Thomas J. Guttuso Jr., MD.

Thomas J. Guttuso Jr., MD, is leading a clinical trial to investigate low-dose lithium as a potential treatment for long COVID.  

Low-Dose Lithium Treatment for Long COVID Explored

By Ellen Goldbaum

Published January 10, 2023

Adults experiencing long COVID may be interested in a new University at Buffalo clinical trial that is testing low-dose lithium as a potential treatment.


The randomized clinical trial is recruiting 50 adults ages 18 to 80 with long COVID to participate. For more information on the trial, call 716-829-5454.

The placebo-controlled trial is examining the effects of low-dose lithium therapy on long COVID symptoms. It is a double-blind trial, meaning neither the patient nor the physician knows if the patient has received lithium or an inactive placebo.

After the 21-day double-blind study phase, all patients will have the opportunity to receive lithium without the chance for a placebo for an additional 14 days.

Clinical Trial Being Funded as CTSI Pilot Project

Thomas J. Guttuso Jr., MD, professor of neurology in the Jacobs School of Medicine and Biomedical Sciences and a physician with UBMD Neurology, is the principal investigator.

The clinical trial is being funded as a pilot project by UB’s Clinical and Translational Science Institute. Anyone with long COVID symptoms is also invited to participate in UB’s Long COVID registry.

Because long COVID is believed to stem from chronic inflammation and lithium has known anti-inflammatory actions, Guttuso decided to recommend that a patient try low-dose lithium for persistent long COVID symptoms.

Patients See Improvements in Matter of Days

“I was shocked when the patient saw improvement within a matter of days,” says Guttuso. Since then, he discovered that during the pandemic, researchers in Spain had published findings revealing that patients who were already taking lithium for bipolar disorder who became acutely infected and hospitalized with COVID-19 had better outcomes than those not taking lithium.

Those findings, and the reports from his own patients, were intriguing. And when other physicians heard of Guttuso’s success, they began referring their patients with long COVID to him. Eventually, he was treating 10 additional long COVID patients with low-dose lithium; nine saw improvement from lithium. None experienced side effects.

“I just kept hearing the same story: that within days they were noticing satisfactory benefit,” says Guttuso. Some said their symptoms didn’t come back even after they stopped taking lithium, while others needed to keep taking it.

Jennifer Stewart of East Amherst was one of them. She had had a mild COVID-19 infection in January 2022, marked by few symptoms aside from brain fog and intense fatigue, which didn’t let up even months later.

“I’m a really energetic person, I never nap, and here I was taking naps in the middle of the day,” she recalls. “I even slept through a Bills game I was going to watch on TV. That’s how bad it was.”

Finally, in July, she went to see Guttuso. After a thorough exam, he mentioned the outcomes he was seeing with his long COVID patients on lithium. She was surprised to hear that lithium, which she knew was prescribed for psychiatric conditions, might help.

“Dr. Guttuso explained to me it’s such a low dose, it’s like the equivalent of taking a mineral like calcium or magnesium,” says Stewart. “I asked him how long it typically takes to kick in and he said about four days. I thought, ‘Wow, that’s fast.'"

“Within about two days, I realized ‘Holy cow, I don’t need to take a nap,’” she says. “That strong need for a nap had disappeared.”

A few weeks later, she stopped taking lithium. Her symptoms have not returned. Asked what advice she would have for others with long COVID, Stewart doesn’t hesitate.

“I’d say, oh my gosh, why on earth wouldn’t you enroll in this trial?” she says. “My symptoms are completely gone.”

Positive Results Inspires Authoring of Book

Guttuso’s interest in low-dose lithium therapy goes beyond long COVID. He is currently conducting a clinical trial on using the therapy for people with Parkinson’s disease with pilot project funding from UB’s CTSI.

Based on the promising results he has observed, as well as previously published research studies, Guttuso was inspired to write a book about lithium.

Called “The Promise of Lithium,” the book focuses on research studies that have shown that low-dose lithium might be a promising treatment not just for Parkinson’s disease, but possibly also for Alzheimer’s disease.

The book is scheduled to be published Jan. 31.