Patients with fibromyalgia may consider using low-dose naltrexone as a treatment option, says review
At the 32nd annual meeting of the American Academy of Pain Medicine, Dr Sean Mackey, professor of anaesthesiology at Standford University in US, reviewed why he believes patients with fibromyalgia may want to consider low-dose naltrexone (LDN) as a treatment option, even if the appropriate dosage is still undetermined.
LDN is typically prescribed for opioid or alcohol dependency and a typical does of 4.5mg/day can be used to be help patients with HIV/AIDS, autoimmune diseases, and central system disorders. Doctors can also prescribe it to reduce symptom severity in patients with fibromyalgia, Dr Mackey says in his review.
An article on Dr Mackey’s presentation first appeared in Clinical Pain Advisor. During the annual meeting Dr Mackey discussed how using low doses of naltrexone will block microglia receptors without blocking opioid receptions on neurons and that patients undergoing treatment with LDN have reported improvements to their symptoms. Specifically, mechanical and heat pain thresholds are improved by the drug. According to Dr Mackey, the greatest reduction of symptoms in response to LDN occur in individuals with high sedimentation rates.
Dr Mackey says that even though side effects of LDN are rare and often described as minor and transient, they do include insomnia and vivid dreams. “I get patients who report to us that they get technicolour dreams,” he says. “Generally, it’s not nightmares.”
Other benefits of using LDN: it’s cheap, well-tolerated, and it is generic and of little interest to drug companies, he noted.
However, he did acknowledge that the appropriate does of LDN for patients with fibromyalgia is still unknown. “We have no idea whether it’s 4.5, or 6 or 3, and we need to have additional studies,” he says. There is also a lack of long-term safety data.
“I think it’s a great option for you because it’s been so incredibly safe and easy to use,” he says. “In my experience, I either find people get dramatic results or they get nothing.”
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