Treatment of psoriasis Vulgaris using low-dose naltrexone
Psoriasis is a common, immune-mediated skin disease affecting 3.1% of the US population. Psoriasis negatively impacts health-related quality of life and is associated with multiple physical and mental health comorbidities in addition to symptoms such as pain, itching, and bleeding.
A variety of treatments have been developed over the last several decades for the treatment of psoriasis. Exogenous therapies include topical corticosteroids, vitamin D derivatives, retinoids, and ultraviolet (UV) therapy. Systemic therapies include disease-modifying antirheumatic drugs, such as methotrexate or cyclosporine, and biologic medications such as adalimumab, ustekinumab, and secukinumab. Unfortunately, although psoriasis treatments are becoming increasingly safe and efficacious, they may not always be successful, affordable, or tolerable.
Low-dose naltrexone significantly improved our patient's affected BSA from 10% to 1% over a span of 6 months, with continued remission to date. Clinically, this result may have implications for patients who cannot tolerate other therapies or for whom other treatments have not been successful. Treatment of psoriasis with low-dose naltrexone may be appealing because of its low side-effect profile, low cost, and its efficacy in patients with chronic inflammatory conditions.
Low dose Naltrexone and Chronic pain
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 of naltrexone's better-known activity on opioid receptors. As a daily oral therapy, LDN is inexpensive and well-tolerated. 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
Chronic inflammatory diseases are complex to treat and have an impact on many patients. Due to the difficulty of treating these diseases and the great impact on the quality of life, patients often seek off-label, complementary, or alternative medicines to gain relief from symptoms. Low-dose naltrexone has been used off-label for the treatment of pain and inflammation in multiple sclerosis, Crohn's disease, fibromyalgia, and other diseases. Naltrexone is a mu-opioid receptor antagonist indicated by the U.S. Food and Drug Administration for opioid and alcohol dependence. The evidence is that LDN has shown more than promise and should be further investigated in clinical practice.