LDN and MS 

 LDN and MS

Naltrexone at its full dose was approved by FDA in 1984 for the treatment of opioid addiction.

Bernard Bihari, MD, discovered the effects of Naltrexone, in low doses, in humans in the 1980s.

Low-dose naltrexone (LDN) has been demonstrated to reduce symptom severity in conditions such as fibromyalgia, 

Crohn’s disease and multiple sclerosis and has astounding case reports in a number of cancers.

I use LDN in my clinical practice and it is low cost and often extremely well tolerated

I reviewed the journal article "Low Dose Naltrexone for Treatment of Multiple Sclerosis: A Retrospective Chart Review of Safety and Tolerability" published in 2015. This article analyzed the medical records of 215 MS patients, aged 18 to 65 years, seen in an MS clinic for a 7-year period which is an excellent resource regarding long term safety and efficacy.  

The safety, tolerability, and effectiveness of LDN (at doses of 3.5mg) on fatigue was analyzed. 

Seventy seven percent (n = 166) of patients taking LDN for any period of time did not report any side effects.

Nearly 60% (n = 128) of patients receiving LDN for any period of time reported a reduction in fatigue with LDN therapy

More importantly, 130 patients (60%) stated that LDN stabilized or improved their disease and 75% of the patients reported improved or stabilized quality of life.

Only nine patients reported that LDN reduced the quality of life, and 8% of the patients had the perception that their disease increased while on LDN. Given the waxing and waning state of MS it is unclear if these declinations could truly be attributed to LDN. 

As far as my clinical practice is concerned, the majority of my LDN patients are cancer patients. 

Please visit our sister site for details on LDN and Cancer: http://www.alternativecancertreatment.ca

LDN is a slow acting treatment and it usually takes 3-4 months to work in its full capacity. So we may pair LDN with anti-inflammatory treatments while we're waiting for its action to start working. 

Because of its action against opioids, it can negate medications like morphine, codeine, hydromorphone and oxycontin which usually are not a concern for most MS patients but we do run into issues with our cancer patients dealing with pain.

It's been observed that LDN in it's full dose of 4.5mg may increase spasticity in MS patients therefore either reduced doses are given (3 - 3.5mg) or patients can use full dose LDN (4.5mg) and add anti-spasticity agents like CBD.

Prior to the review I discussed, LDN had been studied in a 17 week study in MS patients and the results suggested an improved quality of life but the trial was clearly too short to see impact on more serious parameters like relapse frequency. 

I propose the addition of LDN to MS patients if they are on an immunomodulatory treatment but still actively relapse, or if they are not on active medication and still relapse and require help with symptoms such as fatigue. Because it does take a few months to fully work, I suggest using anti-inflammatory treatments such as oral curcumin, boswellia or GLA in the first few months of LDN use.