A lot of people want to know if there are treatments that target their specific symptoms. For the most part, the targeted treatment approach doesn’t seem to work. This may be due to multiple underlying causes. For example, we know that meningitis has multiple causes such as bacteria, fungi, viruses, parasites, etc. There is no uber-treatment that effectively treats all of the possible underlying causes. If the doctors can find a bacteria that is causing the meningitis, they will use antibiotics that are effective against that particular bacteria species. There is no one-size-fits-all treatment for meningitis.
For long haul syndromes, we usually don’t know what is causing brain fog, memory issues, cognitive difficulties, etc. So it’s very possible that there is no one-size-fits-all treatment for it.
Survey data suggests that there may be 4 treatments that work better in people with very severe ‘brain fog’ and ‘brain fog’-like issues. They are ivermectin, Pepcid (famotidine), fluvoxamine, and acupuncture. Note that the data may be erroneous and fluvoxamine has serious risks.
Data from this Nov 2022 video on survey results. See the video description → link to slides (PDF) → slide 33
Also note that these may not necessarily be the top treatments in people with severe brain fog. There are other treatments that are still rated higher (though the average score isn’t a great reflection of how effective a treatment is).
With those caveats aside, let’s look at some treatments.
Ivermectin is one of the top treatments for helping people achieve very high levels of recovery. So it may be worth trying simply because it’s showing one of the strongest signals for efficacy- regardless of how much brain fog you have.
This drug is fairly popular (~28% tried it) and it probably does not help people recover. 0.9% of people who tried it are currently mostly recovered AND rated the drug highly. However, it may offer quick relief of some symptoms. So that’s a reason to try it.
Safety-wise, it’s very safe in healthy people which is why it is sold over the counter in most countries. However, please read the safety labelling. In chronic illness patients, it is riskier. Out of the 54 most popular treatments, it is the 20th riskiest (based on risk score). So it’s riskier than average. See this post for information on how to pull safety-related data from the Treatment Outcomes Survey data dump.
SSRIs have some scary permanent side effects in ‘normal’ patients. (‘Normal’ as in people who have some condition where SSRIs might be useful. ‘Normal’ as in they don’t have ME/CFS, Long COVID, or post vac.) Very debilitating side effects of SSRIs include:
- Possibly linked to the Columbine high school shooting and other school shootings. Some people develop mania while taking SSRIs. David Carmichael murdered his son while on Paxil.
- Severe withdrawal. Please do not stop these drugs suddenly.
- Inability to slowly taper and stay off the drug
- PSSD / Post-SSRI Sexual Dysfunction (there are support groups dedicated to this)
Chronic illness patients react badly to SSRIs at high rates. SSRIs, psych drugs, antibiotics, and exercise battle it out for last place.
This drug might be somewhat useful in patients with very severe brain fog (???). Very severe = the worst suffering imaginable or 3/4ths of the way there. However, there are some serious safety issues to take into account.
Out of the 54 most popular treatments, this is the 11th riskiest (!!!) based on risk score.
1.6% of people who tried this are mostly recovered AND they rate the treatment highly. Maybe it helps some people recover, maybe it doesn’t. Ivermectin is at 4.3%.
It may be worth trying but it’s a double edged sword. I don’t think people experience permanent worsening from this but I haven’t looked too deeply into the anecdotes.
The survey data can be unreliable because people have very different ideas about what brain fog is. Some people will define it very differently than you do. So, the use of this phrase on surveys can be problematic and it can cause data to be unreliable.
Maybe I shouldn’t have asked about ‘brain fog’ on the survey because there will be people who interpret the phrase in weird ways. However, I tried to cover the common interpretations of the phrase so hopefully the survey question asks about a family of symptoms.
There aren’t really great treatments for brain fog. You may want to try ivermectin regardless of how much brain fog you have.