Dummy Article
Dummy Article is there
Fenofibrate for long COVID
FENOFIBRATE
What is fenofibrate?
Fenofibrate is part of a class of medications known as fibric acid derivates. Their primary function is to lower triglyceride levels and increase HDL cholesterol levels in patients.
How does fenofibrate work?
Cholesterol in the body is made up of two parts: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL is often referred to as the “bad” cholesterol, as an abundance of this type can lead to heart attacks, stroke, and other health problems. HDL, on the other hand, is the “good” cholesterol; it works to clear other circulating cholesterol in the body to prevent buildup [1]. Fenofibrate exerts its effects on HDL and triglycerides, another type of potentially harmful fat circulating in the blood. Fenofibrate works to increase the amount of HDL and break down unwanted triglycerides so they can be removed from the body.
How can fenofibrate affect those with long-COVID?
Fenofibrate also possesses anti-inflammatory, antioxidant, and anti-thrombotic properties [2]. These properties may help reduce symptoms for those suffering from long-term COVID. Additionally, fenofibrate has activity against an enzyme called ACE2, the same enzyme that COVID-19 uses to enter the cells. By blocking this entryway, fenofibrate stops COVID-19, halting body access [2].
Although more research needs to be conducted in humans to solidify fenofibrate’s role in long-COVID, it does show promise in the lab-based studies performed [3]. One study showed that viral infectivity may be reduced by up to 70% [4]. In persons with long-COVID, the current theory is that although patients are not actively infected, they still shed the virus in their bodies [4]. Through fenofibrate’s ability to block COVID-19’s access into the cells, COVID-19 is now halted, leading to a decrease in symptoms and eventual recovery.
References:
2https://link.springer.com/article/10.1007/s00011-022-01615-w
3https://www.goodrx.com/fenofibrate/fenofibrate-covid
4https://www.jacc.org/doi/10.1016/j.jacc.2021.08.021
Dummy Article
Article is dummy.
Fluoxetine for long COVID
Fluoxetine (Prozac)
What is fluoxetine (Prozac)?
Most used for depression, fluoxetine 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 [1]. 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 fluoxetine, work by keeping serotonin in the space where it can readily be available for bodily processes.
What is the connection between fluoxetine 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. This inflammation affects the central nervous system (CNS), brain, and spinal cord. To combat this problem, researchers have turned to already existing medication therapies in the hopes they may be able to help decrease “brain fog” symptoms.
Additionally, serotonin has been shown to have an effect against viral inflammation by blocking certain viruses (like HIV-1) from entering the cells. It can decrease the production of cytokines, which promotes the immune response. A trial conducted on 60 patients showed a decrease in depression when treated with an SSR like fluoxetine [2]. It was also observed that treatment with fluoxetine decreased COVID-19 levels, specifically in men, after a minimum of 10 days [3].
Researchers have begun clinical trials to test fluoxetine and its effect on serotonin and COVID-19 [4]. Results will not be available for quite some time; therefore, evidence is currently limited to support the use of SSRIs for inflammation-related long-COVID. However, for symptoms of depression associated with long-COVID, fluoxetine may be a viable option [5].
References:
1 https://my.clevelandclinic.org/health/articles/22572-serotonin
3https://www.frontiersin.org/articles/10.3389/fphar.2022.1036093/full#h7
4https://www.nytimes.com/2023/10/16/health/long-covid-serotonin.html
5https://link.springer.com/article/10.1007/s40267-022-00975-x
Amitriptyline for long COVID
AMITRIPTYLINE
What is amitriptyline (Elavil, Vanatrip)?
Amitriptyline belongs to the class of medications called tricyclic antidepressants. Mostly used for depression, it is normally prescribed as an alternative when other depression medications are not effective. Amitriptyline works by inhibiting the reuptake of the neurotransmitters norepinephrine and serotonin. By preventing the breakdown of norepinephrine and serotonin, it aids in restoring the imbalance of these chemicals caused by depression.
What is the link between amitriptyline and long COVID?
