8 Jun 2023
By Stephanie Brown Published on June 07, 2023
Fact checked by Nick Blackmer
Wladimir Bulgar / Science Photo Library / Getty Images. Key Takeaways
Long COVID is still not well understood, making it difficult for scientists to develop treatments.
Low-dose naltrexone may be a promising treatment for long COVID, but more studies are needed.
Naltrexone is FDA-approved to treat alcohol use disorder and opioid addiction, but it has also been used off-label in low doses to treat inflammatory diseases.
Naltrexone is a drug approved by the Food and Drug Administration (FDA) to treat alcohol use disorder and opioid addiction. Low-dose naltrexone (LDN), usually at a fraction of the regular dose, has been used to treat fibromyalgia and multiple sclerosis. Now, research shows that LDN might also be a promising treatment for long COVID. As many as 23 million Americans may have been affected by long COVID, but the lack of understanding about this condition makes it hard to develop treatments. “I want to encourage people that it is possible to improve and for their symptoms to get better, but I want to discourage people from the belief that there’s one medicine that will cure long COVID,” said Jessica A. Bender, MD, MPH, co-director of UW Medicine’s Post-COVID-19 Rehabilitation and Recovery Clinic. Related: Have Long COVID and Can't Work? Here's What to Do How Might Low-Dose Naltrexone Treat Long COVID? While LDN might not cure all long COVID symptoms, it could serve as part of a treatment plan. A small study published last year found that LDN improved some self-reported symptoms, such as pain and energy levels, for long COVID patients. “It looks like it worked for most people. So I think it’s part of the solution because it’s targeting two of the four issues that I see really critical with long COVID, which is brain inflammation and immune dysregulation,” said Jack Lambert, MD, PhD, a co-author of the study and a professor of infectious disease at the University College Dublin School of Medicine in Ireland. People with long COVID reportedly have an increased level of inflammatory cytokines, which are involved in the body’s immune response, according to Hector Bonilla, MD, co-director of the Stanford Post-Acute COVID-19 Syndrome Clinic. Related: What Should We Expect From Long COVID Treatment? LDN has demonstrated effects on reducing inflammatory cytokines, which might be why it shows promise as a potential treatment for long COVID patients, Bonilla said. LDN is sometimes used to treat chronic inflammatory diseases like inflammatory bowel disease (IBS). Lambert said he has used LDN for patients with chronic Lyme disease, a condition that can lead to inflammation of the brain or spinal cord, and the positive results led him to conduct the pilot study on LDN in long COVID patients. LDN isn’t FDA-approved to treat long COVID, so healthcare providers can only prescribe it off-label. “We’re three years into long COVID, and we’ve not advanced very far in terms of interventions. This is just one of the few promise interventions that I can vouch for based on my clinical experience, and I encourage others to consider using it as well,” Lambert said. Related: How Do You Know if You Have Long COVID? LDN May Not Work for EveryoneLDN doesn’t seem to come with many side effects, but this medication might not work for everyone. “I’ve had some people who had one or two doses and just didn’t feel like themselves or had some hard-to-describe side effects and so decided to not take it,” Bender said. When LDN is prescribed, Bender explained, people often start with a very low dose and work their way up to a higher dose. While people might see improvements after a few weeks, she said it is difficult to track how well the drug works because it’s often prescribed along with multiple treatments. Clinical trials are still needed to help healthcare providers understand exactly how this LDN works. A placebo-controlled study in British Columbia looking at the effects of LDN on long COVID fatigue may be underway soon, which could help provide some answers. “What we as a scientific community need to do is be able to prove that this medication works for this indication with relatively few side effects and that’s how we can help improve the health of the public and everybody with long COVID,” Bender said. Read Next: Low-Dose Naltrexone May Be Opioid Replacement for Chronic Pain What This Means For You If you or a loved one are experiencing long COVID symptoms, consider talking to your healthcare provider about the treatment options available to you. They can help you create a treatment plan that works best for your symptoms. Originally posted: Low-Dose Naltrexone Could Treat Long COVID Symptoms (verywellhealth.com) Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Toljan K, Vrooman B. Low-dose naltrexone (LDN)—review of therapeutic utilization. Med Sci (Basel). 2018;6(4):82. doi:10.3390/medsci6040082 Government Accountability Office. Science & tech spotlight: long COVID. O’Kelly B, Vidal L, McHugh T, Woo J, Avramovic G, Lambert JS. Safety and efficacy of low dose naltrexone in a long covid cohort; an interventional pre-post study. Brain Behav Immun Health. 2022;24:100485. doi:10.1016/j.bbih.2022.100485 Buonsenso D, Piazza M, Boner AL, Bellanti JA. Long COVID: A proposed hypothesis-driven model of viral persistence for the pathophysiology of the syndrome. Allergy Asthma Proc. 2022;43(3):187-193. doi:10.2500/aap.2022.43.220018 Lie MRKL, van der Giessen J, Fuhler GM, et al. Low dose naltrexone for induction of remission in inflammatory bowel disease patients. J Transl Med. 2018;16(1):55. doi:10.1186/s12967-018-1427-5 Bonilla H, Peluso MJ, Rodgers K, et al. Therapeutic trials for long COVID-19: a call to action from the interventions taskforce of the RECOVER initiative. Front Immunol. 2023;14:1129459. doi:10.3389/fimmu.2023.1129459 Bolton MJ, Chapman BP, Marwijk HV. Low-dose naltrexone as a treatment for chronic fatigue syndrome. BMJ Case Reports. 2020;13(1):e232502. doi:10.1136/bcr-2019-232502