ANTIDEPRESSANTS CAN TREAT SEVERAL SYMPTOMS

Source:Daily Mail    Published:2022-11-04     Hist:

Millions of people around the world are living with long Covid – yet it remains something of a puzzle.

The condition affects multiple organs and bodily systems, causing a huge variety of problems to varying degrees of severity and duration. Crucially, they vary from person to person, and are not likely to be consistent – they can come and go.

And the vast majority suffered only a mild initial Covid infection, not requiring hospitalisation. But for almost all who experience it – ‘long-haulers’, as they are sometimes called – the illness impairs every aspect of life.

Take, for example, fatigue – the most commonly reported symptom. You might imagine it to be similar to the tiredness felt at the end of a long day.

But the crippling, systemic exhaustion that long Covid causes is on an entirely different level.

Even simple activities like reading or watching TV are too much, let along the idea of being able to hold a conversation.

Without making an exhaustive list of all the 203 known symptoms, they include brain fog – also known as cognitive dysfunction – chest pains and breathlessness, insomnia, palpitations, dizziness, joint pain, depression and anxiety, nausea and other distressing digestive issues, food intolerances and allergies, headaches, skin rashes, hair loss, menstrual changes, erectile dysfunction, incontinence, hallucinations… it goes on and on.

The broad-ranging problems fall outside the remit of any one medical specialist, making diagnosis and treatment a challenge. But our understanding is evolving – and far from being a lost cause, there are therapies raising hopes of recovery.

The NHS has been ahead of the curve in setting up long Covid clinics – there are about 80 across the UK. Yet they are inundated, and able to handle just 5,000 new patients a month in total.

At this rate, it could take five years for all those severely affected to be seen.

And the treatments on offer in these places can be limited. Doctors who work in long Covid clinics have told us their role is more to refer patients to specialist clinics where they can get help for specific symptoms.

It’s important to say there is a paucity of scientific evidence in this area. Before NHS doctors can recommend treatment, they need to have gone through large controlled clinical trials. No specific long Covid therapy has met this bar, so far.

Yet those who feel they’ve already waited too long may just try things they’ve heard about online. It begs the question: with so many treatments being touted, what is worth exploring? And more importantly, what should be avoided?

We’ve spent month combing the data and found a handful of small studies that show promise, which are worth knowing about before making any decisions. Of course, it’s vital you speak to your GP before embarking on any new treatment, as there may be complex interactions with existing medication. With that disclaimer out of the way, let’s dive in…

HAY FEVER TABLETS START TO SHOW HOPE OF RELIEF

Over-the-counter antihistamines, usually taken for allergy relief, may help, emerging evidence suggests.

In one study, University College London researchers gave 26 long Covid sufferers the tablets, and 19 reported complete or partial resolution of their symptoms. Of 23 patients who weren’t given the pills, only six reported improved symptoms in the same period.

The drugs work by blocking the activity of histamine, a chemical released by the immune system. In some people, production can go haywire in response to certain substances – such as pollen – triggering unwanted symptoms.

Histamine is produced by immune system cells called mast cells – which are thought to become over-active in some people after Covid infection. In theory, by dampening this activity, the symptoms of long Covid could be reduced.

Anecdotally, antihistamines help control skin rashes, fevers, chest pain, mouth ulcers and other problems experienced by some long haulers. Experts suggest trying different over-the-counter brands to see which work best.

ASPIRIN MAY HELP… AND NOT JUST FOR PAIN

Studies show almost one in five long Covid sufferers have persistent tension-like headaches. It’s still not clear why, but one theory is the immune system reacts to long Covid symptoms by repeatedly activating the trigeminal nerve in the head, triggering pain.

Over-the-counter painkillers, such as paracetamol, ibuprofen and aspirin may give some relief but if the pain persists, it may be necessary to ask your GP for something stronger.

But beware that prescription painkillers can be addictive if used regularly for more than 12 weeks.

The benefits of certain painkillers could go beyond just soothing long Covid-related headaches.

For example, in low doses, aspirin or ibuprofen both have anti-platelet properties (platelets are cells that make blood clot) and could be used to counter the ‘sticky blood’ that many long-haulers experience, thought to increase the risk of micro-clotting, one of the condition’s apparent features.

But as things stand, there is little published research to support this and you should not routinely take aspirin or ibuprofen without your GP’s say-so as long-term use is linked with gastrointestinal bleeding, kidney damage and possibly even increased risk of a stroke or heart attack.

ADDICTION-BUSTING TABLETS COULD WORK

A drug used to combat opioid addiction might not be the most obvious choice in the fight against long Covid, but experts increasingly believe it could be key. Naltrexone blocks the effect of opioid drugs – such as heroin and fentanyl – on the body, reducing cravings for these highly addictive substances.

But in very low doses – under a tenth of what is used to treat opioid patients – it can function as a painkiller and an anti-inflammatory.

It has already been shown to benefit patients suffering from a condition known as chronic fatigue – or myalgic encephalomyelitis (ME) – a long-term illness similar to long Covid.

A US study investigating the effect of naltrexone in long Covid patients was launched in January last year and is expected to be completed next month.

It’s a promising treatment, and the results of this study are eagerly awaited.