Miami study finds that antipsychotics show promise over SSRIs in reducing Long COVID risk for veterans

Medical News: Researchers from the University of Miami and the Miami Veterans Administration (VA) Healthcare System have shed light on the potential of certain mental health medications to reduce the risk of developing Long COVID in veterans. The study, published in the peer-reviewed journal COVID, examined how antipsychotic drugs might lower the risk of Long COVID, a condition known to affect patients well after an initial COVID-19 infection. The findings show promising results in veterans using antipsychotics, but SSRIs (selective serotonin reuptake inhibitors), widely used for depression and anxiety, did not demonstrate the any such effectiveness.

 Miami study finds that antipsychotics show promise over SSRIs in reducing Long COVID risk for veterans

Study Highlights: Antipsychotics vs. SSRIs
Long COVID, also known as post-acute sequelae of COVID-19 (PASC), affects a significant number of COVID-19 survivors, leading to symptoms like brain fog, fatigue, and cognitive difficulties. Researchers from the University of Miami's Department of Geriatrics and Palliative Care, alongside the Miami VA Healthcare System, explored whether antipsychotic drugs, which are known to help reduce inflammation, could mitigate these long-lasting symptoms.
 
The study analyzed data from veterans across the United States, with two distinct groups based on when their COVID infection occurred: those infected during the Alpha and Beta waves in 2020 and those infected during the Delta and Omicron waves in 2021-2022. This Medical News report reviews key details from the study, highlighting the comparative effectiveness of these medications on different age groups and the waves of COVID-19 variants.
 
Findings Show Reduced Long COVID in Antipsychotic Users
The study's findings were striking. For veterans infected during the initial COVID waves (Alpha and Beta) who were on antipsychotic medication, the odds of developing Long COVID were reduced by up to 43% in patients under 65 and by 34% in those over 65. In comparison, those infected during the Delta and Omicron waves showed an 11% reduction in Long COVID risk for patients under 65 when using antipsychotics, but no significant reduction for patients over 65. This shift between the two cohorts suggests that antipsychotic use is linked to a lowered risk of Long COVID, particularly when other COVID treatments were less available.

Jerry Bradley, a senior researcher at the University of Miami, explains, “These findings point to a potential role of antipsychotic drugs in reducing the odds of Long COVID by countering inflammation - a key suspected factor in prolonged COVID symptoms. Veterans, who have higher rates of conditions like PTSD, showed lower Long COVID rates with these medications, especially during early pandemic phases.”
 
In contrast, SSRIs, a class of medications commonly prescribed for depression and anxiety, did not show a similar effect. Despite previous research suggesting that SSRIs may benefit COVID patients through anti-inflammatory effects, this study found no reduced risk of Long COVID in veterans using SSRIs. The study suggests that SSR Is may not address the specific mechanisms linked to Long COVID, particularly in veteran populations who may experience higher disease burdens.
 
Age, COVID Variant, and Vaccine Impact on Long COVID
This study also highlighted the role that factors like age, COVID variant, and vaccination status play in Long COVID outcomes. In Cohort 1 (patients infected in the early Alpha and Beta waves), antipsychotics provided substantial risk reduction for all age groups, likely because these patients had limited access to COVID treatments or vaccines at the time. Conversely, in Cohort 2 (Delta and Omicron waves), as COVID-19 vaccines and treatments became more widely available, the preventive effect of antipsychotics on Long COVID was diminished.
 
Researchers note that these findings align with other studies that show the overall risk of Long COVID has decreased with newer COVID treatments and vaccines. However, the substantial impact of antipsychotics in reducing Long COVID risk during the early waves may signal their potential in treating populations with limited access to advanced COVID care.
 
Racial and Ethnic Differences in Long COVID Risk
Interestingly, the study also explored how different racial and ethnic groups responded to antipsychotic medications in preventing Long COVID. In the first wave of infections, white and Hispanic veterans saw the greatest benefit from antipsychotic use, with a reduction in Long COVID cases by about 42% and 47%, respectively. However, Black veterans did not show a significant association between antipsychotic use and reduced Long COVID risk, raising questions about racial disparities in health outcomes.
 
Bradley emphasized the importance of addressing these disparities, stating, “Understanding why these differences exist is crucial. It’s possible that socioeconomic and access-related factors are influencing these outcomes, and further research should aim to unpack these factors.”
 
Possible Explanations for the Effectiveness of Antipsychotics
Antipsychotics are thought to have anti-inflammatory properties that may protect against the neurological effects of COVID-19, such as brain inflammation. In Long COVID patients, inflammation in the brain is linked to symptoms like brain fog and memory loss, often due to immune system disruptions. By reducing inflammation, antipsychotics may limit this prolonged immune response and help protect brain health over the long term.
 
Quetiapine and ziprasidone, two common antipsychotics, have been studied for their effects on stress-related brain inflammation, showing potential in conditions like PTSD. Antipsychotics may thus play a unique role in neuroprotection and immune system modulation, possibly explaining their benefits in reducing Long COVID risk.
 
Limitations and Future Directions
While this study opens up new avenues for understanding Long COVID, it also has some limitations. The research focused on veterans, a population with specific health profiles that may not reflect the general public. Additionally, because the study relied on prescription records rather than self-reported medication use, it’s possible that some veterans were not consistently taking their prescribed medications.
 
Looking ahead, the researchers suggest that further studies are needed to explore the specific types of antipsychotics and dosages that might provide the most benefit. They also recommend investigating how these medications might help other populations and evaluating their long-term effects in COVID survivors.
 
Conclusion: A New Path in Long COVID Prevention?
This study provides promising evidence that antipsychotics, particularly in early COVID waves, can reduce the risk of Long COVID in veterans. While SSRIs did not show the same preventive effects, antipsychotics may offer a new avenue for mitigating long-term COVID symptoms, especially in individuals with preexisting mental health conditions like PTSD. Bradley and his team believe that further research could lead to more targeted interventions for those at high risk of Long COVID.
 
These findings add to the growing body of knowledge on how mental health medications may play a role in COVID recovery and long-term health. For those dealing with the lingering effects of COVID, the use of antipsychotics might offer some hope for relief and recovery. However, more research is essential to confirm these benefits across different populations and determine how best to implement these findings in clinical settings.
 
The study findings were published in the peer-reviewed journal: COVID.
https://www.mdpi.com/2673-8112/4/11/118
 
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