In an exploratory study published in the journal Scientific Reports, researchers from the Netherlands investigated the efficacy of selective serotonin reuptake inhibitors (SSRIs) in the treatment of 95 patients with post-coronavirus disease 2019 (COVID-19) syndrome (PCS). They explored the neurobiological mechanisms underlying the response. They found that all the patients showed improved well-being and decreased symptoms, and about two-thirds of the patients showed a good-to-strong response to SSRIs.
PCS emerged in 2020 as a complex and poorly understood health concern, affecting about a hundred million individuals worldwide. Among the 200 different symptoms associated with PCS, the key ones are sensory overload, brain fog, headache, chronic fatigue, dyspnea, dysautonomia, muscle pain and weakness, palpitations, and disturbed sleep. As per the literature, these symptoms are attributed to increased pro-inflammatory cytokines, autoimmune reactions, microclot formation, neuroinflammation, as well as reactivation of certain viruses.
SSRIs are usually indicated for mental disorders, but they can influence the immune system by modulating the hypothalamic-pituitary-adrenal (HPA) axis, interacting with the kynurenine (KP) pathway, and preventing inflammation. Evidence suggests that SSRIs cure COVID-19. 19 can decrease the severity of the infection and help save you from PCS. Given the current lack of medications to treat PCS and the lack of studies comparing the potential of SSRIs in this regard, the researchers of the provided study attempted to compare the effect of SSRI treatment in patients with PCS and test the underlying mechanisms.
In the prospective segment of the study, approximately 101 pretreatment questionnaires (on demographics, history, and symptoms) were collected from patients interested in SSRI treatment for PCS. Inclusion criteria were a brief history of COVID-19 demonstrated by polymerase chain reaction or antigen. test, followed through PCS symptoms. Patients who received long-term treatment with SSRIs for depression, those affected by other medication studies, and those who had serious adverse events related to SSRIs were excluded from the study. Of the 95 patients included, 3 developed PCS, as demonstrated by their doctor. The average age of the participants was 43 years and the number of women in the organization was 5. 8 times greater than the number of men. In the retrospective segment of the study, completed questionnaires were received from 61 participants who had started taking SSRIs before beginning the study.
Patients were asked to consult their doctor to start treatment. The dose for depression was used as a guideline and modified on a case-by-case basis, taking into account observed adverse reactions and potential drug interactions. Recommended medications included SSRIs such as fluvoxamine, citalopram, escitalopram, citalopram, and fluoxetine, as well as venlafaxine, a serotonin and norepinephrine reuptake inhibitor (SNRI). After 4 to six weeks of treatment, participants completed some other questionnaire related to the outcomes.
Treatment outcomes were assessed using 3 measures: (i) open-ended consultation scores (n = 93), (ii) list of scores (n = 77), and (iii) Bell’s ability score (n = 80). Completed consultations on the SSRI remedy were rated as follows: strong improvement, intelligent improvement, fairly intelligent improvement, moderate improvement, and no improvement. On the scoresheet, patients were asked to rate the severity of PCS symptoms on a scale from 0 (lowest) to 10 (highest), before and remedy. Statistical research included the use of Bayes’ thing (BF), variance research (ANOVA), and Spearman’s rank correlation, among other tools.
According to the pre-remedy score list, the symptoms reported by patients were: mental confusion (100%), fatigue (100%), sensory overload (98. 7%), headache (90. 9%), palpitations (88. 3%), muscles. weakness (85. 7%), muscle pain and spasms (80. 5%), post-exertional malaise (PEM, 100%) and dissociative symptoms (n=14). Based on post-treatment scores, SSRI treatment showed symptom relief. , with maximum relief seen in brain fog, sensory overload, and EMP, while minimal relief was seen in pain and muscle weakness.
Based on the effects of open-ended questions, regardless of the SSRI used, symptom relief was observed in 63. 4% of patients after treatment. The improvement was rated as fairly smart in 26. 9% of patients, smart in 29% of patients, and strong in 7. 5%. In addition, a reduction in EMP, depression, loss of dissociative symptoms, and improvement in sleep was observed in the treated patients. The effects were consistent even in patients who continued treatment for more than six months. SSRI treatment also showed a positive effect on Bell scores. In addition, all 3 effect measures were found to be particularly correlated.
Nine patients who did not respond to SSRI treatment were found to have a greater severity of COVID-19 symptoms than those who did.
The protective study suggests that of the 95 patients studied, 30 initially experienced serious side effects, while 52 participants experienced mild side effects and thirteen experienced no side effects. Future randomised controlled trials could help rule out a possible placebo effect on observed outcomes.
The existing literature describes seven likely neurobiological mechanisms underlying the positive effect of SSRIs on PCS. The paper provides clinical evidence for five of these mechanisms, adding the effect of SSRIs on the HPA axis, brainstem, ANS, CNS, and circulatory system, and highlights the need for further studies in this area. domain.
In conclusion, the study provides evidence of the efficacy of SSRIs in the treatment of SCA. It highlights the need to identify potential roles of PCS treatment and explore the underlying mechanisms to improve patient health outcomes.
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Chaphalkar, Sushama R. (2023, November 5). SSRIs hold promise for alleviating post-Covid hardships, Dutch reveals. Retrieved December 7, 2023, https://www. news-medical. net/news/20231105/SSRIs-display-promise-in-easing-post-COVID-struggles-Dutch–reveals. aspx.
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