Low dose naltrexone

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Low Dose Naltrexone (LDN) refers to very small doses of the generic drug, Naltrexone, normally used to treat drug dependence. When taken at much smaller doses it may allay neurological symptoms. Although prescriptions of LDN are becoming more popular, any use other than for treating drug dependence is considered off-label. Some patients report that LDN helps reduce their symptoms of ME/CFS, multiple sclerosis (MS), fibromyalgia (FMS) and autoimmune disease. Although its mechanism of action is unclear, some have speculated that it may act as an anti-inflammatory.[1]

VLDN and ULDN[edit | edit source]

Very Low Dose Naltrexone (VLDN) and Ultra-Low Dose Naltrexone (ULDN) have recently been used in limited trials, both VLDN and ULDN involve doses of naltrexone significantly below 1mg.[2]

Evidence[edit | edit source]

Data shows a graph with 10% worse after treatment, 57% improved or much improved, and 12% very much improved. Darker colors are the most improved sections.
Low Dose Naltrexone results for 29 patients with Fibromyalgia. Fibromyalgia participants’ (N = 29) self-reported improvement in symptoms after daily LDN treatment. Source: Clin Rheumatol 2014; 33(4):452-459. Fig 1. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962576/figure/Fig1/ PMC3962576

Jarred Younger published a small study that concluded "... low-dose naltrexone may be an effective, highly tolerable, and inexpensive treatment for fibromyalgia".[3][4]

A second study concluded that "specific and clinically beneficial impact on fibromyalgia pain".[5][6]

A 2014 review by Stanford researchers suggests that "LDN may operate as a novel qjanti-inflammatory agent in the central nervous system, via action on microglial cells. These effects may be unique to low dosages of naltrexone and appear to be entirely independent from naltrexone's better-known activity on opioid receptors. As a daily oral therapy, LDN is inexpensive and well-tolerated."[1]

Relationship between ESR, a marker inflammation, and LDN treatment in 29 patients with Fibromyalgia.

The FDA approved naltrexone HCL in 1984 to treat opioid addiction. Low-dose naltrexone is typically given at about 1/10th the typical dose of naltrexone. By blocking opioid receptors, naltrexone can increase pain, but at very low doses naltrexone has both pain-reducing (analgesic) and anti-inflammatory properties.

In 2012 Solve ME/CFS Initiative contracted Biovista to use drug models to identify existing drugs that may be worth investigating for treatment. The results suggested Naltrexone was worth considering.[7]

There is an online patient community where patients with various diseases discuss their experiences taking Low-dose Naltrexone.

Jarred Younger's research suggests that people with an ESR (Erythrocyte Sedimentation Rate) over 40 millimeters an hour, tend to be strong responders to LDN, and that there may be other predictive factors for success.[8]

Notable studies[edit | edit source]

Articles[edit | edit source]

Talks and videos[edit | edit source]

Clinical use[edit | edit source]

Naltrexone is a prescription drug in many countries.[9] Compounding chemists or compounding pharmacists can mix naltrexone with a powder filler or dilute in into a liquid to create the lower dose.

Fast-release fillers only[edit | edit source]

"Pharmacies should be instructed NOT to provide LDN in an "SR" or slow-release or timed-release form. Unless the low dose of naltrexone is in an unaltered form, which permits it to reach a prompt "spike" in the blood stream, its therapeutic effects may be inhibited."[10] Calcium Carbonate filler should NOT be used. "Avicel, lactose (if lactose intolerance is not a problem), or sucrose fillers as useful fast-release fillers."[11]

Do not take with opioids[edit | edit source]

In general, Low Dose Naltrexone (LDN) should not be taken concurrently with opioid-containing drugs (opioid receptors in brain are blocked by LDN), immunosuppressive drugs, or immunomodulator drugs.[12] LDN blocks the effect of opioid drugs.[13] Some opioid drugs are codeine, tramadol, oxycodone, vicodin, hydrocodone, fentanyl and morphine.

Australia[edit | edit source]

Compounding Pharmacies are able to fill these prescriptions, and post if needed.

UK[edit | edit source]

Dickson Chemist in Glasgow dispenses Low Dose Naltrexone in various forms, with a valid prescription. They will usually put patients in contact with private doctors who will consider writing a prescription.

US[edit | edit source]

Neighborhood Compounding Pharmacies are able to fill these prescriptions and mail if needed. Your prescribing doctor can help you locate a compounding pharmacy in your area/state or you can look online.[14]

Clinical trials[edit | edit source]

A large number of clinical trials have been completed for LDN recently, although none have looked at the effect of LDN on symptoms of myalgic encephalomyelitis/chronic fatigue syndrome. Research has been carried out on patients with MS, Chronic Regional Pain Syndrome, FMS, Irritable Bowel Syndrome (IBS), Ulcerative Colitis, Skin Disorders and a range of other illnesses.[15]

When, How To Take[edit | edit source]

Dr Whitaker states that the ideal dose is different for each person. Some doctors recommend starting at 1mg.[16] Common dosages are 1.5mg, 3mg, 4.5mg.[17][18][13] When beginning use of LDN, the drug must be stepped up over 6-8+ weeks as it may keep you awake; discuss how best to do this with your doctor and pharmacist.[18][19][13]

LDN is usually taken at bedtime. Some people take LDN in the morning to minimize sleep disturbance, insomnia, and vivid dreams.[13]

Talks and webinars[edit | edit source]

LDNscience® Presents - How LDN (Low Dose Naltrexone) Works By LDNscience
Functional Medicine & LDN (low-dose naltrexone) with Drs Carnahan and Vasquez By Alex Vasquez
Is Low Dose Naltrexone (LDN) for you? By Integrative Health Solutions

