METHYLPHENIDATE

What is methylphenidate, and how does it work? 

Methylphenidate 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 crucial 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. Methylphenidate is a controlled substance and does have the potential for abuse if used in a manner inconsistent with how it is prescribed.

How can methylphenidate 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 afterward. 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, such as methylphenidate, can improve focus, attention span, and even fatigue. A case study completed in 2022 showed benefits when methylphenidate and other agents were used to help reduce “brain fog” [3]. Although no formal studies have been conducted on using methylphenidate for “brain fog,” one provider stated he has been using it, in conjunction with behavioral exercises, as a treatment option. He saw improved memory, attention, and concentration difficulties [4].

The chronic fatigue many patients face may be mitigated using methylphenidate as well. A study found that treatment with methylphenidate was significantly better than placebo in 17% of patients regarding their fatigue symptoms [5]. Although current recommendations do not advocate for the use of stimulants to treat long-COVID or symptoms of long-COVID, for those suffering from “brain fog” or fatigue, it may be an attractive option to those looking for symptom management.

References:

¹https://americanaddictioncenters.org/antidepressants-guide/ndris#

²https://www.unmc.edu/healthsecurity/transmission/2023/02/14/long-covid-now-looks-like-a-neurological-disease-helping-doctors-to-focus-treatments/

³https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10102822/

⁴https://www.ohsu.edu/sites/default/files/2023-02/PCR23-Mon-18-AndersonWM.pdf

⁵https://pubmed.ncbi.nlm.nih.gov/16443425/