Many patients diagnosed with long COVID are plagued by moderate to severe, frequent headaches. The cause is thought to be massive inflammation accompanied by a cytokine storm (overexaggeration of the immune system) [1]. These headaches can worsen a preexisting primary headache or, more specifically, present as a new (intermittent or daily) headache starting during the acute infection or after a delay [1].
To treat these headaches, providers have turned to amitriptyline as a potential treatment option. One observational study looked at post-COVID patients treated with amitriptyline and found that using amitriptyline reduced the number of headache days per month by 9.6 [2]. Additional case reports found amitriptyline was helpful in patients with long-lasting COVID headache and chronic migraines post-COVID. However, the patients in these case reports did not use amitriptyline as a single agent; it was combined with Botox injections [3].
Although amitriptyline will not cure long COVID, it may offer symptom management in headache sufferers. Additional research may help to solidify amitriptyline’s use in long-COVID treatment.
References:
1https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-022-01450-8
Fluticasone propionate/salmeterol for long COVID
FLUTICASONE PROPIONATE/SALMETEROL
What is fluticasone/salmeterol (Advair)?
Fluticasone/salmeterol is a class of medications used to treat inflammatory respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD). It contains a corticosteroid, fluticasone, which reduces inflammation, and a long-acting bronchodilator, salmeterol, which opens the airways.
How can fluticasone/salmeterol be used to treat long-COVID?
Patients with long-COVID have symptoms such as chronic fatigue, shortness of breath, and exercise intolerance. Due to fluticasone/salmeterol’s mechanism of action in opening the airways, those suffering from breathing issues from long-COVID may be positively impacted. Although no formal studies have been conducted to determine how effective this treatment is, patients have reported positive results [1]. Fluticasone/salmeterol is not indicated for the treatment of long-COVID but could provide symptom management by increasing lung capacity, increasing exercise intolerance, and decreasing inflammation in the lungs.
Anakinra for long COVID
ANAKINRA
What is anakinra?
Anakinra is an IL-1 receptor antagonist that reduces IL-1 in the body. IL-1 belongs to a group of substances called cytokines, which induce inflammation and provoke the immune response. Anakinra works by blocking this immune response from occurring, thus decreasing inflammation in the body. Anakinra treats rheumatoid arthritis in those over 18 years of age.
How can anakinra be used in long COVID?
Patients diagnosed with long COVID are thought to be in a constant state of inflammation. This inflammation manifests in symptoms such as fatigue, “brain fog,” exercise intolerance, wheezing, and trouble breathing. The current working theory is that by decreasing the inflammatory response using anakinra, the inflammation in the body will decrease and bring patients back to their pre-COVID baselines.
Research thus far has been mixed. A systematic review conducted by researchers in Germany found anakinra had no positive or negative effect on hospitalized patients dealing with COVID-19 symptoms [1]. However, in a review of all available evidence of anakinra, researchers think it may benefit patients with severe respiratory problems that may progress to respiratory failure [2]. As of November 2022, the FDA granted anakinra Emergency Use Authorization for certain hospitalized patients requiring supplemental oxygen [3]. Whether that authorization gets extended to use outside of hospitals remains.
References:
1https://doi.org/10.1186/s40001-023-01072-z
2https://doi.org/10.1016/j.intimp.2022.109075
Active Clinical Trials: Long COVID, Anakinra | Card Results | ClinicalTrials.gov
Fluvoxamine for long COVID
FLUVOXAMINE
What is fluvoxamine (Luvox)?
Most used for anxiety and depression, fluvoxamine 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 [1]. It is often referred to in psychology as the “happy” chemical. In conditions like depression and anxiety, the brain is dealing with an imbalance of chemicals such as serotonin. SSRIs, like fluvoxamine, work by keeping serotonin in the space where it can readily be available for bodily processes.
What is the connection between fluvoxamine 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. This inflammation affects the central nervous system (CNS), brain, and spinal cord. To combat this problem, researchers have turned to already existing medication therapies in the hopes they may be able to help decrease “brain fog” symptoms. To date, researchers have found some evidence that fluvoxamine may help mitigate symptoms.
