From the Guidelines
Low-dose naltrexone and aripiprazole may be considered as part of a comprehensive treatment plan for long COVID-19, but their effectiveness is uncertain due to limited robust clinical evidence. The use of low-dose naltrexone (LDN) and aripiprazole for treating long COVID-19 is based on preliminary research and case reports, with some studies suggesting that LDN (typically dosed at 1-4.5mg daily) may help with fatigue, pain, and cognitive symptoms in some long COVID patients, possibly through its anti-inflammatory effects and immune system modulation 1. Aripiprazole, an atypical antipsychotic, has less evidence supporting its use for long COVID, though some clinicians have tried it at low doses (2-5mg daily) for neuropsychiatric symptoms. Some key points to consider when using these medications include:
- Starting at low doses with careful monitoring
- Understanding that these are experimental approaches
- Using them as part of a comprehensive plan that may include physical therapy, cognitive rehabilitation, and management of specific symptoms
- Recognizing that the complex nature of long COVID likely requires individualized treatment approaches rather than single medication solutions It is essential to work with healthcare providers experienced in treating long COVID when considering these medications, as they can help determine the best course of treatment and monitor for potential side effects 1.
From the Research
Effectiveness of Low-Dose Naltrexone and Aripiprazole for Long-Term COVID-19
- There is limited research on the effectiveness of low-dose naltrexone (LDN) and aripiprazole for treating long-term COVID-19, also known as long COVID.
- However, studies have investigated the use of LDN in patients with post-COVID-19 syndrome (PCS) or post-COVID fatigue syndrome (PCFS) 2, 3, 4, 5, 6.
- A study published in 2022 found that LDN was safe and may improve well-being and reduce symptomatology in patients with PCS 3.
- Another study published in 2024 found that treatment with LDN and NAD+ supplementation improved fatigue symptoms and quality of life in patients with persistent moderate/severe fatigue after COVID-19 6.
- A prospective, randomized, double-blind, parallel arm, placebo-controlled phase II trial is currently being conducted to assess the efficacy of LDN for improving fatigue in PCFS 5.
- There is no available research on the use of aripiprazole for treating long-term COVID-19.
- The use of LDN for long-term COVID-19 is still being researched, and more studies are needed to confirm its effectiveness and safety 2, 3, 4, 5, 6.
Safety and Efficacy of Low-Dose Naltrexone
- LDN has been shown to be safe in patients with PCS, with mild adverse events reported, such as new onset diarrhea and fatigue 3.
- A study published in 2024 found that treatment with LDN and NAD+ supplementation was generally safe, with mild adverse events managed with dose adjustments 6.
- The safety and efficacy of LDN for long-term COVID-19 are still being researched, and more studies are needed to confirm its effectiveness and safety 2, 3, 4, 5, 6.
Future Research Directions
- Randomized controlled trials are needed to further explore the effectiveness and safety of LDN for long-term COVID-19 3, 5.
- More research is needed to determine which patient subpopulations might benefit most from treatment with LDN and NAD+ supplementation 6.
- The use of aripiprazole for treating long-term COVID-19 should be investigated in future studies.