Oral naltrexone was first produced in 1963. Low Dose Naltrexone (LDN) has been around for about 20 years; however, it has recently gained some notoriety for helping with Fibromyalgia. Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. While there is currently no cure for fibromyalgia, we can help control the symptoms and pain. The FDA has approved three drugs to treat fibromyalgia: the antidepressants duloxetine (Cymbalta) and milnacipran (Savella), plus the anti-seizure medicine pregabalin (Lyrica). Exercise, relaxation and stress-reduction measures also may help.
Commercially, naltrexone is available by prescription in 50mg tablets and approved for opioid addiction. At this dose, naltrexone reverses the effects of opioids and can cause withdrawal symptoms. However, something interesting happens at lower doses in the 1.5-5mg per day range. Most common dose studied is 4.5mg given once a day usually at night. At these doses, it exerts an analgesic or pain-relieving effect. It is thought that these doses turn down specialized immune cells called microglia that live in the central nervous system including the brain. These microglia cells can be activated in chronic inflammation and can damage nerves and nerve tissue over time. Several studies have shown significant pain relief with low dose naltrexone in Fibromyalgia treatment compared to placebo. There are promising results with LDN as a sole therapy.
If you tried everything else, schedule a consultation with Southwest Pain Management and see how we can help with your pain. Now prescribing naltrexone for this purpose is considered off-label and won’t be covered by insurance, but it is relatively inexpensive.
Here is one study