Treatment and outcomes of 95 post-Covid patients with an antidepressant and neurobiological explanations, 2023, Rus et al

[Grigor]

Carla C.P. Rus

Bert de Vries

Ingmar E.J. Vries1

Idelette Nutma

J. J. Sandra Kooij2

1 Radboud University,

2 Amsterdam UMC/VUMC

After Covid-19 infection, 12.5% develop a post-Covid-syndrome. Symptoms affect numerous organ systems, but after one year they are mainly neurological and neuropsychiatric in nature. There is evidence that treatment with selective serotonin reuptake inhibitors (SSRIs) during Covid-19 infection decreases the likelihood of a post-Covid condition, but there is no known research on treating post-Covid syndrome itself with SSRIs.

This study used an exploratory questionnaire and found that 63,4% of 95 post-Covid syndrome patients reported a reasonably good to strong response to an SSRI. Outcomes were measured with three different measures that correlated strongly with each other. Brainfog and sensory overload decreased the most. Patients experienced improved well-being.

The response to SSRIs in post-Covid conditions was explained by seven possible neurobiological mechanisms as reported in the recent literature. The promising results of this study should be followed by a randomized controlled trial.

https://doi.org/10.21203/rs.3.rs-3153645/v1

 

[Grigor]

The authors Carla Rus has been promoting SSRIs for long-Covid for a while now. She wrote this paper with Idelette Nutma who is a avid Ivermectin promotor.

At the beginning of the pandemic Rus stated that 2/3 of (her) ME patients improved after taking SSRIs. After my criticism they now refer to 1/3rd in the article...

Anyways the paper seems weak on many levels. Patients who were interested joined. Mostly recruited via LinkedIn where both authors are very actively promoting SSRIs.

Chalder Fatigue Scale is not for ME/CFS but for CFS and highly problematic.

Since they're very actively promoting SSRIs on LinkedIn patients have had plenty of positive expectations given again for a placebo effect to explain some of the improvements.

Obviously no control group etc.

 

[EndME]

Long-Covid symptoms mainly being neurological or neuropsychiatric in nature seems like a bold if not simply wrong statement. Considering that in the RECOVER 12 symptom study only 2 of those 12 symptoms, I would consider to be neurological or neuropsychiatric and with those you don't come anywhere close to the 12 points, I don't know how this statement can be justified. I suppose the dutch researchers that view everything as psychological and believe that physiological problems don't exist might argue differently.

They claim that PEM, POTS and other symptoms are mainly neurological or neuropsychiatric is there any evidence for that?

 

[Sly Saint]

actively promoting SSRIs

this happened also 20 years ago for ME; AfME featured it in their magazine at the time. I tried it, starting on extremely low doseage but couldn't increase it anywhere near a meaningful level as it made me feel even worse, I gave up after a few months.

 

[NelliePledge]

Yeah and gradual onset pwME more than likely already on SSRIs before finally getting diagnosed. And yet it doesn’t prevent the worsening.

 

[Hoopoe]

SSRIs lower blood pressure, right? That's going to cause problems.

 

[Peter T]

It is reminiscent of the idea in the 1990s that Prozac could treat ME. If my memory serves my correctly some doctors got very enthusiastic, but when proper controls were used it had no effect.

 

[Hutan]

We have a discussion on anti-depressants here:
Use of antidepressants for ME/CFS?
Anecdotal evidence of antidepressants helping ME/CFS is pretty much absent, except for tricyclics (not SSRIs) which some people report finding useful for pain and sleep.
The evidence for SSRIs causing harm, on that thread and in studies (see the anti-depressant tagged threads) is considerable.

 

[Grigor]

It has now officially been published.

https://www.nature.com/articles/s41598-023-45072-9#

 

[Grigor]

In this interview Carla Rus claims that's only about 10% had no effect. Yikes.

"Two-thirds of patients notice a good to strong improvement and 20 percent have a moderate improvement in their complaints. Then there remains a group where it doesn't do anything at all, which is about ten percent. That is of course a disappointment," says Rus.

https://www-omroepzeeland-nl.cdn.am...p3VhZeh4dUzu0JqvVOhTn-Io6xYbWtGJABTBQg8iAgw1o