Notable studies[edit | edit source]

  • 2013, Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels[5] (Full text)
  • 2014, The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain[1] (Full text)

See also[edit | edit source]

Learn more[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 1.2 Younger, Jarred; Parkitny, Luke; McLain, David (Feb 15, 2014), "The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain", Clin Rheumatol, 2014 Apr (33(4)): 451-9, doi:10.1007/s10067-014-2517-2, PMID 24526250 
  2. Toljan, Karlo; Vrooman, Bruce (Sep 21, 2018). "Low-Dose Naltrexone (LDN)—Review of Therapeutic Utilization". Medical Sciences. 6 (4). doi:10.3390/medsci6040082. ISSN 2076-3271. PMID 30248938. 
  3. Younger, Jarred; Mackey, Sean (Apr 22, 2009), "Fibromyalgia Symptoms Are Reduced by Low-Dose Naltrexone: A Pilot Study", Pain Med, 10 (4): 663–672, doi:10.1111/j.1526-4637.2009.00613.x, PMID 2891387 
  4. 4.0 4.1 Mackey, Sean (May 1, 2009), "An Update on Fibromyalgia - from Sean Mackey, Chief, Division of Pain Management, Stanford University", Research Channel (USA) 
  5. 5.0 5.1 Younger, Jarred; Noor, Noorulain; McCue, Rebecca; Mackey, Sean (Jan 28, 2013), "Low-dose naltrexone for the treatment of fibromyalgia: findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels", Arthritis Rheum, 65 (2): 529-38, doi:10.1002/art.37734, PMID 23359310 
  6. "Low Dose Naltrexone for Fibromyalgia". Systems Neuroscience and Pain Lab. Retrieved Oct 4, 2018. 
  7. Solve ME/CFS Initiative. "Biovista work released". 
  8. Younger, Jarred; Cohen, Joseph M (Mar 29, 2016), "Dr. Jarred Younger: Cutting Edge Research on CFS, Neuroinflammation, Pain, and Fatigue", Self Hacked Blog (video interview with transcript) 
  9. "Naltrexone". Wikipedia. Dec 24, 2018. 
  10. "The Low Dose Naltrexone Homepage". www.lowdosenaltrexone.org. Retrieved Jan 21, 2019. 
  11. "The Low Dose Naltrexone Homepage". www.lowdosenaltrexone.org. Retrieved Jan 21, 2019. 
  12. Drugs To Avoid When Taking Low Dose Naltrexone
  13. 13.0 13.1 13.2 13.3 13.4 "Low Dose Naltrexone and chronic pain - Pradeep Chopra, MD | LDN Research Trust - Low Dose Naltrexone". www.ldnresearchtrust.org. Retrieved Jan 31, 2019. 
  14. Finding a Compounding Pharmacy - WIKI How
  15. "Clinical Trials | LDN Research Trust - Low Dose Naltrexone". www.ldnresearchtrust.org. Retrieved Jan 21, 2019. 
  16. LDN Now. "LDN Dosing". Retrieved Feb 1, 2018. 
  17. www.well-donedesign.com (May 2, 2017). "Amy Myers MD". Amy Myers MD. Retrieved Feb 2, 2019. 
  18. 18.0 18.1 Dr Whitaker. "What is Low-Dose Naltrexone?". www.drwhitaker.com. Retrieved Jan 21, 2019. 
  19. "Low Dose Naltrexone (LDN) – Collier Drug Store". collierdrug.com. What dose of Low Dose Naltrexone (LDN) is best?. Retrieved Feb 2, 2019. 
  20. "LDNscience® Presents - How LDN (Low Dose Naltrexone) Works". YouTube. LDNscience. Dec 20, 2012. 
  21. Carnahan, Jill; Vasquez, Alex (Nov 30, 2015). "Functional Medicine & LDN (low-dose naltrexone) with Drs Carnahan and Vasquez". YouTube. Alex Vasquez. 
  22. "1:05 / 7:05 Is Low Dose Naltrexone (LDN) for you?". YouTube. Oct 11, 2015. 
  23. Brewer, Kori L.; Mainhart, Allison; Meggs, William J. (2018), "Double-blinded placebo-controlled cross-over pilot trial of naltrexone to treat Gulf War Illness", Fatigue: Biomedicine, Health & Behavior, doi:10.1080/21641846.2018.1477034 
  24. "LDN Research Trust - Low Dose Naltrexone". www.ldnresearchtrust.org. Retrieved Feb 2, 2019. 
  25. "Low Dose Naltrexone | The Ultimate Resource | LDNscience". www.ldnscience.org. Retrieved Feb 2, 2019. 
  26. Ringerike, Tove; Pike, Eva; Nevjar, Janicke; Klemp, Marianne (2015). The Use of Naltrexone in Low Doses Beyond the Approved Indication. NIPH. 
  27. Arlotta, CJ (Feb 21, 2016). "Low-Dose Naltrexone as Adjunctive Pharmacotherapy for Fibromyalgia". Rheumatology Advisor. Retrieved Feb 2, 2019. 
  28. Holtof, Kent (Feb 15, 2016). "4". In Elsegood, Lisa. The LDN Book: How a Little-Known Generic Drug — Low Dose Naltrexone — Could Revolutionize Treatment for Autoimmune Diseases, Cancer, Autism, Depression, and More. Chelsea Green Publishing. ISBN 9781603586658. 

The information provided at this site is not intended to diagnose or treat any illness.
From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history.