A Review of Factors Influencing Anxiety and Depression in Persons with Multiple Sclerosis during the COVID-19 Pandemic

Abstract

Patients with multiple sclerosis have been subjected to extra levels of stress during the COVID-19 pandemic when they were singled out by governmental regulatory agencies as sufficiently immune-compromised persons that should be in the first group to receive the untested, new COVID-19 vaccine. The designation of these persons in such a high-risk group compounded their anxiety and depression. Early in the disease in 2020-2021, little was known about the disease, the vaccine, or whether their disease-modifying therapies for multiple sclerosis were subjecting them to more immunomodulatory suppression. This review is not comprehensive of all articles written on COVID-19 and multiple sclerosis, but selectively looks at research on COVID-19 and use of low-doses of naltrexone as treatment. Specific causes for anxiety and depression are discussed in light of evidence that suggests that the length of disease, rather than age, sex, or therapy leads to more anxiety. Low-dose naltrexone in combination with other disease-modifying therapies, or alone, reduced the perceived levels of anxiety. These data suggest that clinicians may want to prescribe low-dose naltrexone for early-stage multiple sclerosis patients.