Bupropion as a Possible Treatment for COVID-19-Related Brain Fog

Jessica George ’24

Figure 1: “Brain fog” is a condition characterized by cognitive impairments such as memory loss, difficulty concentrating, and mental fatigue

The COVID-19 pandemic has affected millions of people worldwide, and many have reported persistent symptoms even after recovery from the initial infection. One of the most common long-term symptoms reported is “brain fog,” a condition characterized by cognitive impairments such as memory loss, difficulty concentrating, and mental fatigue. A recent case series published by Dr. Samuel Reinfeld from the Stony Brook University Renaissance School of Medicine explores the potential use of bupropion in treating COVID-19-induced brain fog.

The case series included two patients who had recovered from COVID-19 but were experiencing persistent brain fog symptoms. Both patients were prescribed bupropion and were assessed for changes in cognitive function. The first patient was a 26 year old white man presenting with brain fog symptoms including mental exhaustion, issues with focusing, and difficulty with short term memory for four months. The patient was administered 150-mg bupropion for fourteen months, titrated to 450-mg once daily. The results of this treatment were positive, improving the patient’s mood, energy, and focus.  Results were also similar for the second patient in the case series. The second patient was a 25 year old black woman presenting with difficulty focusing, difficulty with short term memory, and low mental energy for three months. She was administered 150-mg bupropion once daily for one month and her issues with memory and concentration self-reportedly resolved back to her baseline. Additionally, both patients reported no adverse side effects.

Bupropion is an antidepressant often utilized for depression and smoking cessation which serves as a noncompetitive antagonist to nicotinic acetylcholine receptors and inhibits the reuptake of dopamine and norepinephrine. The author highlights that while the exact mechanisms are unknown, the role of bupropion in treating brain fog may be related to its ability to block hippocampal cell loss, which is associated with memory improvement. Additionally bupropion decreases proinflammatory cytokines, which cause many of the neuropsychiatric deficits associated with COVID-19 brain fog.

In conclusion, the article presents a compelling case for bupropion as a possible treatment for COVID-19-related brain fog. However, further research with larger sample sizes, randomized control trials, and long-term follow-ups is needed to establish the efficacy and safety of bupropion extended release as a treatment option. Nevertheless, the article contributes to the growing body of literature on COVID-19’s neuropsychiatric effects and underscores the need for targeted interventions to address these debilitating symptoms.

Citations: 
[1] S. Reinfeld, Can bupropion treat COVID-19–induced brain fog? A case series. International Clinical Psychopharmacology 38, 189-191 (2023). doi: 10.1097/YIC.0000000000000436
[2] Image retrieved from: https://www.scimex.org/newsfeed/three-in-four-hospitalised-people-report-long-covid,-symptoms-varied-by-variant 

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