Low Dose Naltrexone (LDN) is a promising new off-label medication for management of symptoms from autoimmune diseases and central nervous system disorders. Naltrexone was approved by the FDA for the treatment of opioid addiction by acting as a competitive opioid receptor antagonist and blocking the effects of opioids on the brain.
LDN refers to daily doses of Naltrexone that are within 1-5 mg--a tenth of the typical FDA-approved treatment dosage. At lower doses, naltrexone exhibits properties such as analgesia and anti-inflammatory actions.
What diseases are impacted by LDN?
Autoimmune diseases such as Multiple Sclerosis, Rheumatoid Arthritis, Crohn's Disease, Ulcerative Colitis, and Lupus
CNS diseases such as Fibromyalgia, Parkinson’s Disease, Alzheimer’s Disease, Chronic Fatigue Syndrome
Any Inflammatory (painful) conditions
What is typical dosing?
Dosing is typically between 1.5 mg to 5 mg capsules by mouth every evening between 9pm to 3 am. This causes a brief blockade of opioid receptors between 2 am and 4 am, which in turn produces endorphin production and up-regulation of the immune system
In order to determine what dose has a therapeutic effect for a patient, a titration protocol, slowly increasing the dose until positive changes are observed, is standard procedure.
What are common side effects and contraindications?
One of the most exciting aspects of LDN is the low reported incidence of adverse side effects. Studies have shown no withdrawal symptoms when treatment is stopped due to its low dosage. In some cases, patients may report vivid dreams during the first week of treatment. However, this decreases over time or dosage can be decreased if needed.
Because LDN blocks opioid receptors, patients should not be on any opioid, narcotic or controlled pain medications, as there’s a chance it could cause withdrawal symptoms.
Full-dose naltrexone (50mg) carries a cautionary warning against its use in those with liver disease. This warning was placed because of adverse liver effects that were found in experiments involving 300mg daily. The smaller doses do not apparently produce impairment of liver function
Patients who have received organ transplants or are on immunosuppressive medications are cautioned against use of LDN since it may counteract the effect of those medications.