The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain

Abstract

Low-dose naltrexone (LDN) has been demonstrated to reduce symptom severity in conditions such as fibromyalgia, Crohn’s disease, multiple sclerosis, and complex regional pain syndrome. We review the evidence that LDN may operate as a novel anti-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. Despite initial promise of efficacy, the use of LDN for chronic disorders is still highly experimental. Published trials have low sample sizes, and few replications have been performed. We cover the typical usage of LDN in clinical trials, caveats to using the medication, and recommendations for future research and clinical work. LDN may represent one of the first glial cell modulators to be used for the management of chronic pain disorders.

Evaluation of therapeutic effect of low dose naltrexone in experimentally-induced Crohn's disease in rats

“…LDN could reduce symptom severity in fibromyalgia, multiple sclerosis and complex regional pain syndrome [27]. This suggests the possible anti-inflammatory effect of LDN which may improve CD [28].…”

Exploring the Potential Role of Inflammation as an Etiological Process in ASD

“…A dozen patients with ASD ages 7-15 were placed on naltrexone, an opioid antagonist (Scifo et al 1996). Naltrexone has been proposed as an antiinflammatory proxy in the central nervous system (Younger et al 2014). With treatment, patients showed significant improvement in behavioral symptoms, such as increased eye contact and attention, less affective lability, fewer stereotypies, and less social withdrawal (Scifo et al 1996).…”

Endogenous Opioids in the Etiology and Treatment of Multiple Sclerosis

“…However, the financial burden of individual therapy can range upward to $60K annually (37), and side effects still reduce compliance and thereby overall efficacy (38). Randomized clinical trials of enkephalins or LDN are limited (40)(41)(42)(43), possibly because use of LDN has been reported to have a few side effects, and large pharmaceutical companies are not interested in sponsoring studies on a repurposed drug (i.e., LDN) that is already FDA approved at substantially higher dosages. Nonetheless, there remains a need for safe, effective treatments that are alternatives to the β-interferon products.…”

“…Nonetheless, there remains a need for safe, effective treatments that are alternatives to the β-interferon products. With the widespread use of LDN (42)(43)(44) and the information available on many websites devoted to LDN, physicians are cautiously prescribing LDN.…”