Low Dose Naltrexone

The repurposing of pharmaceuticals isn’t an uncommon one. In fact, its preferred due to the leisure of quicker approval through the Food and Drug Administration (FDA). It also means that it can be more freely prescribed without hesitation or questions from providers. Sometimes, however, these pharmaceuticals have potential in treating other diseases and disorders but aren’t “official” when it comes to its’ use for them.

Developed in Endo Laboratories back in the 1960’s, Naltrexone was taken on by the company and soon became FDA approved for the treatment of alcohol and opioid abuse disorders. It acts on the same parts of the brain and chemical messengers that these drugs work on by directly blocking their effects. Through this mechanism it stops the pleasurable feelings associated with the use of alcohol and pain killers. Now, of course, this isn’t a cure all to addiction because that takes a decent amount of “mind over matter” to take the medication every day and ween off substances of abuse; however, it does a pretty good job with helping those stop or decrease their use.

More recently, Naltrexone has made its way into scientist’s eyes, expanding the research towards other disease states and what potential it may hold. Taking doses at 50mg are great if you want to stop the euphoric rushes associated with substance abuse, but what is now being looked at and questioned is what benefit this drug can bring at lower dosages.

Dr. Bihari can be considered the founding father for its off-label use, bringing about the concept of Low Dose Naltrexone or LDN. Dr. Bihari began using LDN, 4.5 mg, along with other therapies to help manage acquired immune deficiency syndrome (AIDS) for its potential as an anti-inflammatory. AIDS was not the only disease state to be evaluated for LDN’s use, in fact, LDN has gained a lot of research backing when it comes to its use for fibromyalgia, Crohn’s disease, multiple sclerosis, and chronic pain disorders.

This begs the question of why would a drug that does the opposite of pain killers produce a pain killing effect or act as an anti-inflammatory?  The same way these pharmaceutical acts against those with opioid or alcohol abuse.

In an individual who does not take such substances and when Naltrexone is taken at much lower doses, Naltrexone modulates and reduces opioid receptor activity. This in-turn causes the body to react, tricking it into believing that there is a decreased production of endorphins. To compensate for this, the body begins to create more endorphins. This effect, along with its short duration of action, creates an increased effect on endorphin activities. In short, increased endorphin creation means decreased pain and inflammation. LDN, because of its dose, also decreases the likelihood of serious adverse effects. These results make it a target in current research for auto-immune disorders and cancer.

Currently, the use of LDN is not FDA approved; however, with current research backing its use as a therapeutic and current clinical trials being undergone, it’s possible we can see this pharmaceutical backed and in common use in the medical industry.

 

References:

Center for Substance Abuse Treatment. Incorporating Alcohol Pharmacotherapies into Medical Practice. Rockville.Chapter 4.Substance Abuse and Mental Health Services Administration

The use of low-dose naltrexone (LDN) as a novel anti-inflammatory treatment for chronic pain:Jarred Younger, Luke Parkitny, and David McLain

Low-Dose Naltrexone (LDN)—Review of Therapeutic Utilization:Karlo Toljan, and Bruce Vrooman