New York, Oct 2
Low doses of lithium aspartate is ineffective in treating the fatigue and brain fog that is often a persistent feature of long Covid, researchers said on Wednesday. However, higher doses may be promising.
An estimated 17 million people have long Covid in the US, and worldwide the number is estimated at 65 million.
Published in the journal JAMA Network Open, the study was led by Thomas J Guttuso, professor of neurology at University of Buffalo. "It's a negative study with a positive twist," said Guttuso.
Since long Covid is believed to stem from chronic inflammation and lithium has known anti-inflammatory actions, Guttuso had recommended that a patient of his try low-dose lithium for persistent long Covid symptoms.
He was surprised when this patient reported a near full resolution of fatigue and brain fog within a few days of initiating lithium aspartate at 5 milligrams a day.
Based on this single case, Guttuso became interested in lithium aspartate as a potential treatment for long Covid and recommended it to other such patients.
According to Guttuso, nine of 10 long Covid patients he treated with lithium aspartate 5-15mg a day saw very good benefit in terms of improvements to their fatigue and brain fog symptoms.
"Based on those nine patients, I had high hopes that we would see an effect from this randomised controlled trial," says Guttuso. "But that's the nature of research. Sometimes you are unpleasantly surprised."
The randomised controlled trial showed no benefit from 10-15 milligrams a day of lithium aspartate compared to patients receiving a placebo.
After one patient from the study subsequently increased the lithium aspartate dosage to 40 milligrams a day and experienced a marked reduction in fatigue and brain fog symptoms, Guttuso decided to then conduct a dose-finding study designed to explore if a higher dose of lithium aspartate may be effective.
The three participants who completed the dose-finding study reported greater declines in fatigue and brain fog with the higher dose of 40-45 milligrams per day.
"This is a very small number of patients, so these findings can only be seen as preliminary," said Guttuso. "Perhaps achieving higher blood levels of lithium may provide improvements to fatigue and brain fog in long Covid."