Section - Quick Takes

04. Potential Benefits of Silexan for Post-COVID-19 Syndrome

Published on December 1, 2023 Certification expiration date: December 1, 2026

Scott R. Beach, M.D.

Associate Professor of Psychiatry - Harvard Medical School - Massachusetts General Hospital

Key Points

Long COVID presents with a variety of symptoms, the most common being fatigue, neurocognitive impairment, and cardiorespiratory issues, necessitating a multifaceted diagnostic approach.
There is a distinct lack of FDA-approved treatments for long COVID, and commonly used medication, such as SSRIs and alpha-2 agonists, have shown limited efficacy.
Given its favorable safety profile, Silexan might be considered for some patients, but treatments should be symptom specific.

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Text version

I’m Scott Beach, and this is Quick Takes.

In outpatient practices, physicians often encounter patients attributing long-term symptoms to COVID-19. This condition has various names: Long COVID, post-COVID syndrome, or more formally, postacute sequelae of SARS-CoV-2 infection (PASC). Some studies indicate that up to 50% of patients may experience long COVID, whereas others suggest a more conservative estimate of 5%–10%. The risk appears to increase with each subsequent COVID-19 infection. Identified risk factors include female gender; older age; having had a severe infection; smoking; elevated body mass index; preexisting conditions, such as asthma or diabetes; and certain autoimmune diseases.

The most commonly reported symptom is fatigue, followed by neurocognitive impairment—often referred to as brain fog, cardiorespiratory issues, and persistent changes in smell or taste. Psychological symptoms like depression and anxiety are also notable, though they may represent more subacute manifestations of COVID-19, particularly prevalent in patients with preexisting mental health

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05. Should Trazodone Be First-Line Therapy for Insomnia?

Learning Objectives:

Evaluate the risk of pancreatitis among patients being treated with antipsychotic medication.
Evaluate the effectiveness of ECT in conjunction with clozapine therapy for ultra–treatment-resistant schizophrenia.
Discuss the implications of benzodiazepine prescriptions on short-term suicide risk.
Discuss the potential use, efficacy, and limitations of Silexan as a treatment option for long COVID symptoms.
Identify patient profiles that may benefit from trazodone, considering factors like history of substance abuse, presence of comorbid psychiatric conditions, contraindications, and potential drug–drug interactions.

Original Release Date: December 1, 2023

Review and Re-release Date: March 1, 2024

Expiration Date: December 1, 2026

Expert: Scott Beach, M.D., Paul Zarkowski, M.D., Carlos Schenck, M.D. Oliver Freudenreich, M.D.

Medical Editor: Melissa Mariano, M.D.

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians

Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.