Review Psychoneurological Therapy for Post-COVID Syndrome: A Comprehensive Review of Methods and Clinical Effectiveness, 2026, Veretova et al

[forestglip]

Psychoneurological Therapy for Post-COVID Syndrome: A Comprehensive Review of Methods and Clinical Effectiveness

Nellia Veretova, Alfiya Samigullina, Aigul Baialieva, Ruslan Abdyldaev, Begimai Muratbekova

Background
Post-COVID syndrome has emerged as a major global health issue characterized by long-lasting psychoneurological symptoms, including cognitive impairment, anxiety, depression, sleep disturbances, and fatigue. These symptoms can persist regardless of the severity of the initial SARS-CoV-2 infection and often result in long-term functional limitations. The purpose of this review was to summarize current evidence on psychoneurological therapeutic approaches used to manage post-COVID syndrome and evaluate their clinical effectiveness.

Methods
A structured literature review was conducted using PubMed, Scopus, MEDLINE, and Google Scholar. Eligible studies included randomized controlled trials, observational studies, and clinical reports published up to 2024 that examined pharmacological, psychotherapeutic, physical, complementary, or neuromodulation-based treatments for adults with persistent psychoneurological symptoms after COVID-19. The review followed standard ethical practices for narrative reviews; no new human or animal data were collected, and therefore ethical approval or CTRI registration was not required. Findings were synthesized narratively by therapy category.

Results
The review identified consistent evidence supporting the efficacy of multiple therapeutic modalities. Pharmacological agents including SSRIs, SNRIs, anxiolytics, and nootropics reduced anxiety, depression, and cognitive dysfunction. Psychotherapeutic methods such as cognitive behavioral therapy, psychodynamic therapy, and mindfulness-based interventions improved emotional regulation and coping.

Physical rehabilitation, aerobic exercise, and breathing practices enhanced endurance and reduced fatigue. Complementary approaches (e.g., acupuncture, massage) provided additional symptom relief. Neuromodulation techniques, including transcranial magnetic stimulation and electroconvulsive therapy, demonstrated benefits in treatment-resistant cases.

Conclusion
Psychoneurological therapy for post-COVID syndrome requires a multimodal approach that integrates pharmacological, psychological, physical, and neuromodulatory interventions. Current evidence suggests that individualized, combined strategies are most effective for improving cognitive, emotional, and functional outcomes. Further research is needed to optimize treatment protocols and evaluate long-term effectiveness.

Web | PDF | Georgian Medical News | Open Access

 

[forestglip]

Antidepressants, particularly SSRIs (such as fluoxetine, sertraline, escitalopram), are effective in reducing anxiety and depression, while also improving cognitive function. They have a favorable safety profile and are suitable for long-term use [13].

In a randomized clinical trial (2021), SSRIs significantly reduced symptoms of depression and anxiety in 150 PCS patients: 60% showed improvement on the Hamilton scale after 12 weeks of therapy [13]. Similarly, venlafaxine (an SNRI) was found in a 2022 study to improve cognitive function and reduce anxiety in 80 patients compared to a placebo group [13].

13. Al-Aly Z, Xie Y, Bowe B. High-dimensional characterization of post-acute sequelae of COVID-19. Nature. 2021;594:259-64. [Link]

13 is an observational study, not an RCT, and it doesn't include any of the details mentioned. Also, the second sentence refers to a 2022 study, but cites a 2021 paper. I can't find either of the studies they describe (though that doesn't necessarily mean they don't exist).

Diazepam showed temporary anxiety reduction but requires strict monitoring [14].

14. Banerjee D, Viswanath B. Neuropsychiatric manifestations of COVID-19 and possible pathogenic mechanisms: Insights from other coronaviruses. Asian J Psychiatr. 2020;54:102350. [Link]

14 doesn't mention diazepam.

A 2021 study showed that risperidone reduced delusions and hallucinations in 75% of PCS patients [15], while quetiapine stabilized mood in 70% of patients with bipolar disorders [15].

15. Otani K, Fukushima H, Matsuishi K. COVID-19 delirium and encephalopathy: Pathophysiology assumed in the first 3 years of the ongoing pandemic. Brain Disorders. 2023;10:100074. [Link]

15 is a review about delirium in COVID patients. It recommends both of the mentioned drugs (risperidone and quetiapine) for delirium, but it is not a trial and doesn't appear to cite any trials of those drugs.

Piracetam enhances brain metabolism and was shown in a 2022 study to improve memory and attention [16]. Citicoline aids in neuronal repair and has neuroprotective properties [16].

16. Ortelli P, Ferrazzoli D, Sebastianelli L, et al. Neuropsychological and neurophysiological correlates of fatigue in post-acute patients with neurological manifestations of COVID-19: Insights into a challenging symptom. J Neurol Sci. 2021;420:117271. [Link]

16 doesn't mention either "piracetam" or "citicoline".

Corticosteroids (e.g., dexamethasone) help reduce inflammation in PCS but must be used cautiously with prolonged treatment [17]. NSAIDs (e.g., ibuprofen, naproxen) are effective for relieving pain and inflammation but are contraindicated in certain chronic conditions [17].

17. RECOVERY Collaborative Group. Dexamethasone in hospitalized patients with COVID-19. N Engl J Med. 2021;384:693-704. [Link]

17 is a trial of dexamethasone in hospitalized patients with acute COVID to test its effect on mortality, not a study of inflammation in post-COVID syndrome. "NSAID", "ibuprofen", and "naproxen" are not mentioned in that article.

These are all the cited claims in the "Methods of Psychoneurological Therapy" section, and none of them have citations that make sense.

 

[InitialConditions]

"[SSRIs] have a favorable safety profile and are suitable for long-term use [13]."

Sure, Jan!

 

[Turtle]

Strange article with a bottomline message:
"Everything we studied worked, from aerobic exercise and electroconvulsive therapy to all pills available".

 

[StellariaGraminea]

"Georgian Medical News" ==> Georgian Journal of Creative Writing

 

[Trish]

Oh dear. I wonder if they wrote it using AI.

 

[rvallee]

Sure looks like the Georgian Medical News journal doesn't have a significantly better review process than the Romanian journal of experiential medicine. But then again it's not significantly worse than whatever the BMJ, Lancet or JAMA publishes when it comes to "those patients".

It's really absurd seeing all the whining about the explosion of garbage research because of the AI explosion when humans have been publishing complete slop since medical journals have existed.

Strange article with a bottomline message:
"Everything we studied worked, from aerobic exercise and electroconvulsive therapy to all pills available".

Norwegian government responding to this: "hmmm, yes, those patients should have to try all of those treatments before they get any form of support, it's just what the evidence shows, anyway here's our actual head of medical research saying the same thing as the Georgian Medical News".

What a world.

 

[rvallee]

Oh dear. I wonder if they wrote it using AI.

At this point it's a safe bet that AI would have easily done a better job here.

 

[Utsikt]

Norwegian government responding to this: "hmmm, yes, those patients should have to try all of those treatments before they get any form of support, it's just what the evidence shows, anyway here's our actual head of medical research saying the same thing as the Georgian Medical News".

This is 100 % accurate. They’ll even yell at you in court, and have no issue claiming to be an expert on severe ME/CFS while having seen only one severe patient ever, and not being aware of FITNET-NHS or MAGENTA in 2026 (Flottorp).