Abstract |
Chronic inflammatory diseases are complex to treat and have an impact on a large number of patients. Due to the difficulty of treating these diseases and the great impact on quality of life, patients often seek off-label, complimentary, or alternative medicines to gain relief from symptoms. Low-dose naltrexone has been used off-label for treatment of pain and inflammation in multiple sclerosis, Crohn's disease, fibromyalgia, and other diseases. Naltrexone is a mu-opioid receptor antagonist indicated by the U.S. Food and Drug Administration for opioid and alcohol dependence. It is hypothesized that lower than standard doses of naltrexone inhibit cellular proliferation of T and B cells and block Toll-like receptor 4, resulting in an analgesic and antiinflammatory effect. It is the purpose of this review to examine the evidence of the safety, tolerability, and efficacy of low-dose naltrexone for use in chronic pain and inflammatory conditions. Currently, evidence supports the safety and tolerability of low-dose naltrexone in multiple sclerosis, fibromyalgia, and Crohn's disease. Fewer studies support the efficacy of low-dose naltrexone, with most of these focusing on subjective measures such as quality of life or self-reported pain. These studies do demonstrate that low-dose naltrexone has subjective benefits over placebo, but evidence for more objective measures is limited. However, further randomized controlled trials are needed to determine the efficacy of low-dose naltrexone due to insufficient evidence supporting its use in these disease states. This review provides practitioners with the extent of low-dose naltrexone evidence so that they can be cognizant of situations where it may not be the most appropriate therapy.
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Authors | Denise K Patten, Bob G Schultz, Daniel J Berlau |
Journal | Pharmacotherapy
(Pharmacotherapy)
Vol. 38
Issue 3
Pg. 382-389
(03 2018)
ISSN: 1875-9114 [Electronic] United States |
PMID | 29377216
(Publication Type: Journal Article, Review)
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Copyright | © 2018 Pharmacotherapy Publications, Inc. |
Chemical References |
- Anti-Inflammatory Agents
- Narcotic Antagonists
- Naltrexone
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Topics |
- Animals
- Anti-Inflammatory Agents
(administration & dosage, adverse effects, pharmacology)
- Chronic Pain
(drug therapy, etiology, physiopathology)
- Crohn Disease
(drug therapy, physiopathology)
- Dose-Response Relationship, Drug
- Fibromyalgia
(drug therapy, physiopathology)
- Humans
- Inflammation
(drug therapy, etiology, physiopathology)
- Multiple Sclerosis
(drug therapy, physiopathology)
- Naltrexone
(administration & dosage, adverse effects, pharmacology)
- Narcotic Antagonists
(administration & dosage, adverse effects, pharmacology)
- Quality of Life
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