The Safety and Efficacy of Low‐Dose Naltrexone in the Management of Chronic Pain and Inflammation in Multiple Sclerosis, Fibromyalgia, Crohn's Disease, and Other Chronic Pain Disorders

Denise K. Patten; Bob G. Schultz; Daniel J. Berlau

doi:10.1002/phar.2086

journal article Feb 23, 2018

The Safety and Efficacy of Low‐Dose Naltrexone in the Management of Chronic Pain and Inflammation in Multiple Sclerosis, Fibromyalgia, Crohn's Disease, and Other Chronic Pain Disorders

Denise K. Patten Bob G. Schultz Daniel J. Berlau

Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy Vol. 38 No. 3 pp. 382-389 · Wiley

View at Publisher Save 10.1002/phar.2086

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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Details

Published: Feb 23, 2018
Vol/Issue: 38(3)
Pages: 382-389
License: View

Authors

D

Denise K. Patten

Regis University School of Pharmacy Denver Colorado

B

Bob G. Schultz

Regis University School of Pharmacy Denver Colorado

D

Daniel J. Berlau

Regis University School of Pharmacy Denver Colorado

Cite This Article

Denise K. Patten, Bob G. Schultz, Daniel J. Berlau (2018). The Safety and Efficacy of Low‐Dose Naltrexone in the Management of Chronic Pain and Inflammation in Multiple Sclerosis, Fibromyalgia, Crohn's Disease, and Other Chronic Pain Disorders. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 38(3), 382-389. https://doi.org/10.1002/phar.2086

The Safety and Efficacy of Low‐Dose Naltrexone in the Management of Chronic Pain and Inflammation in Multiple Sclerosis, Fibromyalgia, Crohn's Disease, and Other Chronic Pain Disorders

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