Serotonin has also been shown to have an effect against viral inflammation by blocking certain viruses (like HIV-1) into the cells. In addition, it can decrease cytokine production, promoting the immune response [2]. A trial conducted on 60 patients showed a decrease in depression when treated with an SSRI [2]. More research needs to be conducted as there is currently limited evidence to support the use of SSRIs for inflammation-related long-COVID; however, for symptoms of depression associated with long-COVID, fluvoxamine may be a viable option [3].
References:
1 https://my.clevelandclinic.org/health/articles/22572-serotonin
3https://link.springer.com/article/10.1007/s40267-022-00975-x
Active Clinical Trials: Long COVID, SSRI | Card Results | ClinicalTrials.gov
Armodafinil for long COVID
ARMODAFINIL
What is armodafinil (Nuvigil) used for?
Armodafinil is commonly prescribed for narcolepsy and shift-work sleep disorder. It is a central nervous system (CNS) stimulant that impacts the brain and spinal cord; however, it has a low potential for abuse, unlike Adderall or Vyvanse, due to its pharmacokinetic properties [1].
How can armodafinil help patients dealing with long COVID?
Some researchers theorize that neural pathways in the brain become distorted in long COVID. The initial infection caused by COVID-19 increases inflammation in the brain, which may leave cells vulnerable to other organisms or substances that may also cause inflammation. Continuation of this cycle can damage the signaling pathways between the cells in the brain. Over time, this results in the death of brain cells, leading to cognitive symptoms such as “brain fog.” Armodafinil may assist in rebuilding the destroyed pathways, leading to increased concentration and memory [1].
Additionally, as armodafinil is a CNS stimulant, it can promote wakefulness and decrease fatigue, something long COVID sufferers are all too familiar with [2]. Although more research needs to be completed regarding using armodafinil for long COVID, it does show promise in helping patients struggling with concentration, memory, and fatigue problems.
References:
1https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp-rj.2022.170402
2https://journals.sagepub.com/doi/pdf/10.1177/10398562211003598
Gabapentin for long COVID
GABAPENTIN
What is gabapentin?
Gabapentin is a medication that mimics gamma-aminobutyric acid (GABA) in the body. GABA is responsible for inhibiting neurons that produce an excitatory signal. In pain or seizures, neurons constantly fire, inducing an excitatory response. GABA works to calm these neurons and return them to normalcy. Gabapentin is commonly used for neuropathy (nerve pain) and those affected with partial seizures. [1].
Can gabapentin help with long-COVID?
Patients with long-COVID can display a variety of symptoms such as tremors or neuropathy in the fingers or toes. Although the mechanism behind this is still unclear, some theories point to damage of the nerve cells by COVID-19, causing an imbalance in excitatory versus inhibitory neurons [2]. Several providers have turned to therapies, such as gabapentin, to control these symptoms. In a guide created for primary care physicians regarding long-COVID, the use of gabapentin is warranted for neuropathic pain [2]. Additionally, a review study published in 2022 found that in patients with neuropathy from long-COVID, 61% were prescribed agents such as gabapentin for symptom management [3].
An additional theory for COVID-19 involves its proposed effect on the nerve cells responsible for smell. Since damaged nerve cells are thought to be involved, researchers turned to gabapentin to mitigate this loss of olfactory neurons. A study found that the use of gabapentin did not significantly improve the sense of smell compared to placebo [4].
Gabapentin may be a helpful therapy for those suffering from neurological pain associated with long-COVID. It may offer symptom management and help restore a patient to pre-COVID baseline function.
References:
1https://medlineplus.gov/druginfo/meds/a694007.html
2https://www.jabfm.org/content/jabfp/34/6/1229.full.pdf
3https://onlinelibrary.wiley.com/doi/10.1002/acn3.51570
4https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2809346#:~:text=Conclusion%20and%20Relevance%20In%20this,COVID%2D19–induced%20OD.
![](https://compendirx.com/wp-content/themes/medical-directory-child/assets/img/insta.png")
