In August 2024, the number of people impacted by Long COVID (LC) was estimated to be
about 400 million globally (Al-Aly et al., 2024). Currently, there are no FDA–approved
treatments for LC. Many of the centres treating LC have noticed the similarity to myalgic
encephalomyelitis/chronic fatigue syndrome (ME/CFS) in some patients. Low–dose
naltrexone (LDN) is a drug that has recently shown potential in treating ME/CFS. In this
integrative review, ten articles were selected for analysis to investigate whether LDN could
be a viable treatment for LC. Although the studies conducted on LDN and LC are small,
non–randomized, and unblinded, a few interesting themes emerged from this analysis that
could guide future studies and treatment decisions. LDN seems to be most effective for
individuals with a LC phenotype that mimics ME/CFS, as, of all the symptoms of LC, it was
found to be most effective for fatigue and pain. In the future, pre–screening tools will likely
be developed to identify patients most likely to respond to LDN. Two double–blind
randomized controlled trials (RCTs) are currently underway that will be published next year,
yielding a higher degree of evidence and certainty around LDN for LC. In the meantime,
initial findings support consideration of LDN for patients with LC whose primary complaints
are fatigue or pain.
