As the world continues to grapple with the aftermath of COVID-19, a recent case study has suggested that psychedelics like psilocybin and MDMA may have an impact on the neurological and mental health challenges associated with Long COVID symptoms. The promising review highlights the potential for these substances to alleviate persistent symptoms and improve quality of life, offering a new ray of hope for those struggling with the prolonged effects of the virus.

What is Long COVID

Most individuals who get COVID tend to feel better after a few days to weeks from their first symptoms, especially with treatment. However, in some rare cases, these symptoms can last for much longer. This prolonged manifestation of symptoms is known as Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC). Long COVID can cause a wide array of symptoms that can last for weeks, months, or even years after developing the infection. The most commonly reported symptoms include fatigue, difficulty breathing, joint or muscle pain, chest pain, heart palpitations, and a range of neurological symptoms such as brain fog, headache, sleep problems, depression, and anxiety.

Because the condition is still relatively new, there is no determinant cause for why Long COVID occurs. Yet, researchers believe it may stem from viral remnants in the body, an overactive immune system, or lingering inflammation affecting various organs and tissues. Additionally, there is evidence to suggest that Long COVID may be related to vascular issues like blood clots or damage to blood vessels, which could disrupt normal blood flow and oxygenation throughout the body. Pre-existing health conditions may also play a role.

Currently, there are no specific treatments for Long-COVID because of its sheer amount of symptoms. However, the recent findings detailed in the case report could potentially revolutionize the approach to managing these prolonged health issues. The use of psychedelics such as MDMA and psilocybin for therapeutic purposes is not new, but their application in treating Long COVID represents a novel and expanding field of research. 

Major findings of the case report

The case report involved a 44-year-old woman who was previously healthy but began to suffer from a range of persistent and debilitating symptoms following a COVID-19 infection. Some of these symptoms involved fatigue, depression, anxiety, joint pain, and cognitive impairments such as brain fog and memory issues. 

The patient attempted multiple different treatment options to reduce her symptoms, including several medications, fasting, acupuncture, and massages. While some of these treatments provided temporary relief, her Long-COVID symptoms persisted. 

It wasn’t until the patient self-administered two different dosing sessions of psychedelics that she noticed a significant improvement in her symptoms. In the first session, she consumed a dose of psilocybin, and in the second session, she combined MDMA with an additional dose of psilocybin. 

Overall, the patient reported an 80% improvement in her symptoms, with the most notable improvements in her mental health, where she experiences a significant decrease in depression and anxiety levels. She also noted a noticeable enhancement in cognitive function regarding clarity of thought and memory (1).

How this aligns with what we already know about psychedelic medicine

While it may seem unusual to consider psychedelics as a treatment for post-viral conditions like Long COVID, current evidence surrounding their therapeutic capabilities offers a compelling justification for such an approach. There is a significant body of research that has shown that psychedelics like psilocybin and MDMA can be effective in treating a variety of mental health conditions like depression, anxiety, and PTSD. These substances are believed to facilitate a resetting of brain activity patterns that contribute to these conditions. The patient’s reported reductions in depression and anxiety align with these findings, suggesting a similar mechanism may be at play for Long COVID related mental health issues.

Research has also indicated that psychedelics can promote neuroplasticity, the brain’s capability of creating new neural pathways. This characteristic is believed to help improve cognitive abilities, including memory and concentration, which was reflected in the patient’s reported improvements in mental clarity and memory. 

More recent studies have found that psychedelics could have anti-inflammatory effects, which could also have impacted the patient’s symptoms (2). While more research is needed in this area, the patient’s improvements in physical symptoms may hint at these underlying anti-inflammatory effects.

Other instances of symptom reduction from psychedelic treatment

Surprisingly, this case study isn’t the only of its kind. Several other individuals with Long COVID symptoms have reported significant improvements in their symptoms following psychedelic use.

A TIME report highlights the experience of a 31-year-old, Ruth, who preferred to be identified only by her first name. She consumed 5 grams of psilocybin mushrooms and observed immediate improvements such as a normalized heart rate, improved breathing, and reduced brain fog, among other symptoms. Despite some lingering issues, Ruth is convinced that the psilocybin was key to her recovery. “That’s probably difficult for a lot of people to process or believe,” she says. “But it really worked.”

Renée, 53, also had a similar experience. Following a suspected case of COVID-19, which resulted in loss of smell, dizziness, an accelerated heart rate, brain fog, psychosis, hallucinations, tinnitus, and suicidal thoughts, she decided to give microdosing a try. This involved consuming a small dose of LSD every few days over the course of a month to induce a minimal physiological response without causing intoxication.

After these microdosing sessions, Renée reported dramatic improvements in her cognitive functioning and a burst of creativity, both commonly noted effects of periodic microdosing. “I started to feel connected to humanity again. I had emotions again. I had some joy again. I felt normal.”

Dr. Joel Castellanos, associate medical director at the University of California and one of the lead authors of the case report, recognizes that case studies and anecdotal reports such as these aren’t grounds for broad medical recommendations yet, but they do suggest potential areas for deeper investigation. He notes that he’s “excited about psychedelics. It’s a brand-new way of looking at a lot of different symptoms that people experience.”

Implications for future research and treatment

As promising as the results are for this case study and the additional anecdotal evidence, it’s important to note that these results are not enough evidence to fully confirm the safety and efficacy of psychedelics as a treatment for some Long COVID symptoms. Further clinical trials and comprehensive studies are crucial to establish a better scientific basis for these treatments, especially for a post-viral condition as complex and Long COVID. Researchers need to continue investigating how psychedelics exert their effects on the symptoms of Long COVID. This includes exploring their impact on the immune system, inflammation, brain function, and overall physical health. Given the intriguing yet preliminary nature of these findings, future research should be aimed at dissecting the mechanisms that cause psychedelics to exert these effects.

Dr. Saleena Subaiya, a physician and researcher at Columbia University Irving Medical Center who also suffers from Long COVID, plans on initiating a small pilot study to determine if single-dose hallucinogenic treatments can alleviate Long COVID symptoms. Following the administration session, the participants will be monitored for two months to assess improvements in symptoms like depression, brain fog, and fatigue.

Yet regardless of the current noted results, this form of treatment has not been conclusively proven. Until then, “the safest way to engage with these substances right now would be in a trial,” says Subaiya. “We’re dealing with very powerful psychoactive medications. People need to proceed with immense amounts of caution.”

References

  1. Chopra, Harman, Timothy Furnish, Monica Verduzco-Gutierrez, David Jevotovsky, and Joel Castellanos. 2024. “Long-COVID Symptoms Improved after MDMA and Psilocybin Therapy: A Case Report,” April. https://doi.org/10.22541/au.171206643.31518756/v1.
  2. Flanagan, Thomas W., and Charles D. Nichols. 2018. “Psychedelics as Anti-Inflammatory Agents.” International Review of Psychiatry 30 (4): 363–75. https://doi.org/10.1080/09540261.2018.1481827.