TREATMENT DATABASE
Naltrexone (Depade or ReVia) is an opioid antagonist. Naltrexone binds to opioid receptors in the nervous system, blocking the effects of narcotics.
Naltrexone was first synthesized in 1963 by a small pharmaceutical company in Long Island. Because of its limited application, there was virtually no interest in the drug until 1971 when the Federal government stepped in and endorsed the use of naltrexone for the treatment of heroin addiction. After ten years of trials with narcotics, the drug was determined to be useful for alcoholism. In 1995 naltrexone (ReVia) was formally approved by the FDA for the treatment of alcoholism. Derivatives of naltrexone have been also been used to treat smoking addiction.
Dr. Ian S. Zagon, Professor of Neuroscience and Anatomy at Pennsylvania State University, discovered that, in contrast to normal doses of naltrexone (50 mg), low dose naltrexone (LDN) blocked the growth of certain cancer tumors. Dr. Zagon's studies drew considerable attention from the scientific community, and researchers began to investigate other possible medical applications of LDN.
In 1985 Dr. Bihari, director of the Division of Alcoholism and Drug Dependence, SUNY/Health Science Center at Brooklyn, New York, began to prescribe LDN to AIDS patients, and in the 1990s he successfully used LDN to treat multiple sclerosis. In the decade following Dr. Bihari's success with LDN, researchers found that LDN was also successful in treating Crohn's disease, rheumatoid arthritis, celiac disease, lupus and other autoimmune disorders.
It is believed that low doses of naltrexone act to stimulate endorphins by temporarily blocking opioid receptor sites. (Endorphins are naturally occurring substances present in high concentrations during various illnesses, including viral and autoimmune disease.) When low dose naltrexone blocks opioid receptors for a few hours, the body produces more endorphins to compensate for the temporary lull.
LDN also appears to block pain receptors along the spine.
USES IN ME/CFS: Dr. Susan Levine, a well-known ME/CFS expert affiliated with Mt. Sinai Hospital, New York, has used LDN for cognitive symptoms. She explains the rationale for the use and success of naltrexone as follows: "Naltrexone can act to counteract some of the negative effects of excess stimulation by endorphins, such as diminished immune function, and may help to improve cognition and listlessness" (CFIDS Chronicle, January/February 1989).
In 2009 Drs. Sean Mackey and Jarred Younger of Stanford University completed a successful trial of LDN in ten patients with fibromyalgia. The researchers found that low-dose naltrexone reduced fibromyalgia symptoms in the entire cohort, with a greater than 30% reduction of symptoms over placebo. In addition, laboratory visits showed that mechanical and heat pain thresholds were improved by the drug. Side effects were minor. They concluded that “low-dose naltrexone may be an effective, highly tolerable, and inexpensive treatment for fibromyalgia.”
| Rating | Side Effects | Reason for Treatment | Dosage / Duration | Age | Sex M/F | # of years Ill | Additional Comments | Illness Severity | Date Added |
|---|---|---|---|---|---|---|---|---|---|
| 5 | Increased dreaming | Pain and immune dysfunction | 3 year 3.5 1X day | 57 | Female | 28 | Worked well to lower pain levels and improve sleep. Also appears to modulate immune system. | Moderate/Severe | 12/09/17 |
| 2 | to reduce fibromyalgia pain | 1 year 6 mg 1X day | 53 | Male | 3 | I was initially on 4.5 mg but was increased to 6 mg because there was no effect. | Moderate/Severe | 12/10/17 | |
| 5 | None | Joint and muscle pain, immune dysfunction, allergies | 5 month 4.5mg 2X day | 32 | Male | 18 | Start at 0.5mg or lower and slowly increase. Best times to take medication are 10am and 9pm, when endorphin production spikes. | Moderate | 12/17/17 |
| 2 | No side effects. | I tried LDN to see if it can help with pain, fatigue and neurological/cognitive symptoms. | 18 month 4.5mg 1X day | 40 | Male | 6 | It did not help me with my CFS. | Moderate/Severe | 06/20/18 |
