belongs to a class of medication called selective serotonin reuptake inhibitors (SSRIs). Serotonin is a molecule in the body that aids in mood, sexual desire, sleep, digestion, wound healing, bone health, and blood clotting. It is often referred to in psychology as the “happy” chemical. In conditions like depression, the brain is dealing with an imbalance of chemicals such as serotonin. SSRIs, like citalopram, work by keeping serotonin in the space where it can readily be available for bodily processes.
What is the connection between citalopram and long-COVID?
In those diagnosed with long-COVID, many suffer from “brain fog”; decreased cognitive acuity, memory deficits, poor focus, reduced ability to multitask, and reduced concentration [2]. The proposed reason is that during a COVID-19 infection, the body’s immune response becomes activated, causing heavy amounts of inflammation. Additionally, serotonin has been shown to have an effect against viral inflammation by blocking certain viruses (like HIV-1) in the cells. Serotonin can decrease cytokine production, promoting the immune response [2]. This inflammation affects the central nervous system (CNS), brain, and spinal cord.
Researchers have begun to look at the use of citalopram to help in long-COVID due to its effects on serotonin and its role in depression. One trial conducted in 60 patients showed a decrease in depression when treated with citalopram [2]. A second study found the use of citalopram significantly contributed to a reduction in long-COVID symptoms [3]. Although more research needs to be conducted to support the use of SSRIs for inflammation-related long-COVID, for symptoms of depression associated with long-COVID, citalopram may be a viable option [4].
References:
2https://www.nature.com/articles/s41598-023-45072-9
3https://link.springer.com/article/10.1007/s40267-022-00975-x
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Colchicine for long COVID
COLCHICINE
What is colchicine (Colcrys)?
Colchicine is a medication prescribed for the prevention and treatment of gout. Gout is caused by a buildup of uric acid crystals in the joint space. These crystals are hard and very sharp, causing tremendous pain. Colchicine works by reducing the inflammation resulting from the buildup of these crystals [1].
Does colchicine play a role in long-COVID?
As colchicine decreases inflammation, researchers have turned to it in hopes it may reduce symptoms associated with long-COVID. Researchers theorize that those affected by long-COVID live in a state of inflammation. COVID-19 sets off a cytokine storm, an immune system overresponse. Although they are not actively infected, patients are still shedding the virus, resulting in symptoms of “brain fog,” exercise intolerance, and shortness of breath.
Currently, results only from studies looking at adding colchicine to hospitalized patients exist. These studies aim to see if adding colchicine can improve patient outcomes. One study looked at 72 patients, 36 using a placebo and 36 using colchicine, and found after ten days of treatment, the use of supplemental oxygen and hospitalized were reduced [2]. Another study found that patients treated at the outpatient level, diagnosed as COVID-19 positive by a PCR test, colchicine did help prevent hospitalizations and death after 30 days of treatment [3].
Colchicine does show some benefit in decreasing symptoms in those actively infected with COVID-19, so it may also have an indication in the long-COVID population. A study in India is currently looking at the relationship between colchicine and long-COVID patients to determine whether colchicine is better at improving functional outcomes and respiratory/mental health outcomes than placebo. However, this study is ongoing, and results are not yet available [4].
References:
1https://www.nhs.uk/medicines/colchicine/about-colchicine/
2https://rmdopen.bmj.com/content/7/1/e001455
3https://www.thelancet.com/action/showPdf?pii=S2213-2600%2821%2900222-8
4https://www.georgeinstitute.org/projects/Colchicine-for-Long-COVID
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Dexmethylphenidate for long COVID
DEXMETHYLPHENIDATE
What is dexmethylphenidate, and how does it work?
Dexmethylphenidate is a stimulant medication that belongs to the drug class amphetamines. This medication acts on the central nervous system (CNS) by increasing levels of two chemicals, dopamine and norepinephrine, in the brain. Norepinephrine is thought to play a role in the body’s stress response and helps to regulate sleep, alertness, and blood pressure. Dopamine plays a key role in movement and affects motivation, perception of reality, and the ability to experience pleasure [1]. By increasing these levels of chemicals, it leads to an increase in focus and attention. Dexmethylphenidate is a controlled substance and does have the potential for abuse if used in a manner inconsistent with how it is prescribed.
How can dexmethylphenidate be used in long-COVID?
Sufferers of long-COVID often deal with “brain fog,” a persistent cognitive defect resulting in memory problems, poor focus, and decreased ability to concentrate. Although the reasoning is still unclear, researchers think COVID-19 may linger in the brain for months. Even though it does not cause an active infection, it is a foreign substance in the body. This leads to constant attack by the immune system, causing inflammation. Over time, the continuous inflammation manifests as “brain fog” symptoms [2].
Stimulants like dexmethylphenidate can improve focus, attention span, and even fatigue. A case study completed in 2022 showed benefits when using methylphenidate, a cousin to dexmethylphenidate and other agents, to help reduce “brain fog” [3].
The chronic fatigue many patients face may be mitigated using dexmethylphenidate as well. A study found that treatment with methylphenidate was significantly better than placebo in 17% of patients regarding their fatigue symptoms [4]. Although current recommendations do not advocate for the use of stimulants, or dexmethylphenidate in particular, to treat long-COVID or symptoms of long-COVID, for those suffering from “brain fog” or fatigue, they may be an attractive option to those looking for symptom management.
References:
1https://americanaddictioncenters.org/antidepressants-guide/ndris#
3https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10102822/
4https://pubmed.ncbi.nlm.nih.gov/16443425/
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