Methylphenidate in COVID-19 Related Brain Fog: A Case Series

Abstract

Limited literature exists regarding specific pharmacological treatments for COVID-19-associated brain fog (BF) syndrome. One previous study using bupropion lacked objectivity. In this multiple baseline case series study, methylphenidate was used in treating post-COVID BF syndrome. Four cases of post-COVID BF syndrome were diagnosed by two psychiatrists after a liaison diagnostic workup with the medical fraternity and treated with methylphenidate (10–30 mg for 1–2 months) resulted in objective improvement as evident by the change in Fatigue Severity Scale (FSS) and Mini Mental Status Examination (MMSE) scores in follow-up compared to baseline. FSS scores were 9 (37–40 at baseline) and MMSE scores were 30 (27–29 at baseline) for all subjects at 3- and 6-month follow-up. No relapse of symptoms was noted at follow-up. Methylphenidate, being a stimulant drug, can be a promising option for BF. However, this study has a few limitations, like the fact that neuroimaging was not done for all subjects, and studies with a larger sample size are required for a definitive conclusion.