| 5 | none. | As an immune modulator, prescribed by Stanford CFS clinic | 3 year 4.5mg 1X day | 53 | Female | 4 | LDN stopped my daily skull crushing headaches in just two weeks, and they never returned. Also reduces body pain to the point that I am pain free unless I am post exertional. Doesn’t seem to impact insomnia, brain fog or energy in my case. | Moderate/Severe | 06/20/18 |
| 5 | none | Fibromyalgia pain and sleep problems | 3 year 3mg 1X day | 55 | Female | 35 | LDN has been a miracle drug. I'm not perfect or where I thought I would be at this point in my life, but it has helped me better than Cymbalta and other drugs that had terrible side effects. | Mild | 06/25/18 |
| 4 | Weird dreams | Pain, insomnia, sensory issues, immune modulator | 6 month 4.5mg 1X day | 49 | Female | 33 | Really helped my baseline pain level and improved my sleep. My hearing isn’t as sensitive and I recover faster from a crash | Moderate | 07/18/19 |
| 4 | nausea and stomach upset | pain and fatigue | 2 year 3.5 mg 1X day | 48 | Female | 8 | LDN 3.5 mg oral liquid each night helped with pain and wellbeing, but I discontinued due to random daytime nausea. The flavor lingers and is very bitter, but worth it. I also tried topical and sublingual forms. With the cream I had mood problems, and the sublingual did not ease the nausea 'for me. I'm having better success with calcium channel blockers now - verapamil and nemodipine. Would have liked to continue the oral LDN too but the nausea was becoming a problem. | Moderate | 08/10/19 |
| 5 | vivid dreams; some headache pain and increased brainfog at first (for first 10 days or so) | For all ME symptoms: pain, brainfog, PEM, flu-like malaise, difficulty sleeping, fatigue | 1 year 1 mg 1X day | 42 | Female | 15 | LDN has helped me dramatically by allowing me to sleep more deeply, experience less pain (even for unrelated shoulder problems), reduce anxiety, and shorten PEM. | Mild | 09/14/19 |
| 5 | Mental dreams all night long. Dropped to 3 mg no improvement. Took in morning slightly less but still too disturbing to continue. | Spinal pain | 6 month 5mg 1X day | 53 | Female | 20 | Very effective but took 8 weeks to work. Was pain free for the first time in 20 years. Shame it was like an hallucinogen while asleep. | Moderate/Severe | 09/18/19 |
| 5 | 4 year 4.5mg 1X day | 35 | Female | 20 | I take as needed. Helps with pain and malaise associated with PEM | Moderate/Mild | 09/24/19 | ||
| 4 | Increased exhaustion and pain for a few days - but thats a good sign. According to my doctor: If you dont feel worse in the beginning, it means its not gonna make you feel better either. | ME/CFS | 3 month 1.5mg 3X day | 31 | Female | 11 | It is the only medication so far that I have felt any effect from at all, except for meditation, yin yoga and strict pacing which are more lifestyle things. LDN helped a little with all symptoms. | Moderate/Severe | 06/16/20 |
| 5 | some temporary mental lowness and greater fatigue. both only for a brief time | to help cfs. 22 hours a day in bed due to profound fatigue and for fibro pain | 4 month 4.5 1X day | 68 | Female | 15 | This med (found through your site) has been a life changer. I have had to be in bed 21-22 hour daily for over 15 years and in constant pain. Within the first month I was able to be out of bed 3 additional hours and now 6!! The pain the even oxycodone couldn't help, was helped by ldn | Moderate/Severe | 02/17/22 |
| 5 | none | for energy and pain related to multiple autoimmune diseases and cfs | 7 month 4.5 1X day | 69 | Female | 16 | after 16 years in bed 22-23 hours a day, i am now able to be out of bed 8-10 hours daily and throbbing pain gone! | Moderate/Severe | 07/07/22 |
| 4 | Long Covid | 2 year 3.5 mg 1X day | 52 | Female | 3 | Moderate/Severe | 02/02/23 | ||
| 3 | 4mg worsened sleep so settled for 3mg | CFS | 6 month 3mg 1X day | 68 | Male | 38 | Fatigue slightly improved. Had moderate Covid filled by more severe RSV and hardly napped at all despite being largely housebound for most of 2 months. | Moderate/Mild | 02/03/23 |