Reported Benefits of Low-Dose Naltrexone Appear to Be Independent of the Endogenous Opioid System Involving Proopiomelanocortin Neurons and β-Endorphin

Metz, Marissa J.; Daimon, Caitlin M.; Hentges, Shane T.

doi:10.1523/eneuro.0087-21.2021

Cited by 5 publications

(2 citation statements)

References 56 publications

(74 reference statements)

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“… 1 A recent study has cast doubt on this proposed mechanism of action, finding no evidence of LDN’s effect on opioid receptor sensitivity, production of β-endorphin precursor or β-endorphin release in the plasma. 9 This leaves TLR4 inhibition as a significant mechanism of action for analgesia with LDN.…”

Section: Discussionmentioning

confidence: 99%

Low-Dose Naltrexone (LDN) for Chronic Pain at a Single Institution: A Case Series

McKenzie-Brown¹,

Boorman²,

Ibanez³

et al. 2023

JPR

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Purpose Low-dose naltrexone (LDN) has increased in popularity as a non-opioid medication that may decrease chronic pain symptoms. LDN is most commonly used to treat fibromyalgia, complex regional pain syndrome (CRPS), and painful diabetic neuropathy. Other studies suggest that LDN provides general symptom reduction in inflammatory conditions such as Crohn’s disease and multiple sclerosis. We reviewed our experience with patients to whom we have prescribed LDN to see what types of painful conditions were most responsive to LDN in our patient population. Patients and Methods Charts from patients who came to the Pain Center between 2014 and 2021 were reviewed. Results Of the n = 137 patients who were prescribed LDN, 44% had no evidence of ever filling the prescription, and 4.4% of the responses were not charted. Of the remaining who took LDN (n = 70), 64% had some relief and were designated as ‘Responders’. The most common pain diagnosis was neuropathic pain which, when added to the diagnosis of complex regional pain syndrome, accounted for 51% of responders to LDN. Patients who experienced greater than 50% pain relief from LDN were more likely to have the diagnosis of neuropathic pain or complex regional pain syndrome (p = 0.038, Fisher’s Exact Test). There was a significant difference in the diagnosis of patients who responded to LDN. Patients with spondylosis were much less likely to respond to LDN when compared with other diagnoses (p = 0.00435, Chi-Square Test). Conclusion Patients with all types of neuropathic pain, including CRPS, were significantly more likely to have pain relief from LDN than patients with spondylosis (p=0.018). The diagnosis of spondylosis was more often associated with a lack of response to LDN than any other diagnosis. Patients may need to have a trial of several weeks before analgesic effects are seen with LDN.

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Section: Discussionmentioning

confidence: 99%

Low-Dose Naltrexone (LDN) for Chronic Pain at a Single Institution: A Case Series

McKenzie-Brown¹,

Boorman²,

Ibanez³

et al. 2023

JPR

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“…No serious side effects have been reported and there does not appear to be a risk of withdrawal, dependence, or tolerance [ 17 ]. Overall, LDN appears to be safe [ 33 , 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Low-Dose Naltrexone and Predictors of Treatment Success or Discontinuation in Fibromyalgia and Other Chronic Pain Conditions: A Fourteen-Year, Enterprise-Wide Retrospective Analysis

Driver

D’Souza

2023

Biomedicines

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Current pharmacologic treatments may provide limited analgesia in fibromyalgia and other chronic pain disorders. Low-dose naltrexone (LDN) has emerged as a potential analgesic option that has been minimally explored. This study aims to describe current real-world prescribing practices of LDN, to investigate if patients have a perceived benefit of LDN in treating pain symptoms and to identify predictors associated with a perceived benefit or discontinuation of LDN. We evaluated all outpatient prescriptions for LDN prescribed for any pain indication in the Mayo Clinic Enterprise from 1 January 2009 to 10 September 2022. A total of 115 patients were included in the final analysis. The patients were 86% female, had a mean age of 48 ± 16 years, and 61% of prescriptions were for fibromyalgia-related pain. The final daily dose of oral LDN ranged from 0.8 to 9.0 mg, while the most common dose was 4.5 mg once daily. Of patients who reported follow-up data, 65% reported benefit in their pain symptoms while taking LDN. Adverse effects were reported in 11 (11%) patients and 36% discontinued taking LDN by the most recent follow-up. Concomitant analgesic medications were used by 60% of patients and were not associated with perceived benefit nor discontinuation of LDN, including concomitant opioids. LDN is a relatively safe pharmacologic option that may benefit patients with chronic pain conditions and warrants further investigation in a prospective, controlled, and well-powered randomized clinical trial.

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Low-dose naltrexone for treatment of burning mouth syndrome

Sangalli¹,

Miller²

2023

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Reported Benefits of Low-Dose Naltrexone Appear to Be Independent of the Endogenous Opioid System Involving Proopiomelanocortin Neurons and β-Endorphin

Abstract: The authors thank Ms. Connie King for excellent technical assistance and colony maintenance and Ms. Chrystina Crown for performing injections.

Cited by 5 publications

References 56 publications

Low-Dose Naltrexone (LDN) for Chronic Pain at a Single Institution: A Case Series

Low-Dose Naltrexone (LDN) for Chronic Pain at a Single Institution: A Case Series

Efficacy of Low-Dose Naltrexone and Predictors of Treatment Success or Discontinuation in Fibromyalgia and Other Chronic Pain Conditions: A Fourteen-Year, Enterprise-Wide Retrospective Analysis

Low-dose naltrexone for treatment of burning mouth syndrome

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