Low-dose naltrexone in multiple sclerosis (MS)

Low-dose naltrexone (LDN) in multiple sclerosis (MS)

• mechanism of action of LDN is based on the duration of opioid receptor blockade (1)
  
  • naltrexone is an opioid antagonist originally used to treat opioid and alcohol addiction (2)
    
  • the low doses of naltrexone (2.5–4 mg/day) block opioid receptors for a short period of time resulting in a biofeedback stimulus to increase circulating levels of β-endorphin and [Met5]-enkephalin (1)
    
  • LDN is inexpensive, safe, and used effectively for treatment of fibromyalgia, Crohn’s disease, and MS (1,2)
    
  • study evidence suggests that LDN may be beneficial in lessening anxiety in MS (1)
    
  • currently, evidence supports the safety and tolerability of low-dose naltrexone in multiple sclerosis, fibromyalgia, and Crohn's disease (3)

Reference:

1. McLaughlin PJ et al. Low-dose naltrexone reduced anxiety in persons with multiple sclerosis during the COVID-19 pandemic. Int Immunopharmacol. 2022 Dec;113(Pt B):109438.
2. Raknes G, Småbrekke L. Low dose naltrexone in multiple sclerosis: Effects on medication use. A quasi-experimental study. PLoS One. 2017 Nov 3;12(11):e0187423.
3. Patten DK, Schultz BG, Berlau DJ. The Safety and Efficacy of Low-Dose Naltrexone in the Management of Chronic Pain and Inflammation in Multiple Sclerosis, Fibromyalgia, Crohn's Disease, and Other Chronic Pain Disorders. Pharmacotherapy. 2018 Mar;38(3):382-389.