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Low Dose Naltrexone (LDN)
What is low dose Naltrexone?
Naltrexone is a class of drug known as an opiate antagonist and is normally used in
treating addiction to opiate drugs such as heroin or morphine. It has been used in the
treatment of auto-immune diseases in the USA since 1985 but is relatively new in
Europe. At a much lower dose (1.75 -.4.5 mg) it has been gaining popularity as a
treatment for symptoms of auto-immune diseases such as MS.
LDN is administered orally in capsule form once a day. How does it work?
Some research suggests that when Naltrexone is given at low doses it triggers a
prolonged up –regulation of endorphins. This increase may have an anti-inflammatory
effect which could be beneficial in the treatment of MS. It has also been suggested
that LDN may be able to reduce injury to the nervous system by decreasing harmful
effects of two types of chemicals called free radicals and excitotoxins . What does the research say?
Following major interest in LDN from people with MS and the media several small pilot
studies have begun to investigate whether there are any benefits on the quality of life
for people with MS.
Dr. Gianvito Martino (San Raffaele Hospital, Milan, Italy) and colleagues
assessed LDN in an open labeled trial of 40 people with primary progressive MS for six months. At the end of the trial a significant reduction of spasticity was measured but an increase in pain was noted. However, no significant data on improvements in fatigue, quality of life or depression were found.
The University of California in San Francisco published a study in 2010
involving 80 people with relapsing remitting and primary progressive MS. People on the trail noted a general improvement in their quality of life but
no changes in fatigue, bowel problem, sexual functioning or vision were noted.
Although the research has not found significant benefits, anecdotal evidence suggests
that many Irish people use LDN. Some people report that it helps with particular
symptoms or just with their overall well being.
What are the side effects?
The most common side effects included short term increase in liver enzymes
urinary tract infections, mild agitation and sleep disturbance. Is it advisable to take LDN and is it available in Ireland?
Naltrexone is currently prescribed in Ireland for a number of drug addictions. It is not
licensed for MS as there is not enough evidenced-based research to prove LDN is an
effective treatment for MS. For this reason it is not prescribed by Neurologists for MS.
However, as LDN is available for prescription in general, some GP’s prescribe it ‘off-
label’. This is a process whereby GP’s can, at their own discretion, prescribe drugs for
treating conditions the drug is not licensed for. Hence, some GP’s prescribe LDN for
their patients with MS. This is the decision of the GP. What does MS Ireland think of LDN?
MS Ireland supports an evidence-based approach to research and as such does not
recommend that people use unproven treatments that have not been through rigorous
trials. However, LDN is well tolerated and currently prescribed in Ireland for other
conditions. As with all treatments and intervention we encourage people to make
informed decisions and choose treatment based on their own research and advice for
healthcare professionals. Further Information
http://www.ldnaware.org/ - A portal to LDN information worldwide
http://www.lowdosenaltrexone.org – A collection of LDN research
MS Ireland provides information to the MS Community on an array of topics
associated with MS. This information is for reference purposes only and medical
advice should always be sought before any treatment or intervention is tried.
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