Naltrexone is a partial pain site blocker/stimulant used primarily to help alcoholics get off drinking. It was found in a controlled pilot study some years ago to help with pain in Fibromyalgia. It was well tolerated. Present controlled unfortunately shows mediocre results like most agents used in FM.
Arthritis Rheum. 2013 Feb;65(2):529-38.
Low-dose naltrexone for the treatment of fibromyalgia: Findings of a small, randomized, double-blind, placebo-controlled, counterbalanced, crossover trial assessing daily pain levels.
Younger J, Noor N, McCue R, Mackey S. abstract here
Naltrexone has many different effects:
- It prevents the high you get from drinking and hence used in alcohol addiction:
CNS Neurol Disord Drug Targets. 2010 Mar;9(1):13-22.
Naltrexone for the treatment of alcoholism: clinical findings, mechanisms of action, and pharmacogenetics.
Ray LA, Chin PF, Miotto K. abstract here - It has anti-viral effects and helpful in AIDs cases:
Low dose naltrexone in the treatment of AIDS: long term follow-up results.
Bihari B, Drury F, Ragone V, Ottomanelli G, Cannon G, Klein E;
International Conference on AIDS. Int Conf AIDS. 1989 Jun 4-9; 5: 552 - It has anti-cancer properties with accumulating evidence it can slow tumor growth (reviewed in):
Med Hypotheses. 2009 Mar;72(3):333-7.
Low-dose naltrexone for disease prevention and quality of life.
Brown N, Panksepp J. - It has anti-inflammatory properties and can help induce remission in crohn’s disease:
Am J Gastroenterol. 2007 Apr;102(4):820-8.
Low-dose naltrexone therapy improves active Crohn’s disease.
Smith JP, Stock H, Bingaman S, Mauger D, Rogosnitzky M, Zagon IS.
A study in 2009 suggested Naltrexone was useful in Fibromyalgia pain at low dose:
Fibromyalgia Symptoms Are Reduced by Low-Dose Naltrexone: A Pilot Study
Jarred Younger, PhD, and Sean Mackey, MD, PhD
Pain Medicine 10(4),663 – 672, 2009 free article here
Now, naltrexone can be expensive with a 50 mg tab costing $6.00 or so. However, they used 4.5 mg/day (1/10 that dose) which would come to 60 cents a day or so – you would only need 3 full tablets a month.
Results:
Now, I am always a bit suspicious of pilot studies – they all seem to get better results. However, this study has now been replicated as per initial reference at top.
- Used 4.5 mg/day over 12 weeks
- For those not tolerating 4.5 mg cut does to 3 mg/day
Results scaled to 7/10 to start:
This results in a 0.6/10 drop from placebo – not exactly the 1/10 demanded by the FDA for validity. -was about 10% better than placebo.
Side effects:
Comment – was well tolerated and may work for a subgroup so might be worth a try, but like most agents used in FM – is inadequate by self.
Any comments?