Bonilla, Hector, Tian, Lu, Marconi, Vincent C et al. · International immunopharmacology · 2023 · DOI
This study looked at whether a medication called low-dose naltrexone (LDN) might help people with long COVID symptoms. Researchers reviewed 59 patients who took LDN and found that those who used it reported fewer overall symptoms, felt less fatigue and brain fog, experienced better sleep, and had improved ability to do daily activities. While these early results are encouraging, the study was not designed like a typical clinical trial, so more rigorous testing is needed to know if LDN truly works.
ME/CFS and long COVID share overlapping pathophysiology, including post-exertional malaise and suspected immune dysregulation. This study proposes naltrexone as a potential anti-inflammatory treatment and suggests a mechanism that may be relevant to both conditions. If validated in controlled trials, LDN could provide a novel therapeutic option for patients with debilitating fatigue and immune-mediated symptoms.
This study does not prove that LDN is effective for PASC—it is observational and lacks a placebo control group, so symptom improvement could be due to placebo effect, natural recovery, or other confounding factors. The findings cannot establish causality or determine which patients are most likely to benefit. Single-center results also may not generalize to other populations or healthcare settings.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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