Tamariz, Leonardo, Bast, Elizabeth, Klimas, Nancy et al. · Clinical therapeutics · 2024 · DOI
This study looked at whether treatments used for ME/CFS could help people with long COVID. Researchers reviewed records from 108 patients who tried different treatments including low-dose naltrexone, amitriptyline, duloxetine, and physical therapy. They found that patients taking low-dose naltrexone were about 5 times more likely to improve compared to those doing physical therapy alone, with improvements in both fatigue and pain.
This study is important because it suggests that ME/CFS-adapted treatments may be effective for post-COVID-19 condition, which affects millions of patients. For ME/CFS researchers, it provides preliminary evidence that mechanisms and treatments relevant to their disease may apply to a related condition, potentially opening new therapeutic avenues. The finding about low-dose naltrexone is particularly significant given its favorable safety profile and accessibility.
This observational study cannot establish causation—patients choosing naltrexone may have differed in ways that affected outcomes independent of the medication itself. The study does not definitively prove low-dose naltrexone is effective, only that improvement was associated with its use; a randomized controlled trial is needed to confirm efficacy. Results are from a single clinic and may not generalize to all post-COVID-19 or ME/CFS populations.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Tamariz, Leonardo, Bast, Elizabeth, Klimas, Nancy, & Palacio, Ana (2024). Low-dose Naltrexone Improves post-COVID-19 condition Symptoms.. Clinical therapeutics. https://doi.org/10.1016/j.clinthera.2023.12.009
BibTeX
@article{mecfsatlas-tamariz-2024-low-dose,
author = {Tamariz, Leonardo and Bast, Elizabeth and Klimas, Nancy and Palacio, Ana},
title = {Low-dose Naltrexone Improves post-COVID-19 condition Symptoms.},
journal = {Clinical therapeutics},
year = {2024},
doi = {10.1016/j.clinthera.2023.12.009},
note = {PubMed: 38267326},
url = {https://www.mecfsatlas.com/evidence/tamariz-2024-low-dose},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-25. https://www.mecfsatlas.com/evidence/tamariz-2024-low-dose
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