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

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.