Evidence from a small study suggests that a combination of two FDA-approved medications may help relieve brain fog in people with Long COVID. Researchers say they hope their findings will encourage larger, more formal randomized clinical trials of the treatment. In the meantime, patients can speak to their doctors to see if the regimen might be appropriate for them.*

Cognitive effects of Long COVID

People with Long COVID can experience a wide variety of ongoing symptoms, including persistent cough, fatigue, and loss of taste or smell. Ongoing cognitive difficulties, known as brain fog, are also common. 

People with brain fog may experience:

• Problems concentrating,
• Inability to focus,
• General confusion or lack of clear thinking, and/or
• Inability to multitask. 

Currently, there is no proven treatment for the cognitive effects of Long COVID, but a small study by Yale researchers has shown what they consider to be promising results. 

Possible new therapy for brain fog

Yale University’s Amy Arnsten, Ph.D., professor of neuroscience and psychology, and Arman Fesharaki-Zadeh, M.D., Ph.D., assistant professor of neurology and psychiatry, have joined forces to study the effects of a new combination therapy on COVID-related brain fog.

Early evidence has shown that a combination of guanfacine, currently approved by the FDA to treat Attention-Deficit/Hyperactivity Disorder (ADHD), and a powerful antioxidant called N-acetylcysteine (NAC) may help relieve brain fog in Long COVID patients.

In the study, 12 COVID-19 long-haulers took 600 mg of NAC and up to 2 mg of guanfacine per day. Eight of the patients reported an increase in:

• Memory,  
• Multi-tasking skills, and 
• Organization.  

Some even reported that the treatment completely resolved their symptoms, and they were able to return to their normal daily activities. 

Fueling future studies

Memory, attention, and many other cognitive functions are controlled in an area of the brain called the prefrontal cortex. Arnsten says inflammation and stress can significantly affect the connections in this area and interfere with their ability to function properly. 

Guanfacine works to make these connections more resistant to stress and inflammation, and NAC is a strong antioxidant that can also help fight inflammation in this area of the brain. 

Arnsten and Fesharaki-Zadeh hope their study encourages larger, placebo-controlled clinical trials to confirm their findings. In the meantime, they suggest that patients seeking brain fog relief speak with their doctor about combining a guanfacine prescription with over-the-counter NAC. 

*Backman, I. (2022, December 13). Potential New Treatment for “Brain Fog” in Long COVID Patients. Yale School of Medicine. https://medicine.yale.edu/news-article/potential-new-treatment-for-brain-fog-in-long-covid-patients/