Low-dose naltrexone

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Low-dose naltrexone (LDN) describes the "off-label" use of the medication naltrexone at low doses for various purposes.

Naltrexone at "high" doses (50 mg or more per day) is typically prescribed for opioid dependence or alcohol dependence, as it is a strong opioid antagonist. Government regulatory agencies such as the U.S. Food and Drug Administration have approved the use of naltrexone for chronic treatment of opioid dependence and for drug detoxification.[1]

Low-dose naltrexone, by contrast, is typically dosed at less than 5 mg per day. At such lower levels, naltrexone, rather than blocking opioid receptors, increases both their number and sensitivity, and also increases the production of the endogenous opioids that activate them, leading to an overall increase in opioid activity.

Numerous anecdotal reports have been published which describe improvements attributed to LDN treatments for a large variety of conditions and diseases. While clinical trial results are available for some claimed benefits, no review of such results has been published that recommends adoption as treatment for any disease category.

Reported uses[edit]

Uses have been reported of LDN for treating a very large number of conditions, but only a few of these uses have been substantiated by clinical trials.[2]

Scientific research[edit]

Verifiable clinical studies on low-dose naltrexone are limited, but presently there is a small and growing number of studies using LDN to treat a limited number of illnesses and conditions, with mostly positive results for the areas studied thus far, and with generally positive affirmations regarding the drug's safety.[3]

Usually, applications of a treatment that are judged to be most promising are studied first, so it should not be assumed that favorable results in studies for one purpose in any way imply that results will be favorable for others not yet under study. Some of these studies are pilot studies, which only suggest future directions in research.[2] A few studies have indicated a more clearly positive effect but none have yet been recommedned for clinical use.[3][4][5][6][7]


  1. ^ Bourdette, Dennis. "Spotlight on low dose naltrexone (LDN)". US Department of Veteran Affairs. Retrieved 5 July 2011. 
  2. ^ a b Novella, Steven. "Low Dose Naltrexone – Bogus or Cutting Edge Science?". Retrieved 5 July 2011. 
  3. ^ a b Younger J, Noor N, McCue R, Mackey S (February 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. "The medication is widely available, inexpensive, safe, and well-tolerated." 
  4. ^ Smith JP, Bingaman SI, Ruggiero F, Mauger DT, Mukherjee A, McGovern CO, Zagon IS (July 2011). "Therapy with the opioid antagonist naltrexone promotes mucosal healing in active Crohn's disease: a randomized placebo-controlled trial.". Dig Dis Sci. 56 (7): 2088–97. doi:10.1007/s10620-011-1653-7. PMID 21380937. 
  5. ^ Younger J, Mackey S (May 2009). "Fibromyalgia symptoms are reduced by low-dose naltrexone: a pilot study.". Pain Med. 10 (4): 663–72. doi:10.1002/art.37734. PMID 19453963. "At low doses (4.5 mg), naltrexone may inhibit the activity of microglia and reverse central and peripheral inflammation." 
  6. ^ Mannelli P, Gottheil E, Van Bockstaele EJ (2006). "Antagonist treatment of opioid withdrawal translational low dose approach". J Addict Dis 25 (2): 1–8. doi:10.1300/J069v25n02_01. PMID 16785213. 
  7. ^ Smith, Katie. "What is the evidence for low dose naltrexone for treatment of multiple sclerosis?". National electronic Library for Medicines, National Health Service. Retrieved 24 October 2011.