This chapter explores pharmacological and non-pharmacological interventions for managing Long COVID-related fatigue. The chapter examines three main treatment approaches: stimulants, symptom-focused medications, and cannabis-based therapies, concluding with emerging evidence on noninvasive brain stimulation techniques. For stimulants, while methylphenidate and modafinil show promise in small studies, evidence remains limited and their use requires careful consideration of individual patient factors. The review discusses various symptom-focused medications, including those targeting pain (NSAIDs, gabapentinoids, low-dose naltrexone), autonomic dysfunction (beta-blockers, midodrine), and cognitive impairment (acetylcholinesterase inhibitors). Recent research on cannabis and cannabinoids suggests potential benefits through anti-inflammatory and antioxidant mechanisms, though clinical evidence specifically for Long COVID remains preliminary. The chapter concludes by examining transcranial direct current stimulation (tDCS), presenting contrasting findings from recent clinical trials and discussing future directions in AI-guided neuromodulation. Throughout, the review emphasizes the importance of individualized treatment approaches, careful consideration of contraindications and side effects, and the need for larger, well-designed clinical trials to establish definitive evidence-based guidelines for treating Long COVID fatigue.

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Pharmacological and Non-pharmacological Interventions

  • Thorsten Rudroff

摘要

This chapter explores pharmacological and non-pharmacological interventions for managing Long COVID-related fatigue. The chapter examines three main treatment approaches: stimulants, symptom-focused medications, and cannabis-based therapies, concluding with emerging evidence on noninvasive brain stimulation techniques. For stimulants, while methylphenidate and modafinil show promise in small studies, evidence remains limited and their use requires careful consideration of individual patient factors. The review discusses various symptom-focused medications, including those targeting pain (NSAIDs, gabapentinoids, low-dose naltrexone), autonomic dysfunction (beta-blockers, midodrine), and cognitive impairment (acetylcholinesterase inhibitors). Recent research on cannabis and cannabinoids suggests potential benefits through anti-inflammatory and antioxidant mechanisms, though clinical evidence specifically for Long COVID remains preliminary. The chapter concludes by examining transcranial direct current stimulation (tDCS), presenting contrasting findings from recent clinical trials and discussing future directions in AI-guided neuromodulation. Throughout, the review emphasizes the importance of individualized treatment approaches, careful consideration of contraindications and side effects, and the need for larger, well-designed clinical trials to establish definitive evidence-based guidelines for treating Long COVID fatigue.