ABSTRACT Purpose Treatments for myalgic encephalomyelitis and chronic fatigue syndrome can be adapted for post–COVID-19 condition. Our aim was to compare treatments in patients from our post–COVID-19 clinic. Methods We conducted a retrospective cohort study and included consecutive patients enrolled in our post–COVID-19 clinic. We included patients who received low-dose naltrexone, amitriptyline, duloxetine, and physical therapy, and evaluated improvements in fatigue, pain, dyspnea, and brain fog recorded in the electronic health record. We calculated the adjusted relative hazard of improvement using Cox proportional models. We adjusted for demographic characteristics, comorbidities, and prior COVID-19 hospitalization. Findings We included the first 108 patients with post–COVID-19 enrolled in the clinic. Most of the patients received amitriptyline. The relative hazard of improvement for those taking low-dose naltrexone was 5.04 (95% CI, 1.22–20.77; P = 0.02) compared with physical therapy alone. Both fatigue and pain were improved in patients taking low-dose naltrexone; only fatigue was improved in patients taking amitriptyline. Implications Post–COVID-19 condition symptoms may improve in patients taking medications adapted from myalgic encephalomyelitis and chronic fatigue syndrome. Randomized controlled trials should evaluate these medications and translational studies should further evaluate their mechanisms of action. Paywall, https://www.clinicaltherapeutics.com/article/S0149-2918(24)00003-1/fulltext#
Has there been an RCT for MECFS? I don't seem to be able to find one. There are several papers on dopamine's ability to modulate glial cells, both of which LDN is presumably capable of. My experiences of temporary improvement whenever I move to a new place seem to tie in with that, so I'd be interested seeing the result of LDN trial.
