People’s Pharmacy: Could antiviral Valtrex help post-COVID-19 brain fog?
Q. I had the flu in March 2020 and then came down with another infection. I think it was COVID-19, but there were no home tests at the time. Even though my case was no worse than the flu, it left me with brain fog. I couldn’t concentrate well enough to pay a few bills and organize a simple budget.
After six months, I was still having trouble thinking. Then, I suffered an outbreak of cold sores. My primary care doctor prescribed the antiviral drug Valtrex to treat them.
Coincidentally, after two rounds of medication, I found that I was thinking much better than before. I am not certain if the Valtrex was responsible, but it was the only change I made. Perhaps the fact that both COVID-19 and cold sores (herpes) are viral diseases helps explain it.
A. We have not seen clear explanations for the brain fog so many people experience after COVID-19 infection. One hypothesis is that it could be a result of neuroinflammation (Frontiers in Neuroscience, Aug. 19, 2024).
Scientists do not appear to have studied valacyclovir for post-COVID-19 brain fog. Another reader found valacyclovir helpful, however: “An immunologist prescribed valacyclovir for long COVID-19, and it helped me with brain fog. Sleeping issues and headaches were worse temporarily, but my brain is much more functional.”
Q. Our 16-year-old son has been on venlafaxine for six months for depression. Now the doctor wants to change him to fluoxetine.
The first time the doctor took my son off venlafaxine, he put him on half the dose for three days and told him to spend a week on nothing before starting fluoxetine.
Going off the drug gave my son terrible side effects, so he went back on it. Now, we are ready to try again. This time, the doctor told him to take half a dose for three days and on the third day add the fluoxetine. My son is having very bad head rushes and is exceedingly irritable. Does this approach make sense?
A. Venlafaxine (Effexor) is a short-acting antidepressant, which can make it challenging to discontinue. A three-day “taper” might not be long enough. We have heard from hundreds of readers who have had tremendous difficulty discontinuing such antidepressants.
You can learn more about this problem and some possible solutions to antidepressant tapering in our “eGuide to Dealing with Depression.” This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.
Q. A couple of months ago, I read your article about someone who had success using Polysporin to treat toenail fungus. I’ve battled the fungus for 30 years with just about everything I could imagine.
After a month of Polysporin application, my rotten toenails were gone. Now, my big toenails are about half-grown and are clear. All the other nails are also clear, with no sign of infection. I wouldn’t have believed it if I hadn’t done it myself.
A. Polysporin is an over-the-counter antibiotic ointment containing bacitracin and polymyxin B. Most health professionals would not expect an antibiotic to treat a fungal infection. Some toenail infections, however, are actually due to bacteria (Journal of the American Podiatric Medical Association, March 1, 2021). In such a case, the antibiotic ointment could be helpful.
Without DNA analysis of the pathogen, it is hard to determine the cause of a toenail infection. We’re glad this OTC antibiotic worked so well for you.
In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, Fla., 32803, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”