What is Low Dose Naltrexone?

Naltrexone is an opioid antagonist (it binds to opioid receptors in the brain without causing opioid effects). It is used in treatment of addictions to opioids and alcohol, and is FDA approved for such uses. Doses for addiction treatment are typically 50 – 150 mg a day for three days a week. At much lower doses of typically 3 to 4.5 mg daily, Naltrexone has been prescribed for various autoimmune disorders, including MS and ALS (amyotrophic lateral sclerosis). Thus the term Low Dose Naltrexone, or LDN.

A recent study of LDN treatment in Crohn’s disease was published by Smith et al (Am J Gastroenterol 2007;102:1–9) that showed that LDN was effective and safe in the treatment of Crohn’s disease.

The bad news

The bad news is that currently there is no clinical proof that low dose naltrexone aids in the treatment of multiple sclerosis. There have been no clinical trials, data is not being gathered by prescribing physicians, and some prescribing physicians are not even consulting with patients’ neurologists or general practitioners.

The good news

There is currently an online petition to garner support for proper clinical trials of Low Dose Naltrexone at  www.thepetitionsite.com . Everyone agrees that there is solid reason for proper clinical trials. Often when results are only anecdotal, they miss the big picture of what happens when large populations are treated with a medication. In scientific language, this is known as a study having enough “power” to stand up to
statistical analysis.

What’s the buzz?

The buzz suggests that LDN reduces the frequency of MS relapses, and even halts the progression of the disease. That’s big news in a world where patients at best have a few treatment options with possible heavy side effects and little to no hope that those treatments will halt the disease.

At http://www.ldners.org/, there are at least two self-reported surveys of LDN users. The site is also a great resource for finding the latest news in LDN treatment of MS, and the progress of the funding and implementation of clinical trials. Soon there should be some reliable clinical data, thanks largely to the activity of MS patients themselves.

The one article by Y.P. Agrawal in a peer reviewed journal (Medical Hypothesis 2005, 64, 721-724) presents a hypothesis of how naltrexone may possibly help in MS treatment. Essentially his hypothesis is that altrexone could help in fighting the death of oligodendrocytes, the cells that manufacture myelin. A clinical trial could help further or disprove his hypothesis.

Proponents of LDN treatment indicate that LDN does not work when taken in conjunction with beta interferon, a standard MS treatment. There does not seem to be interference with glatiramer acetate. Neither piece of information has any medical or scientific proof yet.

Where does that leave us?

At this point, since LDN is not a proven treatment, it would be poor medical advice to discontinue a treatment that is working for an MS patient. Patients should be encouraged to join the clinical trials if they are able. Patients and advocates should continue to push for proper testing and aid in the fund raising for proper research of LDN treatment of MS.

If you are an MS patient, you should always listen to your neurologist and general practitioner. Discuss the latest LDN news with them and ask what they recommend. Soon there should be more information available for your medical practitioners to make educated ecisions about your treatment and LDN therapy.

Samantha Rangen writes about home health issues. She has a BA in chemistry and has worked as a research technician for over 20 years in biochemistry, genetics, biochemistry, and cancer research.

Samantha markets discount home medical equipment,  including Firmgrip Grab Bars at http://www.getinspec.com